‘To call on Mr Shield again?’
‘No; but to examine apartments in the house opposite to the one in which he is staying. Whilst I was engaged in that way, I looked across the road and saw, in the room opposite, Beecham, Shield, and Miss Heathcote together.’
‘Well, you guessed that Beecham was a friend of my uncle’s, and as she started this morning to visit Mr Shield, there was nothing extraordinary in seeing them together.’
‘Oh, you were aware of that! No; nothing extraordinary at all in seeing them together; but it confirms my surmise that Miss Heathcote can give us—you, I mean—information which may be useful.’
They were interrupted by a gentle knock at the door, and when Philip opened it, Madge entered.
SANITARY INSPECTION OF THE PORT OF LONDON.
We move easily in the little beaten track of our own concerns, and do not think of the care that is taken of us. What snug citizen of us all ever imagines danger to himself and the community from such a source as the port of London? Nevertheless, if the matter be given a moment’s consideration, it must be allowed that danger threatens there of a very real kind. Our great port swarms all the year round with vessels of every nationality. They come with human and other freight from this country and that, from ports maybe in which disease of one sort or another was rife when they sailed; they carry the germs of many a deadly malady in cabin or in hold; disease often ripens on the voyage amongst passengers or crew, and is carried right up to the port itself; and the vessels, on their arrival here, lie a day, a week, a month in our docks. What, if any, precautions are taken, and by whom, to prevent the diseases that are thus borne so near to us, from spreading through the port, and from the port through the wide area of London itself? The thing is worth looking into for a moment.[1]
There is no better known craft in all the Port of London than the Hygeia. She is the little steam-launch used by the medical officer of the port when, accompanied by his inspector, he goes up and down the river on his sanitary rounds. The inspector inspects, and the medical officer receives the report and gives instructions. Through the kindness of the medical officer (Dr Collingridge), I was enabled, a few days ago, to accompany him on board his fast-going and comely little craft. The purpose I had in going will be better understood if I explain first what are the functions of the port medical officer. He acts under the corporation of London, who for ten years or more have been the sanitary authority for this vast and teeming port. The custom-house has sanitary powers of a kind, but they are little better than nominal. The duty of discovering an infected ship rests upon them, but having done that, their responsibility is almost at an end. For example, every vessel arriving at the port of London from a foreign port is bound, on reaching the quarantine ground at Gravesend, to signal, for the information of the boarding officer. This officer at once visits the vessel, and interrogates the master as to the health of the crew and passengers. If all questions be answered in a satisfactory manner, the vessel is allowed ‘free pratique,’ and the quarantine certificate is issued, without which no vessel is allowed to report. If there has been any sickness of an infectious or contagious character, the vessel is examined by the Customs medical officer, who, if he find infectious cases on board, communicates with the medical officer of the ship-hospital at Greenwich. But the arrangements in force at this moment for preventing the importation of disease into the port of London are exceedingly defective, insomuch as—unless the disease be cholera, plague, or yellow fever—there exists no power by which an infected vessel can be detained at the entrance to the port. Unless, therefore, the hospital officer—who acts in concert with the port medical officer—arrive immediately, a vessel containing infectious disease is allowed to pass up the river with her cases on board, and it is not until her arrival in dock that the patients are able to be removed by the medical officer of the port. But this weak point in the system is now in train to be wholly remedied, for the corporation have within the last few weeks framed a regulation by which no vessel with any contagious or infectious disease on board will be allowed to pass into port until the cases have been removed and the vessel thoroughly cleansed and fumigated.
A notion may be gathered from the foregoing of the functions of the port medical officer. He derives his authority from the Port of London Sanitary Committee of the corporation, a main part of whose business it is to prevent the importation of epidemics into London by means of the vessels which arrive daily in the port from all quarters of the globe. It is hardly necessary to expatiate on the extreme importance of their functions; but let me endeavour to show these by one or two picked examples, and then—for the Hygeia has her steam up, and the fog is rising rapidly—we shall be off on our tour of inspection. In the latter part of the summer of 1882, a very serious epidemic of smallpox occurred at the Cape of Good Hope. What has smallpox in South Africa to do with us in London? A good deal, considering that the shipping which arrives here from that colony is enormous. The disease spread, the death-rate rose, and our port medical officer was very properly alarmed. He at once set to work to take all due precautions, and by his orders, rigid note was had of every vessel arriving from the Cape. Beyond this, a circular letter was addressed to the principal Companies and shipowners engaged in that trade, calling attention to the disease, and asking for immediate notice in the event of its breaking out on board any vessel. It turned out that very few vessels carried the disease; but, thanks to the precautionary measures that had been taken, such cases as did arrive in the port were promptly discovered and dealt with. At another time Boulogne was attacked by the same disease, and as this is a port within nine or ten hours’ voyage of London, and steamers arrive almost daily, the matter was of great importance to the port sanitary authorities of London. The medical officer himself visited Boulogne, to inquire into the causes and extent of the disease; and in the port an inspector was told off to examine each vessel on its arrival; while the General Steam Navigation Company were advised to order the revaccination of all officers and crews on vessels running to Boulogne. The recent outbreak of cholera in Egypt occasioned no small anxiety to the Port Sanitary Committee, and it was owing in part no doubt to the vigilance of the medical officer and his assistants that not a single case of the malady appeared in this port. To the crew of every infected ship, or of any ship arriving from an infected port, the medical officer offers vaccination free of cost. These are some amongst the precautions that are taken to protect the citizens of London against the importation of infectious diseases from foreign ports. Not a vessel that enters the port of London, great or small, or of any nationality, escapes inspection. There are two inspectors for the river, one of whom, in the Hygeia, and the other in a rowing-boat, goes through and through the port every day of the week; and two for the docks, the whole of which—miles in extent—undergo a careful daily inspection. I forget how many thousands of vessels the medical officer told me were overhauled in this way in the course of a year—British, American, French, German, Dutch, Danish, Austrian, Russian, Italian, Spanish, Portuguese, Greek, Swedish, and Norwegian. Cases of infection are received at present on the hospital-ship at Greenwich; but a land-hospital has just been opened there, an improvement on the floating establishment for which the medical officer has long been anxiously waiting. A ship-hospital, he says, is useful enough for one class of infectious disease; but he holds that it is impossible effectually to isolate more than one class in the same vessel; and in addition to this grave disadvantage, there is the danger to the vessel herself, an illustration of which was afforded one rough night lately, when the hospital-ship Rhin broke from her moorings and went pitching down the river.
But let us see how the work of inspection is done. We are aboard our pretty little launch, which has been steaming impatiently this half-hour past. The master is at the wheel, the ‘boy’ is lively with the ropes, and the inspector has his note-book ready. The medical officer descends to the cosy little cabin; and when he has changed his silk hat for the regulation blue cloth cap, and bestowed his umbrella where no nautical eye may see it, he produces a cigar-case, and observes casually, that should stress of weather confine us below, the locker is not wholly destitute of comforts. That all may know what we are and what our business is, we fly in the bows, or the stern—I speak as a landsman—a small blue flag, whereon is inscribed in white letters, ‘Port Medical Officer.’