Visiting Ellis Island’s Hospital Complex

On June 7, our Friends of the Rare Book Room and ARCHIVE Global: Architecture for Health enjoyed a private visit to the hospital zone on Ellis Island. The private support group Save Ellis Island offers hardhat tours of the hospital complex, which is adjacent to the main reception center operated by the National Park Service. More than 30 people took the ferry from Battery Park across New York Harbor to Ellis Island to learn more about the site and its importance to the history of public health in New York City. Some stayed on for lunch afterward at historic Fraunces Tavern.

Our Save Ellis Island tour guide gives safety instructions before the group enters the hospital zone.

Our Save Ellis Island tour guide gives safety instructions before the group enters the hospital zone.

On the south side of the island, and out of use since 1954, the hospital complex housed would-be immigrants who were not permitted to immediately enter the country. All steerage passengers were inspected—usually for only a few seconds, given their great numbers—and some 1 to 2% were detained for health reasons. Completed in 1909, the 750-bed hospital included wards for infectious diseases, kitchens, massive laundry facilities, an autopsy room, and recreation spaces for patients and staff alike.

The autopsy room.

The autopsy room.

Even in its semi-derelict condition, the complex is one of the few remaining “pavilion” style hospitals in the country. Pavilion hospitals were first built in France in the 18th century, and were enthusiastically endorsed by reformers such as Florence Nightingale in the 19th century. The design emphasized the need for ventilation, with wards built to promote sanitary conditions, provide light, and maximize the circulation of air. Pavilion hospital design fell out of use in the 20th century.

Caged verandas allowed patients access to fresh air while controlling their movement around the complex.

Caged verandas allowed patients access to fresh air while controlling their movement around the complex.

The Ellis Island site, already abandoned and crumbling, was further damaged during hurricane Sandy, and Save Ellis Island is working to stabilize the buildings, while preserving the sometimes eerie atmosphere of the site, now partially overgrown with vegetation. For more information about the complex, and the Save Ellis Island project to bring it back into public view, see:


Wall with a tide mark showing the level of water during Hurricane Sandy.

We are increasingly offering our Friends group exclusive events such as this visit. If you are interested in becoming a Friend, find out more here. Friends who missed out on this sold-out event should e-mail to express their interest in another tour at a later date.

The Doorstep of America

By Johanna Goldberg, Information Services Librarian

Ellis Island opened on January 1, 1892, a gateway to the United States for 700 immigrants on three steamships that first day.1 By its close in 1924, more than 12 million people had passed through to America.2

Landing at Ellis Island. From Quarantine Sketches. Click to enlarge.

Landing at Ellis Island. From “Quarantine Sketches.” Click to enlarge.

About 10 years after Ellis Island’s opening, The Maltine Company, a patent medicine manufacturer, released “Quarantine Sketches: Glimpses of America’s Threshold,” a pamphlet oddly juxtaposing photographs of Ellis Island with advertising for its products. The full pamphlet can be viewed online:

It begins with the text:

Hundreds of thousands—men, women, and children—pass over, or are detained at, the Doorstep of America every year. In this pamphlet are illustrated the various precautions which the Government takes to insure desirable material for future citizenship.

One such precaution described in the pamphlet was the two-day quarantine of all passengers arriving from Cuba between May 15 and October 1, an effort to prevent the spread of yellow fever in the United States. But for all other steerage passengers, the procedure was different.

The hospital at Ellis Island. From "Quarantine Sketches." Click to enlarge.

The hospital at Ellis Island. From “Quarantine Sketches.” Click to enlarge.

During the “Line Inspection,” United States Public Health Service physicians reviewed each entrant as he or she walked past. According to a 1917 article, the process typically took two to three hours.3 Those who passed the initial review continued on to the Immigration Service, “who take every means to see that he is not an anarchist, bigamist, pauper, criminal, or otherwise unfit.”3 Those who did not pass the inspection, about 15–20% of immigrants in 1917, were routed to the Public Health Service.3

From Mullan EH. "Mental examination of immigrants: Administration and Line Inspection at Ellis Island." Public Health Reports. 1917; 32(20): 734.

From Mullan EH. “Mental examination of immigrants: Administration and Line Inspection at Ellis Island.” Public Health Reports. 1917; 32(20): 734. Click to enlarge.

There, physicians assessed immigrants for “speech, pupil symptoms, goiters, palsies, atrophies, scars, skin lesions, gaits, and other physical signs,” along with “signs and symptoms of mental disease.”3 Some got sent to Ellis Island’s hospital (one of the best in the country), some to a detention room for further assessment.4

Filing past the doctors. From "Quarantine Sketches." Click to enlarge.

Filing past the doctors. From “Quarantine Sketches.” Click to enlarge.

Would-be immigrants could be deported for medical reasons—in 1898, 18% of deportations were medical; this rose to 69% in 1916.4 Even so, most immigrants entered the United States: in 1914, the peak year for deportations, only 2.5% of passengers were forced to return to their country of origin.4

Detention pen for immigrants awaiting deportation. From "Quarantine Sketches." Click to enlarge.

Detention pen for immigrants awaiting deportation. From “Quarantine Sketches.” Click to enlarge.

Today, you can visit Ellis Island without going through a Line Inspection. You can even book a Hard Hat Tour to see the previously closed-to-the-public hospital complex. Can’t make the trip? Take a look at Hyperallergic’s recent Ellis Island hospital portraits.


1. Landed on Ellis Island – new immigration buildings opened yesterday. A rosy-cheeked Irish girl the first registered — Room enough for all arrivals — Only railroad people find fault. New York Times. Published January 2, 1892. Accessed November 19, 2014.

2. National Parks of New York Harbor Conservancy. Ellis Island. Available at: Accessed November 24, 2014.

3. Mullan EH. Mental examination of immigrants: Administration and Line Inspection at Ellis Island. Public Health Reports. 1917;32(20):733–746. doi:10.2307/4574515. Available at Accessed November 21, 2014.

4. Yew E. Medical inspection of immigrants at Ellis Island, 1891-1924. Bull N Y Acad Med. 1980;56(5):488–510. Available at: Accessed November 21, 2014.

Chinese Opium Dens and the “Satellite Fiends of the Joints”

By Anne Garner, Curator, Rare Books and Manuscripts

Dr. John Thackery (Clive Owen) visits an opium den. Cinemax, 2014

Dr. John Thackery (Clive Owen) visits an opium den in The Knick. Cinemax, 2014

Dr. John Thackery passes through a number of dimly-lit opium dens in the heart of New York’s Chinatown during the course of The Knick. What were these dens really like—and who frequented them?

In the mid-19th century, the Chinatowns of America were largely isolated communities, populated by immigrants brought by labor brokers to work on the Central Pacific Railroad or other jobs. Many of these workers planned to return home after several years; there was little desire to assimilate. Scholar Gunther Barth has suggested that with the safety of a familiar culture came familiar vices.1

A large number of Chinese immigrants came from Canton, a region with a rich history of opium-smoking. As the Chinese presence spread east, opium dens cropped up in the Chinatowns of every major American city.

American Opium-Smokers Interior of a New York Opium Den/ Drawn by J.W. Alexander. [New York] : Harper and Brothers, Oct. 8, 1881. Courtesy of Images from the History of Medicine (NLM).

American Opium-Smokers Interior of a New York Opium Den/ Drawn by J.W. Alexander. [New York] : Harper and Brothers, Oct. 8, 1881. Courtesy of Images from the History of Medicine (NLM).

H. H. Kane wrote in 1882 that the first white American to smoke opium did so in San Francisco’s Chinatown in 1868.2 Until then, opium smoking had been strictly confined to the areas of Chinese settlement. By 1875, the practice was widespread enough that San Francisco passed a law prohibiting opium dens. This ordinance was America’s first anti-narcotics law.

The San Francisco ordinance coincided with an increasing anxiety among whites in large urban areas that the low-paid Chinese would threaten wages and standards of living. At the time, the country was mired in a deep recession. The federal Page Act, passed the same year as the San Francisco law, similarly targeted Chinese immigrants, aiming to “end the danger of cheap Chinese labor and immoral Chinese women.”3

Beginning with Virginia City the following year, local ordinances banning opium-smoking quickly passed across the U.S. These laws were largely ineffective. Law enforcement, focused on prosecuting Chinese dens known to attract white clientele, only drove whites deeper into Chinatown, and to smoke at higher rates.4

As opium use among whites increased, community leaders began to signal a concern about the morals of white women. Philadelphia missionary Frederic Poole cautioned that white women exposed by the Chinese to opium-smoking were at risk of “a life of degradation.”5 In 1883, Reverend John Liggins wrote of the dangers of the many New York City dens found in Mott and Pearl Streets (still the heart of Chinatown today), and quoted Kane that the habit, learned from the Chinese, contributed to “the downfall of innocent girls and the debasement of married women.”6 The same year, Allen S. Williams wrote in an early book on the opium-smoking habit about New York’s Chinatown dens:

Chinamen flit noiselessly by in ghostly, fluttering garments, and startle the Caucasian intruder by the very suddenness of their unsympathetic companionship…. the Chinese opium joint…is run for the sole purpose of pandering to a vicious taste whose indulgence is injurious to society.7

On the left coast, The Wasp, a popular San Francisco paper, sent two “reporters” to that city’s Chinatown in 1881, and published their findings:

In reeking holes ‘two stories’ underground, where the light of heaven and healthy atmosphere never penetrate, we found human beings living—if it may be called living, which is at best but an existence—as contentedly as rats in a sewer, whose habitation theirs so much resembles. The opium smokers’ resorts were among the first visited…a person once there, he may well desire to make himself oblivious of such surroundings and raise himself to a temporary heaven of his own, but how white men, and even white women, can bring themselves to descend to such filthy holes, where the reeking slime courses down the walls and the air is heavy with foetid odors, is a mystery to any well-regulated mind.8

The Wasp article offers an especially disturbing example of how many Americans implicated the Chinese as a group with standards and moral habits far inferior to those of whites. As early as the 1880s, opium dens run by the French and even white American-born women could be found in New York and Philadelphia, but the imagery continued to portray them as exclusively Chinese-owned and -operated. “It’s a poor town now-a-days that has not a Chinese laundry, and nearly every one of these has its lay-out [pipe plus accessories],” wrote one white traveler in 1883.9

Fig. 2—Smoker's Outfit. In Opium-Smoking in America and China.

Fig. 2—Smoker’s Outfit. In Opium-Smoking in America and China.

The framing of opium smoking as a Chinese problem continued as the century drew to a close. Temperance advocates and moral reformers identified opium smoking with indolence and passivity, qualities out of sync with a culture that emphasized hard work and a fast-paced industrial society. These kinds of characterizations became an important way to generate public revulsion for an immigrant group perceived to threaten both economic and social stability, and to gain traction for legislative action.10

The antagonisms toward the Chinese and attendant immigration restrictions resulted in a Chinese immigrant population that decreased by 1920 to less than half of what it was in 1890.11 The last opium den in New York was raided in 1957. Decades before, many of Chinatown’s dens, largely abandoned because of the rise of opium derivatives morphine and heroin, had all but disappeared.


1. Courtwright, David. Dark Paradise. Opiate Addiction in America before 1940. Cambridge: Harvard, 1982. 68.

2. Kane, H.H. Opium-Smoking in America and China. New York: G.P. Putnam’s, 1882. 1.

3. Peffer, George Anthony. Forbidden Familes: Emigration Experiences of Chinese Women Under the Page Law, 1875-1882. Journal of American Ethnic History, Vol. 6 No. 1, Fall, 1986.

4. Courtwright, 79.

5. Courtwright, 78.

6. Liggins, John. The Spread of Opium-Smoking in America. New York: Funk & Wagnalls, 1883. 20.

7. Williams, Allen Samuel. The Demon of the Orient and his Satellite Fiends of the Joints. New York: [the author], [1883]. 12.

8. The Chinese in California, 1850-1925.

9. Courtwright, 73.

10. Musto, David F. The American Disease. Origins of Narcotic Control. New Haven: Yale, 1973. 294-300.

11. Courtwright, 85.