1. Scope.--For purposes of this chapter the term "alien seamen" refers only to seamen not seeking permanent residence in the United States. For those who are seeking permanent residence, the certification procedure shall be the same as for alien passengers.

2. Certifiable conditions.-- All class A conditions in alien seamen shall be certified. The procedure for detaining seamen with suspected class A conditions shall be the same as for passengers.

3. Statement regarding curability.--In each certificate medical officers shall include a statement as to whether the seaman can likely be cured within 30 days.

4. Class B conditions.--Neither medical holds nor medical certificates are issued for class B conditions in alien seamen. When the inspector observes or suspects a class B condition in a seaman, he shall place on the crew list a notation as to the condition and whether hospital treatment is necessary.

5. Class C conditions.--Class C conditions in alien seamen are not certified, and no report or record of these conditions is required. 6. Inspection procedures.--The general procedure for medical inspection of seamen is similar to that described in chapter 3 of this part.

a. In addition, the Medical Officer in Charge shall be responsible for deciding whether seamen shall be given a specific, thorough inspection for venereal disease. Where experience has indicated a continuing need for these inspections, it is expected that they will be performed. This may relate to all ships undergoing inspection at a station, to a selected few, or to ships from certain ports.

b. With respect to a ship on which venereal disease inspection is not deemed necessary routinely, the Medical Officer in Charge shall instruct quarantine inspectors concerning questions to include

in the inspection of alien seamen as to the presence of any signs or symptoms that might indicate venereal disease. It is essential that such questions be worded and presented in a courteous manner. A seaman reporting these symptoms shall be given necessary specific physical inspection for venereal disease.

c. The Medical Officer in Charge should remind ships' masters that, pursuant to §71.31 of Foreign Quarantine Regulations, they are responsible for reporting promptly by radio to the Medical Officer in Charge at the port of entry any known or suspected cases of gonorrhea and certain other diseases on board a ship bound for a port under the control of the United States.

d. Medical Officers in Charge are to include in narrative reports to Division headquarters information on experience related to subparagraphs 6a-c preceding.

7. Expediting examinations.--Obviously, when alien seamen held for medical examination are detained until their ship has departed and are then declared free of disease, considerable hardship results--to the seamen, left without their ship; to the foreign consuls who must care for them; and to the ship operators, who pay for their maintenance during detention. Officers making medical examinations of alien seamen shall therefore ascertain how long their ship will be in port, and exert every reasonable effort to complete all examinations before it departs.

Workaways and Stowaways

8. The certification procedure for alien workaways shall be the same as described above for seamen, unless the workaways are seeking permanent residence in the United States, in which case they shall be considered passengers. Unless otherwise indicated by immigration officials, alien stowaways shall be considered passengers.

Section B--Types of Certificates in Various Diagnostic
Categories.

6-9

Section C--Intelligence, Its Nature and Measurement.

6-16

Section D--References

6-26

Section A.--Basic Certifiable Conditions

1. General.

a. The purpose of this section is to take up separately various excludable (class A) mental conditions with the object of clarifying the meanings of the terms, and to furnish criteria that will help the examiner determine the proper classification of mental conditions according to the terms contained in the law1 and regu

1 Section 212 (a), Immigration and Nationality Act of 1952, as amended, quoted in Introduction.

2 Section 34.7, Regulations for the Medical Examination of Aliens, quoted in chapter 1.

3

b. A description of the various types of mental illness will be found in the Diagnostic and Statistical Manual, Mental Disorders, ' which correlates with the chapter, Diseases of the Psychobiologic Unit, in the Standard Nomenclature of Diseases and Operations. To facilitate the medical examiner's work, the relationships between the legal categories and the mental illnesses are listed in section B of this chapter.

2. Basic provision on certification.--Under the law and regulations, mental illnesses are not certifiable as class B or C. Mental conditions not severe enough to be class A should not be certified at all. However, this should not be interpreted to mean that physical conditions with a mental component should not be certified class B; many class B conditions have a mental component.

3. Feeble-mindedness.

a. "Feeble-mindedness" is the legal term equivalent to the medical term "mental deficiency." This condition may be defined to exist in a person who exhibits such a degree of mental retardation existing from birth or acquired at an early age that his common knowledge, retentiveness of memory, reasoning power, learning capacities, and general mental reactions are severally and distinctly below those normally exhibited by the average of the same age and race living under similar environment.

b. The condition may be divided into several grades, depending on the severity.

c. In certification of such persons the legal term "feeblemindedness" should be used as well as the official medical term-for example, class A, Feeble-mindedness, Mental deficiency, idiopathic, moderate.

d. There are certain diseases in which mental deficiency is merely a symptom of the basic pathological process; such cases should be classified in the appropriate legal and medical categories. An example of such is Class A, Mental defect, Chronic brain syndrome associated with mongolism, mental deficiency, moderate.

e. With children under 12 years of age manifesting mental retardation, the examiner should be careful to distinguish between actual mental deficiency and delay of normal mental development due to causes such as poor environment, deafness, blindness, emotional illness, specific learning disturbances, or other physical defects. If there is good reason to believe that the retardation may be due to such causes, the person should not be certified for mental

3 Committee on Nomenclature and Statistics, American Psychiatric Association, Washington 6, D.C., 1952.

4 Fourth edition. Copyright by American Medical Association; published by The Blakiston Co., Philadelphia, New York, and Toronto, 1952.