This examines how and why South Asians were prevented from immigrating to British Columbia, Washington, Oregon, and California between 1900 and 1920. In the first decades of the twentieth century, all Asian immigrants to Canada and the United States faced opposition to their arrival and settlement. While racism and fear of labour competition were at the heart of this resistance, panic soon swept up and down the West Coast of North America over unsubstantiated public health concerns. Public leaders--including physicians, union leaders, civil servants, journalists, and politicians--latched on to these health concerns as the basis for the exclusion of the South Asians, who were said to suffer from medical conditions and diseases attributed to their race. Even though many officials knew the public health argument had no grounds, they promoted it to support their racist views and concerns about labour. Legislation to restrict the immigration of South Asians took effect in Canada in 1908 and in the United States in 1917. This book is an important study of how white North Americans saw first-wave South Asian immigrants as separate from, and inferior to, other groups in the evolving racial hierarchy on the West Coast of North America.