eye work in varous parts of the United States that trachoma be placed in the list of excluded affections. This was done in 1897, with the result that a great many suffering with the disease were taken from among the steerage immigrants and deported. It was then discovered that ordinary steerage aliens suffering from trachoma were being transferred to the cabin, while en route, or after being refused passage in the steerage at the port of departure, would be sold a cabin passage, with the assurance that cabin passengers were not inspected at the port of arrival. To check this practise and to make the inspection of aliens complete, an inspection of cabin passengers was instituted in the fall of 1898. The cabin inspection has been very successful in preventing evasion of the law, but many steamship companies were still apparently careless of the diseased condition of immigrants to whom they sold tickets. By the last immigration law (1903) a penalty of $100 is imposed upon the steamship company for each diseased alien brought to our ports, provided the disease evidently existed at the time of the immigrant's taking passage and could have been detected by ordinary medical skill. This penalty has had a salutary effect in causing the steamship companies to institute a more rigid medical inspection at the European ports of departure. Formerly the presence of a diseased alien in the steerage was a matter of more or less indifference to the steamship companies, as they could carry him back to Europe, if deported, and still make a profit on the price of his original passage.
Two points about trachoma have occasioned considerable discussion. These are its contagiousness and its likelihood of causing permanent injury to sight. The contagiousness of trachoma is recognized and conceded by those who have seen a sufficient number of cases of the disease to form an accurate impression. Striking examples of its contagious character can be seen any day on Ellis Island. The Annual Conference of State and Provincial Boards of Health, held at New Haven, October, 1902, placed trachoma in the category of diseases communicable and dangerous to the public health.
Permanent injury to sight is most likely to occur in cases where early treatment is neglected. Among immigrants with trachoma, ignorance of personal hygiene and inability to secure proper treatment make the spread of this disease alarming and the consequences to sight disastrous.
The area in Europe where trachoma is most prevalent extends from the Gulf of Finland on the north to the Black Sea and the Mediterranean on the south, and from Moscow and the Volga on the east to the Carpathian Mountains on the west. In addition, it is prevalent in Greece and southern Italy, probably because of commercial intercourse with Syria, Egypt and the Barbary States. The first-mentioned area is occupied by Finns, Lithuanians, Russians, Poles, Russian--
