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PAPER 1 THE BRITISH SECTOR OF THE WESTERN FRONT, 1914–18: INJURIES, TREATMENT AND THE TRENCHESSECTION B MEDICINE THROUGH TIMESTUDENT Exam practiceNAME:________________________________________TEACHER: ________________________REVISION TIPS…Now you have you have made your notes, get memorising them!Repetition if the key! You could create shortened hand-written version of your answers.: these could be on revision cards / mindmaps / hand-written notes. Improve your understanding of how beliefs about cause of disease / treatments / methods of prevention have developed over time – try to get all the detail onto a timeline (see end of booklet)Learn them off by heart – it could help to read aloud / self-record them and play them back to yourself / highlight and summarise each paragraph or section of your notes in the margin make your timelines visible around your home .TEST yourself – do practice questions Section A1a) Describe two features of….2b) How useful are Sources A and B for an enquiry into …Explain your answer, using Sources A and B and your knowledge of the historical context. 2b) Study Source B.?How could you follow up Source B to find out more about4 MARK DESCRIBE TWO FEATURES QUESTIONSE.g Casualty Clearing StationsEXAMPLE ANSWER: Casualty Clearing stations needed to be close enough to the frontline to be able to deal quickly with the wounded (1), but far enough away to be protected from attack (1). A triage system was used to divide the wounded into groups in the clearing stations.(1) Those who were not likely to survive would only be made comfortable, not treated. .(1)E.g. Gas AttacksChlorine gas affected the victim’s breathing (1). The victim died quickly from suffocation (1). Phosgene gas had similar effects to chlorine gas and killed the victim through suffocation (1). It affected the lungs (1). Mustard gas caused blisters on the skin, internal bleeding and affected the eyes and lungs (1). It could take days for the sufferer to die (1).1.The Trench System2.Stretcher Bearers3.Ambulances4.Trench Foot6.RAMC7.FANY8.Dressing Station10.Base Hospitals11.Underground Hospital at Arras12.Thomas Splint13.Blood Transfusions14.Blood Bank at Cambrai15.Plastic SurgeryHow useful are sources 1 and 2 for understanding surgery on the western front?SOURCE 1From an interview with Captain Maberly Esler in 1974. He was a medical officer. Here he is recalling events at Hooge, in the Ypres Salient, in June 1915. We’d never attempt any major surgery of anything like that in the trenches – one couldn’t do it. The only thing you could do was to cover a wound to keep it from getting infected, or stop a haemorrhage by compression if they were bleeding to death. Several people got tetanus afterwards from an infection in the ground which was carried in shelled areas. The ground has been shelled for such a long time it was in rather a septic sort of condition.SOURCE 2From A Surgeon’s Journal 1915-18, by Harvey Cushing, published in 1936. Here he is describing the conditions under which he is working during the battle of Passchendaele on 19 August 1917.My prize patient, Baker, with the shrapnel ball removed from his brain, after doing well for three days suddenly shot up a temperature to 104 last night about midnight. I took him to the operating theatre, reopened the perfectly healed external wound, and found to my dismay a massive gas infection of the brain. I bribed two orderlies to stay up with him in the operating room, where he could have constant thorough irrigation over the brain and through the track of the missile [passing a warm saline solution along the path taken by the shrapnel to prevent infection]. No light except candles was permitted last night.How useful are sources 1 and 2 for understanding medical treatment on the Western Front?SOURCE 1 - From an interview with Gunner William Towers in 1989. Here, he is recalling his treatment following a wound to his leg at Ypres in October 1917.“They took us to a hospital at Etaples and fitted me with a Thomas Splint, a round wooden ring with iron bands and a footrest. The pain from my knee was getting terrible so when I saw an officer coming up with his arm around two sisters (nurses) and laughing, I said ‘excuse me, sir, could you have a look at my knee?’ He came over and he stank of whisky. When the nurses took the bandages off he said, ‘Oh, there’s fluid above the knee. We’ll tap that tonight.’ So they came for me to go to the theatre and I thought, ‘Thank God for that.’ But when I woke up in the early hours of the morning I thought ‘Oh my God. My leg’s gone.’ They’d guillotined it off without saying a word. There had been no hint at all that I was going to lose my leg. They hadn’t even looked at it until I asked the doctor. After that they put me on a boat and I was taken to England. A civilian doctor came to look at me and when he took the bandages off the smell was terrible. He thought I was going to die.”SOURCE 2- An extract from a Surgeon’s Journal 1915-18, by Harvey Cushing, published in 1936.. In this extract, Cushing is describing his first impressions of medical treatment on the Western Front soon after his arrival in France on 2 April 1915.‘It is difficult to say just what are one’s most vivid impressions: the amazing patience of the most seriously wounded, some of them hanging on for months, the dreadful deformities (not so much in the way of amputations, but broken jaws and twisted, scarred faces); the tedious healing of infected wounds with discharging sinuses, tubes, irrigation and repeated dressings. Painful fractures are simply abandoned to wait for wounds to heal, which they don’t seem to do.’Question 2b – How could you follow up Source B to find out more about….Starter – Using table below - identify sources you may be able to use to help you find answers:What kinds of wounds did soldiers suffer from?What kinds of weapons caused particular injuries?What kind of illnesses did soldiers suffer from in the trenches?What did the army do to address health problems for soldiers at the Western Front?Did surgical techniques improve during war time?What pressures were medical staff under?Who was providing the medical care?What work was done by nurses?How successful were new techniques e.g. blood transfusions, mobile x-ray machines, Thomas Splints?Did transport from the front line to CCS increase death rates?What problems did the transportation of injured soldiers create?Type of SourceWhat can be learnt from this type of sourceNational Army Service Records for individual soldiersDates of service; Where soldiers fought; Record of wounds, treatments and hospitals admitted to, discharge records, death recordPension record cards Details of war related wounds, sickness and injuries and post-war medical resultsNational newspaper reportssuch as The Times.Battles, number of injuries, deaths etc recorded, eye-witness accounts, government statistics – should be fair but may be one-sided. Propaganda often published as fact. Censorship relaxed during ernment reports on aspects of the warDepartmental overview of aspects of the war – spending on munitions etc.British Medical JournalAlthough BMJ is produced for medical professionals it provides an insight in the medical care of soldiers e.g. articles like ‘Head injuries in War’, ‘Some notes on Trench Fever’Recollections of the work undertaken – injuries of soldiers, conditions, chain of evacuation, new techniques and technology etcOrders of Battle (ORBATS) Documents produced by the military to show the hierarchical structure, command organisation and disposition of units for engagements of the British MilitaryMilitary Hospitals Admissions and Discharge Registers from WW1 CollectionRecords of soldiers' admission to, or discharge from, hospital in the First World War.Royal Army Medical RecordsDate of admittance, records of injuries and care given, discharge notes, death records, new techniques attemptedDiary accounts by a surgeon on front line / a stretcher bearer / member of Fany or RAMCCould provide specific detail about their experience of transportation / surgery / care in base hospital (depending on the person). Try to be as specific as possible.if you know the name of a famous surgeon – and it is relevant – give this.Question 2b PRACTICE…Question 1: How could you follow up Source B to find out more about facial wounds on the Western Front? In your answer, you must give the question you would ask about facial wounds and the type of source you would use.(4 marks) Each section is worth one mark.Source B:“It is difficult to say what are one's most vivid impressions: the amazing patience of the most seriously wounded, some of them hanging on for months; the dreadful deformities (broken jaws and twisted, scarred faces); the tedious healing of infected wounds with discharging sinuses, tubes, irrigation, and repeated dressings.”From A Surgeon's Journal by Harvey Cushing. He is describing his first impressions of medical treatment on the Western Front soon after his arrival in France on 2 April 1915Detail in Source B that I would follow up: ____________________________________________________________________________________________________________________________________________________________Question I would ask: ____________________________________________________________________________________________________________________________________________________________What type of source I could use: ____________________________________________________________________________________________________________________________________________________________How might this help me answer my question____________________________________________________________________________________________________________________________________________________________Question 2: How could you follow up Source B to find out more about X Rays on the Western Front? In your answer, you must give the question you would ask about X rays and the type of source you would use.(4 marks) Each section is worth one mark.Source B: “The need for portable outfits in connection with the war has led to a great development in the provision of motor wagons containing complete X Ray apparatus with all accessories. The mechanism used for driving the wagon i.e. the motor is coupled with a powerful dynamo which delivers a continuous current.”From Radiography and Radiotherapeutics, by Robert Knox, published 1917.Detail in Source B that I would follow up: ____________________________________________________________________________________________________________________________________________________________Question I would ask: ____________________________________________________________________________________________________________________________________________________________What type of source I could use: ____________________________________________________________________________________________________________________________________________________________How might this help me answer my question___________________________________________________________________________________________________________________________________________________________.....ANSWERSQuestion: How could you follow up Source B to find out more about facial wounds on the Western Front? Answer Question 1Detail in Source A I would follow up “the dreadful deformities”Question I would ask What type of facial wounds did patients experience on the Western Front? What type of source I could use?Royal Army Medical RecordsHow this might help answer my question? RAM records would give me accurate information on type of wounds patients suffered, because written by medical professionals. Question 2: How could you follow up Source B to find out more about X Rays on the Western Front? AnswerDetail in Source B I would follow up The need for portable outfits led to great developments in wagons containing x ray apparatus Question I would ask How were these x rays wagons used on the western frontWhat type of source I could use?An article in British Medical Journal about use of portable x-ray unitsHow this might help answer my question? The BMJ is produced for medical professionals it provides an insight in the medical care of soldiers. It was designed to inform the medical professional working at time so should provide accurate explanation. Practice Questions Medicine Through Time4 mark questions Explain one way in which people’s reactions to the plague were similar in the 14th and 17th centuries. Explain one difference between surgery in 14th century and surgery in 19th century.12 mark questionsExplain why there was continuity in ideas about the cause of disease during the period c1200-1700 You may use: (12) The ChurchGalen’s Theory of the 4 HumoursExplain why treatment in hospitals was hospital treatment improved from 1500-1900You may use: (12)Role of ChurchFlorence Nightingale Explain why surgery remained dangerous from 1250-1860. (12)You may use: Barber surgeons James’ Simpson discovery of Chloroform. 16 mark questionsHospital treatment in England in the period 1250 to 1700 was very limited. How far you agree. You may use: (16)Charity hospitalsCare in the homeVesalius was the most important figure in bringing about medical progress from 1500-1800. How far do you agree? (16)Discovery of William Harvey 1628Edward Jenner’s small pox ernment intervention was the most important factor in bringing about effective prevention of disease from 1500-1900.How far do you agree? (16)John Snow’s work in Soho London, 1854Great Plague 1665Timeline TaskOn A3 paper create a detailed timeline for each area of medicine (CAUSE / TREATMENT / PREVENTION.) You could get a question on any area and between any dates. This task will help you think across the 4 time periods and consolidate your revision notes down 3454400231140Religious explanations for disease continued because people believed in God without doubt00Religious explanations for disease continued because people believed in God without doubt-139700307340Miasma continued – seemed rational at this time0Miasma continued – seemed rational at this timeTimeline explaining changes in CAUSE of DISEASE3110865825500252453878796120000120085090070485Galen’s theory of 4 humours continued because of Church0Galen’s theory of 4 humours continued because of Church5080000260350New ideas about cause of disease emerge e,g, Fracastoro – 1546 – “seeds in air spread disease” .0New ideas about cause of disease emerge e,g, Fracastoro – 1546 – “seeds in air spread disease” .-190500882651543 Fabric of Human Body important because…001543 Fabric of Human Body important because…351790037465REFORMATION – challenged Catholic Church – people less accepting of Church dogma00REFORMATION – challenged Catholic Church – people less accepting of Church dogma322389518415150000150048260003098800020574001504951665 Plague caused by…..001665 Plague caused by…..-203200869951628 Harvey important… 001628 Harvey important… 5219700141605Social Attitudes – Enlightenment search for rational explanation.0Social Attitudes – Enlightenment search for rational explanation.-2667001746251660s Sydenham important because…001660s Sydenham important because…447040023749024942802089151700001700140970019939018th century Theory of Spontaneous Generation popular0018th century Theory of Spontaneous Generation popular459740023749000516890034290Technology – developments in microscopes by 1850 00Technology – developments in microscopes by 1850 -10160065405Miasma still popular – S.G fitted in with idea of miasma0Miasma still popular – S.G fitted in with idea of miasma27686003067051882 Koch proves Germ Theory – TURNING POINT!!01882 Koch proves Germ Theory – TURNING POINT!!4749800311785005194300223520Individuals – Pasteur 1861 publish theory0Individuals – Pasteur 1861 publish theory-2032001207135Create a detailed version of this timeline.Add the BELIEFS about cause of disease (the clouds)Add the factors which led to the belief (boxes)Could you add the ‘case study boxes’ – Plague 1348, Plague 1665.How to use colour?00Create a detailed version of this timeline.Add the BELIEFS about cause of disease (the clouds)Add the factors which led to the belief (boxes)Could you add the ‘case study boxes’ – Plague 1348, Plague 1665.How to use colour?11049003873500154940065341500-25400305435Individuals – Many scientists promoted SG….0Individuals – Many scientists promoted SG….4940300386080005130800534035Individuals – Koch 1882 proved theory.0Individuals – Koch 1882 proved theory.3214370794385190000190023799802927985PresentPresent ................
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