Treasury Department, United States Public Health Service Miscellaneous Publication No. 18. Guidelines issued by the Surgeon General for the screening of immigrants at Ellis Island and coastal ports. Softcover 16mo, 118pp. Very Good condition: Spine rolled with very slight loss at the ends; last lined page and first page of the index are stuck together with a small tear where they're attached. Light sunning and signature to cover. Illustrated in b&w with photographs including "An average group of suspected mental defectives" and individual photographs of persons labeled as low- and high-grade imbeciles and morons, constitutional inferiors, etc. Intended for reference by examiners, it includes a fold-out chart with conversational phrases in various languages, as well as several ruled pages for notes at the rear. The previous owner has contributed about 6 pages of notes, guidelines for quarantine, and longer notes about bacterial testing and pasteurization. The manual calls for suspected individuals to participate in non-verbal performance tests including the Healy-Fernald construction test and the Seguin Form Board. No attributions are made within the text, but the manual reflects the legacy of Howard Andrew Knox, recognized as the architect of the performance testing regimes at Ellis Island from 1912-1916. The photographs are possibly the work of Augustus F. Sherman, a senior clerk at Ellis Island who photographed the people detained for special investigation there from 1905-1920.

An interesting document from a period of evolving opinions regarding the etiology of mental illness. The elusive nature of psychiatric diagnosis is reflected in the rules for steamship companies, who were responsible for screening their passengers: "If an idiot, imbecile, feeble-minded person, epileptic, chronic alcoholic, or person suffering with constitutional psychopathic inferiority is found who could have been detected by a competent examination at the port of embarkation," the steamship company would be fined:
"In the case of the insanities due allowance should be made for the sudden development of manic or depressive symptoms in person who might have appeared entirely normal when the vessel sailed. The time of development as shown by the history should determine the course of action in cases of this kind. Likewise it is to be remembered that many delusional cases show nothing in their faces and very little in their conduct or conversation which would make them easily detected. With a few exceptions, fines for bringing in insane persons will be justified only in those cases showing deterioration, mannerisms, and peculiarities of facies or abnormal conduct, and whose type of psychosis is such that it could not have arisen after embarkation."