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s.s. "ADJUTANT" - FEVER OF UNKNOWN ORIGIN
On the 20th November, the Marine Superintendent of the General Steam Navigation Co., reported
that he had received a signal from the above-named vessel that the Boatswain was very ill and
had been unable to stand on his feet since leaving Leghorn and that the vessel was due to
arrive at Gravesend at 09.00 hours on the 21st November.
The message was immediately forwarded to the Medical Officer on Duty on the "Hygeia" .
The vessel duly arrived at Gravesend at 09.00 hours on the 21st November and was boarded by
Dr. J.A. Jones who, after examining the patient, telephoned the following history
"The patient started his illness on 10th November in Leghorn complaining of fever.
Temp. 103°. He was seen by a doctor who diagnosed a malarial recurrence, the man having
had malaria in 1942. He was treated with quinine.
11.11.56. Temp. 102.6°. Complained of aches in arms and legs.
12.11.56. Temp. 102°. Seen by a doctor in Naples who gave the same diagnosis and
treatment was continued with paludrine and quinine. Since then he has had a continuous
though swinging temperature with a daily peak of 102° and going down to as low as 99° in
the same day. His aches became pains in the limbs, both arms and legs and moved from
one to the other.
All this time he had a very strong slow pulse little above normal (72-74). Has had no
cough, no rash, no diarrhoea, no vomiting and no localised symptoms until yesterday,
20.11.56, when the Chief Officer thought there was a puffiness behind the right knee and
today he has got a considerable swelling of the right calf which is red and very tender but
not very tense and there is no surface localisation. He has also got some swelling behind
the right knee and of the right ankle but there is no redness. There is nothing in his chest
and his heart seems all right and in my opinion there is no paralysis but some weakness in
the right leg. This is difficult to judge owing to the pain on movement.
The original diagnosis seems reasonable on the evidence at the time. Although the antimalarial
course was not completed it is possible that the patient had enough of these drugs
to affect the pyrexia if this diagnosis had been correct. Until I examined the legs, rheumatic
fever did seem a possibility but this and poliomyelitis seemed to be excluded. I think he
has a septicaemia with a localised lesion in the right calf. The slow pulse, is of course,
suspicious of enteric but I do not think this to be the organism in this case."
The patient was allowed to remain on board since it was understood that the Shipping Company
had already made arrangements for an ambulance to meet the ship on arrival in London Dock.
On telephoning the Marine Superintendent of the Shipping Company it was found that no such
arrangement had been made.
Having ascertained that the vessel would be berthing at No. 19 Shed, London Dock at approximately
13.00 hours, arrangements were made with the Dreadnought Seamens Hospital, Greenwich,
to admit the case, which they very kindly consented to do by sending an ambulance to the dock
to arrive at 14.00 hours.
A copy of Dr. Jones' case notes reported above was sent to your Health Inspector at London
Dock with instructions that the notes were to be handed to the Ambulance Driver for transmission
to the Resident Medical Officer at the Seamen's Hospital, for his information.
Your Health Inspector on the dock, Mr. E.H. Johnson, reported that the patient was removed
by ambulance at 14.30 hours. He also reported that between 14.00 and 14.30 hours the patient
had passed a stool in a bed-pan and it was noted that the stool contained a quantity of blood.
He thereupon telephoned the hospital asking that this incident should be brought to the notice
of the Resident Medical Officer.
On 3rd December, 1956, the hospital reported that the final diagnosis proved to be Malignant
Tertian Malaria.
s.s. "BORGSDEN" (NORWEGIAN) - INJURY TO MEMBER OF CREW
Your Medical Officer reports this incident as a further example of the smooth working arrangements
between the Authority and the Emergency Bed Service.
At 16.15 hours on the 27th November, your Boarding Medical Officer, Dr. J.A. Jones, reported
that at 20.00 hours the previous evening, the 3rd Officer of the above-named vessel, while going
up to the Bridge for his watch slipped, hitting his head and left side. The ship was pitching
badly at the time. The Officer was not knocked unconscious and actually carried out his four
hour watch.
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