Brewer's: Bill of Health

A clean bill of health. A document, duly signed by the proper authorities, to certify that when the ship set sail no infectious disorder existed in the place.

A foul bill of health
is a document to show that the place was suffering from some infection when the ship set sail. If a captain cannot show a clean bill, he is supposed to have a foul one.
Source: Dictionary of Phrase and Fable, E. Cobham Brewer, 1894
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