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As explained in the last chapter, this book has four themes. First and most prominent is the "double helix of health and fear of the foreign born." Kraut is particularly fond of this awkward metaphor, and he sums up the central message of his book by repeating (and compounding) it in a final sentence: "The double helix of health and fear that accompanies immigration continues to mutate, producing malignancies on the culture, neither fatal nor readily eradicated."
Most of the pages of Silent Travelers explore episodes in this story—thoroughly justified in the case of the original inhabitants of America, who died by the millions from exposure to new diseases brought by European and African immigrants; and regularly exaggerated subsequently, when old settlers attributed malign diseases and dangerously heritable defects to later immigrants, notably the Irish, Italians, Jews, Chinese, and, most recently, Haitians. The author's sympathies are entirely on the side
McNeill WH. Silent Travelers: Germs, Genes, and the 'Immigrant Menace,'. JAMA. 1994;272(5):406-407. doi:10.1001/jama.1994.03520050088039