Even the most superficial examination may well cause us grave concern. We find that in one year (1908) at Ellis Island alone, 3,741 paupers, 2,900 persons with contagious disease, 184 insane, 121 feeble-minded, 136 criminals, 124 prostitutes and 65 idiots were denied entrance, and yet, according to the estimate of Doctor F. K. Sprague, of the United States Public Health Service, probably only about 5 per cent of the mentally deficient and 25 per cent. of those who will become insane have been detected. When confronted by such data we can begin to realize what we are facing. Others estimate that from 6 to 7 per cent. of the immigrants who are now arriving are feeble-minded. We learn further that recently while the foreign-born population of New York state was about 30 per cent., the foreign-born population of the insane hospitals of the state was over 43 per cent., and at one time approximately 65 per cent. for New York City. In one year (1908) 84 per cent. of the patients in Bellevue Hospital, New York City, were of foreign parentage. Paresis, which probably always has syphilis as its antecedent, is proportionately twice as prevalent among foreigners as among natives in New York City. But from the standpoint of inheritance, however great the danger may be from classifiable defectives, it is probably far greater from that much larger class of aliens we are now receiving with open arms who are below the mental and physical average of their own countries. Moreover, with our present system of inspection there is no way of detecting the grades of feeble-mindedness above idiocy and imbecility in the great numbers of foreign children under five when brought in, who are beginning to show up in alarming numbers in the schools of some of our larger cities. About thirty per cent. of the annual increment of our population is due to immigration and not to births; and once in our country the alien far outbreeds the native stock, with relatively little increase in death-rate, thus making a double contribution to the increase of population. When we take all these facts into consideration it certainly is high time that we arouse from our self-complacent attitude and consider the whole question of immigration most earnestly. In spite of the fact that many individuals are caught in the net of inspection at our portals, it is clear that still more rigid rejection[16] is imperative. The inspectors at our various ports are doing the best they can under the circumstances, but there are at present too few of them and they are too restricted in their powers to meet the situation satisfactorily. Moreover, when at one of our ports in one year (1910), of 1,483 immigrants certified by the inspecting surgeons as unfit to land because of serious mental or physical defects, 1,370 were landed anyway, it is evident that there is a strong and reprehensible pull somewhere to evade the obvious intent of the law.