SILENT TRAVELERS

Fascinating, well-researched account of how immigration and public health have influenced each other in the American experience. Kraut (History/American University; Huddled Masses, etc.— not reviewed) asserts that ``the double helix of health and fear that accompanies immigration continues to mutate, producing malignancies on the culture.'' Current fears about AIDS and Haitian refugees, for example, echo the concern of Californians in the early 1900's over bubonic plague and Chinese immigrants and that of easterners in the 1830's over cholera and Irish immigrants. Kraut examines the nativist prejudices that can stigmatize an entire group as a health menace and shows how scientific medicine has been used by some Americans to advocate exclusion and by others to promote assimilation. Further, he looks at how national, state, and local governments have codified and regulated public-health issues and what the immigrant response has been. Kraut vividly and sympathetically describes the inspection of newcomers at Ellis Island, using both oral history sources and excerpts from the US Public Health Service's Book of Instructions for the Medical Inspection of Immigrants. He demonstrates how health care became a cultural battleground involving the home, the hospital, and the corner drugstore as folk healers and midwives met opposition from physicians and home health nurses, and as quackery thrived. Reliance on Old World remedies—such as tying a potato to the wrist to reduce a fever or using charms to ward off the evil eye—conflicted with the health advice published by such groups as the DAR, eager to turn immigrants into robust Americans. B&w illustrations include photographs that depict actual conditions, as well as drawings that reveal prevalent attitudes and misperceptions.) Absorbing and sobering illumination of a dark corner of the American psyche.