Considering all the corruption and confusion that existed on the borders, one might ask why medical inspections of immigrants were necessary at all. There were a few factors that contributed to the decision to examine immigrants at the border. One was to develop America’s working class. Immigrants coming in to America were assumed to be entering the workforce, and examiners wanted to ensure that immigrants coming to America did not have any defects that could potentially cost employers money or keep immigrants from working. Many medical examiners were employees at other institutions—Dr. Frederick Wright was a doctor at an Arizona Smelting Company. This potentially created a conflict of interest for Dr. Wright in which he was more interested in an immigrant’s ability to work at a factory than in their actual health or well-being.
Another factor was changes in the scientific field occurring at the time. New medical theories—particularly Eugenics and Germ Theory—were emerging. Eugenics was a pseudoscientific study of racial genetic differences, and it was used by many scientists at the time as an excuse for their more racist beliefs. It was believed that some races were genetically predisposed to disease, and so immigrants in those racial categories would be singled out during the examination process. Germ Theory was another new discipline in the field of medicine. Researchers were only beginning at the time to uncover how germs were transmitted from one person to another, and so in the minds of nativists everywhere a connection developed between immigrants and disease.
There were two kinds of diseases that examiners were looking for—described by the Immigration Act of 1891 as “Loathsome Contagious” and “Dangerous Contagious” diseases. “Loathsome Contagious” was shorthand at the time for “sexually transmitted.” Examiners believed that if an immigrant had a sexually transmitted disease that they were morally unfit for US citizenship. “Dangerous Contagious” diseases were diseases like Typhus which would pose a threat to “public health” (the Public Health Service was originally conceived to examine immigrants at ports of entry across the US). Despite this, because of the backlog of immigrants the inspections themselves were woefully inadequate. The average inspection only lasted a couple of seconds, during which immigrants were primarily examined for lumps, nodules or asymmetries.
 File 54,671-005, accession E9, Subject Correspondence, 1906-1932, Records of the Immigration and Naturalization Service, RG 85 (National Archives, Washington, DC)