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"HYGEIA", at Gravesend as a quarantine station where accommodation is provided for the Boarding
Medical Officer. There is a Boarding Medical Officer on duty around the clock, 24 hours
every day. Any ship with an infectious disease or suspected infectious disease on board is
subject to inspection. "Infectious disease' in this context has a wide connotation. In addition
to the six "quarantinable" diseases (plague, cholera, yellow fever, smallpox, louse-borne typhus
and relapsing fevers) it includes any other infectious or contagious disease other than venereal
disease or tuberculosis.
The Boarding Medical Officer has at his disposal a modern quarantine launch — the
"HUMPHREY MORRIS" with a gross tonnage of 125 and a speed of almost 12 knots—one of the
largest and best equipped medical launches. It has a consultation room, a small hospital with
accommodation for two stretcher cases and three sitting patients. It is centrally heated and has
very spacious and comfortable quarters for its crew of five. Radio-telephone equipment enables
the Medical Officer to talk directly to vessels or the quarantine station on the "HYGEIA" as well
as to the Thames Navigation Service at Gravesend. The "VICTOR ALLCARD" is also used as
a second-in-line launch. This vessel has a gross tonnage of 38 and a speed of 10 knots. There is
an ambulance room equipped to take two stretcher cases and six sitting patients.
The Master of a ship due to arrive in the Port Health district having on board a case of
infectious disease or a suspected case or having had a case within the previous four weeks or
circumstances requiring the attention of a Medical Officer, flies the international three flag
signal LIM indicating "I require a Medical Officer". Between sunset and sunrise the same signal
LIM is flashed in Morse code by lamp or indicated by a red light over a white light shown at
the peak.
The Masters of any ships on arrival from a foreign port, other than most European ports
which are excepted, are required to complete a Maritime Declaration of Health and have it countersigned
by the Ship's Surgeon if there is one. The ship, if the paragraph above does not apply, will
fly the international flag signal 'Q' and between sunset and sunrise flash the same signal 'Q' in
Morse code by lamp or show a red light over a white light at the peak.
The Declaration is a statutory form and contains six "Health Questions" which briefly are
framed to elucidate whether there has been a case or suspected case of infectious, and in
particular, quarantinable disease on board or if there are other circumstances giving rise to a like
suspicion. If the six questions are answered in the negative and the ship has not called at an
infected port or any port in Asia, Africa or Central or South America, then "free pratique" can be
given by the Customs Officer if he boards first and the ship is allowed to proceed to berth. The
passengers and crews on ships arriving within 14 days from an infected port of the Continents
listed above are required to have a valid vaccination certificate against smallpox. The Port
Health Authority usually has notice in advance, if the ship is equipped with a radio transmitter,
of any circumstances requiring the attention of a Medical Officer, for the Master is required to
send a message to "Portelth London" not more than 12 hours nor less than 4 hours before
arrival, containing the relevant information of the Maritime Declaration of Health. This message
is received by the North Foreland Radio Station and telephoned direct to the Boarding Medical
Officer on the "HYGEIA".
On arrival of a ship from a foreign port or an area infected with a quarantinable disease,
no person other than a Pilot, a Customs Officer or an Immigration Officer is allowed to board or
leave the ship until it is free from control of the regulations without the permission of the Medical
Officer. The Master is required to take all steps necessary to comply with this provision.
On boarding, the Medical Officer interviews the Master or Ship's Surgeon and examines any
patient with infectious disease or suspected infectious disease. When the diagnosis is confirmed
or if there is doubt, if need be, the patient is transferred by the "HUMPHREY MORRIS" or
"VICTOR ALLCARD" to Denton Isolation Hospital near Gravesend. Cases of infectious disease
can be isolated and treated here, even minor infections such as measles or whooping cough in
children whose parents have no private home to go to and are proceeding to an hotel. But more
important, doubtful cases can be fully examined in congenial surroundings rather than in the
disadvantageous circumstances often found aboard, especially in crews' quarters.
The Boarding Medical Officer is in clinical charge of any cases of infectious disease retained
in Denton Hospital. The more serious major infections are transferred to appropriate
Infectious Disease Hospitals.
Chickenpox is a notifiable infectious disease in the Port Health District. This and any
other skin rash which simulates smallpox is a major concern of the Boarding Medical Officer. If
there is any doubt regarding the diagnosis clinically he errs on the side of safety and treats the
case as one of suspected smallpox. He accordingly decides whether or not the ship should be
required to go to a mooring station. Complete kits of protective clothing comprising cap, gown or
combination overalls, mask, gloves, overshoes are available on the hulk "HYGEIA" and the
launches "HUMPHREY MORRIS" and "VICTOR ALLCARD'. This is worn when attending a
case or suspected case of smallpox. The Medical Officer of Health, if time permits, visits the
patient and in any case notifies the Ministry of Health. If necessary, a Consultant from a panel
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