In this extensively researched monograph, Amy L. Fairchild analyzes data from immigrant medical inspections conducted by the United States Public Health Service, in conjunction with the Immigration and Naturalization Service, between 1891 and the late 1920s. Smartly combining quantitative and qualitative methods, Fairchild provides a detailed portrait of inspections at all ports of entry into the United States, from Ellis Island and Angel Island on the two coasts, to Galveston, Texas, and Port Huron, Michigan, on the southern and northern borders. The result is an informative text that sheds light on the myriad ways in which class, race, and disease helped to determine regional variations in medical inspections, while, at the same time, being continuously redefined in response to shifting congeries of ideas about human and social difference.

     One of the most innovative aspects of Fairchild's work is her reinterpretation of the medical inspection not as an act principally aimed at exclusion and deportation, but as a ritualized passage of integration and inclusion into American society. Fairchild argues that the inspection functioned primarily as a disciplinary process, in which the future industrial working class was exposed to the rhythms and logic of assembly line production and scientific management: "first and foremost, then, the immigrant medical inspection became an important part of a subtle yet pervasive nationwide endeavor to discipline the labor force" (7). As they filed through the "line" at Ellis Island and were scrutinized by the gaze of health examiners, many newcomersÑespecially those from Eastern and Southern EuropeÑtook the initial steps toward assuming their places at the lower rungs of the new industrial economy.