Edexcel GCSE History: Medicine in Britain, c1250-present and The British sector of the Western Front, 1914-18: injuries, treatment and the trenches

These cards are the content from MrThorntonTeach’s Medicine Through Time booklet and Save my Exams for the Western Front, summarised by ChatGPT. If this is not enough information then I don’t know how you’re supposed to memorise all of it. Hopefully this isn’t too much information that you can’t memorise it though. Medicine in Britain, c1250-present: {Medicine in medieval England, c1250-c1500: Cards 1-7 | The Medical Renaissance in England, c1500-c1700: Cards 8-18 | Medicine in eighteenth- and nineteenth-century Britain, c1700-c1900: Cards 19-26 | Medicine in modern Britain, c1900-present: Cards 27-34} | The British sector of the Western Front, 1914-18: injuries, treatment and the trenches: Cards 35-53

What rational explanations for the cause of disease were there in medieval England?

Hippocrates, a Greek doctor, believed illness was caused by an imbalance of the Four Humours – blood, phlegm, black bile, and yellow bile. To stay healthy, humours had to be balanced. Treatments included bleeding or purging to remove excess humours, like using leeches for too much blood. Galen, a Roman doctor, developed this into the Theory of Opposites – you cured illness with the opposite quality. For example, cold phlegm was treated with hot, spicy food. The Church supported these ideas, so they were taught in medical schools. Physicians also used urine charts to check for imbalances. People also believed in miasma – bad-smelling air from waste caused disease. This idea was supported by both Hippocrates and Galen, as well as King Edward III during the Black Death, who blamed filth for spreading illness.

What supernatural and religious explanations for the cause of disease were there in medieval England?

In the Middle Ages, people believed that disease was a punishment from God for sins like gambling or drinking, or a test of faith. Leprosy and the 1348–49 Black Death were seen as divine punishments. Religious leaders claimed suffering was meant to cleanse people of sin. Superstition and the supernatural also played a major role. People believed in witchcraft, bad luck, and astrology. Physicians were trained to study the stars and planets, believing their movement could cause illness. For example, the Black Death was blamed on the movement of Saturn and Jupiter. Minority groups like Jews were also wrongly blamed, with accusations of poisoning wells.

What approaches to treating disease were there in medieval England?

Medical treatments in the Middle Ages made little progress due to the lack of understanding of disease causes. Treatments were based on religion, the Four Humours, and superstition. Religious healing included prayers, fasting, pilgrimages, and paying for mass. People believed spiritual healing would cure illness. Herbal remedies were common, made by apothecaries or wise women using herbs like honey or aloe vera. Some unusual mixtures included garlic, onion, and animal parts. Treatments using the Four Humours were still popular, including bloodletting (cupping or leeches), purging, and warm herbal baths. Supernatural cures were also used, like wearing a magpie’s beak for toothache. Some barber surgeons even trepanned skulls to release ‘demons’, though this was risky and often deadly.

What approaches to preventing disease were there in medieval England?

In the Middle Ages, people focused more on preventing illness than curing it, especially as many treatments were ineffective. Religion played a big role - people believed only God could cure disease, so they tried to avoid getting ill in the first place. Flagellants whipped themselves during the Black Death to show repentance, while others fasted, lit candles, and prayed. Prevention also included superstition, like wearing charms or amulets, and following zodiac charts. To fight miasma, people carried sweet herbs, lit fires, or rang bells to cleanse the air. The rich used bath houses and hung herbs to keep air clean. Physicians recommended a Regimen Sanitatis, advising exercise, diet, bathing, and avoiding stress, but only the wealthy could afford it.

What approaches to hospital care were there in medieval England?

The first hospital in England was St. Bartholomew’s (1123), and by 1400 there were over 500, mostly set up by the Church or wealthy merchants. They focused on ‘care not cure’, offering warmth, food, and prayer, rather than medical treatment. Most patients were the old, poor, or travellers, not those with infectious diseases. Hospitals were run by monks and nuns, not doctors, and they believed only God could heal. Hospitals were clean, with herb gardens, but most sick people were still treated at home by women using herbal remedies.

Who provided treatment and care in the community in medieval England?

Treatment depended on your wealth, status, and how ill you were. The rich could afford physicians, who trained for 7 years using ideas from Hippocrates and Galen. They used urine charts, the Four Humours, and astrology to diagnose illness, but they couldn’t dissect bodies so their knowledge was limited. Apothecaries were like chemists, mixing herbal remedies. They were cheaper than physicians and knew a lot about plants and healing. Barber surgeons were untrained but experienced. They could pull teeth and perform basic surgery like amputations without anaesthetic or antiseptic, making them the cheapest option. Wise women treated locals with herbs, charms, and spells, often acting as midwives.

How did people attempt to treat and prevent the spread of the Black Death?

Treatment of the Black Death (1348-49) followed common medieval methods, like bleeding, purging, or using herbal remedies, even rubbing onions or chicken bottoms on swellings! People also popped buboes, drank vinegar or arsenic and sat by fires or in sewers to drive out disease. Prayer was a key method, as many believed it was sent by God. For prevention, people wore herbs or flowers, bathed, or tried to avoid others. The government introduced quarantine and closed hospitals to plague victims. Many turned to flagellation, prayers, and pilgrimages to seek God’s forgiveness.

What continuity and change in explanations of the cause of disease was there in the Renaissance?

The Renaissance saw old ideas revived and questioned. Scientists like Sydenham and Paracelsus began to challenge Galen and Hippocrates’ Four Humours, but most people and doctors still believed in them – even King Charles II was diagnosed using this theory in 1685. Belief in supernatural causes declined, but many still blamed astrology or God for events like the Great Plague (1665). The idea of miasma (bad air) remained strong. Scientific thinking grew, with Frascatoro suggesting disease spread through seeds in the air, and Sydenham pushing for observation over book learning. Despite this progress, many physicians still used old ideas because they were respected.

How did the Royal Society influence the transmission of ideas in the Renaissance?

Founded in 1660, the Royal Society was a key part of the Scientific Revolution. It aimed to share experiments, challenge old ideas, and develop new scientific knowledge. Backed by King Charles II with a Royal Charter, it gained respect and influence. Its motto “Nullius in Verba” (“Take nobody’s word for it”) showed its focus on evidence over tradition. In 1665, it began publishing the journal ‘Philosophical Transactions’, which spread discoveries like blood transfusion (Richard Lower) and microscopic drawings (Robert Hooke). It also translated scientific works, helping spread new medical ideas and promoting experimentation across Europe.

How did Thomas Sydenham improve diagnosis in the Renaissance?

Known as the “English Hippocrates”, Thomas Sydenham challenged old ideas in medicine. In 1676, he published Observationes Medicae, a medical textbook used for 200 years. He stressed that doctors should observe patients, take notes, and diagnose based on symptoms, not just read old texts. He rejected the Four Humours and the idea that God caused disease, instead believing diseases could be grouped into types like measles and scarlet fever. Though he still believed in ‘atmospheres’ causing disease, Sydenham helped advance treatment by using quinine for malaria and iron for anaemia. While his work didn’t lead to immediate changes in medicine, it laid the foundations for future progress by promoting science and observation.

What continuity and change in approaches to treatment was there in the Renaissance?

In the Renaissance, chemical cures became more popular, inspired by Paracelsus and known as iatrochemistry. Doctors used substances like antimony and mercury (both poisonous) to try and purge illness. A new idea called transference suggested illness could be transferred to objects, e.g. rubbing an onion on warts. Herbal remedies remained common and were now chosen by colour-matching (e.g. red wine for smallpox). New World exploration introduced cures like quinine for malaria. However, there was continuity - bleeding and purging were still used, even for King Charles II, and many believed in the King’s healing touch for diseases like scrofula. Prayer, charms, and magical treatments were also still used during the Great Plague.

What continuity and change in approaches to prevention was there in the Renaissance?

Preventing disease was still seen as the best protection. The Regimen Sanitatis continued, encouraging people to stay clean and live healthily, though bathing declined due to fears of syphilis. People still believed in miasma, using sweet-smelling herbs and now took more steps to clean the air, like removing sewage and rubbish. Instruments like thermometers helped people avoid disease by checking the weather. Moderation in lifestyle (diet, exercise, rest) became more important. Prayer and superstition remained common, and some people blamed later illness on being a weak child at birth.

What continuity and change in hospital care was there in the Renaissance?

There was some change in hospitals – now more focused on treatment than just care. Patients could expect healthy food, a physician visit, and medication from an apothecary. However, after the Dissolution of the Monasteries (1536), hundreds of Church-run hospitals closed. Only a few survived, like St. Bartholomew’s. Smaller charity hospitals appeared, focusing more on cure, not just comfort. Pest houses were set up to treat people with one disease (e.g., plague), a big change from the Middle Ages. Still, most people were treated at home, and women (including wealthy women like Lady Grace Mildmay) continued to care for the sick.

What continuity and change in care within the community was there in the Renaissance?

In the Renaissance, apothecaries and surgeons were still seen as less important than physicians and received no university training, though they were a cheaper option. They formed Guild Systems, training through long apprenticeships to become Masters, and needed licenses to work. Practical experience increased due to warfare and new treatments like iatrochemistry. Physicians trained at universities and studied new subjects like anatomy due to discoveries by Vesalius and Sydenham. The printing press gave trainees access to detailed medical books, helping them challenge traditional ideas. However, training was still mostly book-based, with little hands-on practice, as few universities had operating theatres, despite dissection being legal.

How did the work of Vesalius influence medicine in England?

Andreas Vesalius was a Renaissance anatomist who challenged Galen’s long-accepted ideas. In 1537, he published Six Anatomical Tables with detailed, labelled drawings of the human body in four languages, helping train future doctors. In 1543, he released The Fabric of the Human Body, based on human dissection, revealing 300 mistakes in Galen’s work - for example, that the jaw is one bone, not two, and that blood doesn’t pass through invisible holes in the heart. His books, rich in anatomical illustrations, were widely printed and used in places like Cambridge University by 1560. Vesalius inspired others to dissect human bodies, leading to England’s first dissection in 1565. Though his work was developed by others, such as Fabricus, who taught William Harvey, Vesalius’ impact was more educational than practical. While he proved Galen wrong and helped shift attitudes, his work did not directly improve treatment or health at the time, and many still resisted his ideas.

What did William Harvey do? How did this impact medicine in the Renaissance?

William Harvey built on Vesalius’ ideas and disproved Galen’s theory that blood was made in the liver and burned up. Inspired by mechanical water pumps, Harvey dissected humans and animals to show that blood flows in one direction, carried only in veins and arteries, not with pneuma. In 1628, he published An Anatomical Account of the Motion of the Heart and Blood, proving blood circulates around the body, pumped by the heart, and that arteries and veins are connected (via what we now call capillaries). Though his work was ignored at first and Galen’s ideas stayed in textbooks until 1651, Harvey encouraged more dissection and experimentation, laying foundations for later advances in surgery and blood transfusions.

What approaches to treatment for the Great Plague in London were there?

During the Great Plague (1665), people still used old methods like bleeding, purging, and herbal remedies (e.g. London Treacle). New ideas like transference became popular, such as tying a live chicken to a plague sore. Though prayer remained common, there were no flagellants this time. As the cause was unknown, the best advice was to avoid catching it. Many physicians fled, while quack doctors became popular, wearing bird-like masks filled with sweet herbs to protect against miasma.

How did people attempt to prevent the spread of the Great Plague in London?

During the Great Plague, Charles II and the government took more action than before. Public events were banned, theatres closed, and streets cleaned with tar and herbs burned to drive away miasma. Cats and dogs were killed, and infected houses were marked with a red cross and quarantined. Searchers and wardens tracked cases and collected the dead. The rich followed the College of Physicians, while most people used remedies from local healers, like pomanders, fasting, plague water, tobacco, and prayer. Some even believed catching syphilis would stop the plague, though this was false.

What continuity and change in explanations of the cause of disease was there in eighteenth- and nineteenth-century Britain?

Old ideas like the Four Humours, God, and supernatural causes were no longer believed. However, the miasma theory (bad air causing disease) remained popular, especially during events like the Great Stink (1858). A new theory called Spontaneous Generation emerged, suggesting germs appeared from decay, but it was wrong. In 1861, Pasteur’s Germ Theory proved germs in the air caused decay, not the other way around. Koch later identified specific bacteria (e.g., TB and Cholera). Though revolutionary, Germ Theory wasn’t widely accepted until after 1900. (Note: There is more information about Pasteur and Koch on other flashcards)

How did Pasteur’s Germ Theory influence medicine in Britain?

In 1861, Louis Pasteur developed the Germ Theory, challenging Spontaneous Generation. He showed that microbes in the air cause decay and disease, and that they can be killed by heating (Pasteurisation). His experiments on milk, beer, and animals proved germs were everywhere, and some were harmful. Although a major breakthrough, it had little immediate impact, as many doctors, like Henry Bastian, refused to accept that microbes caused illness, and Spontaneous Generation remained widely believed for some time. Germ Theory showed that germs cause disease, replacing old ideas like miasma and Spontaneous Generation, though it took nearly 50 years to be widely accepted. Koch built on Pasteur’s work, identifying specific bacteria like Cholera and Anthrax, helping prove Snow’s theory. In treatment, Germ Theory had little short-term effect but inspired Joseph Lister’s antiseptic surgery and later aseptic methods. It also led to vaccines, building on Jenner’s work, and helped wipe out diseases like Smallpox and Polio. In hospitals, Germ Theory influenced cleaner designs, better hygiene, and sterilisation. It even pushed the government to invest more in public health, including the Public Health Act of 1875.

How did Koch’s work on microbes influence medicine in Britain?

Robert Koch built on Pasteur’s Germ Theory, and in 1876 became the first to link a specific bacteria to a specific disease: Anthrax. He later discovered the bacteria for TB (1882) and Cholera (1883), proving John Snow right. Koch developed techniques like using agar jelly and petri dishes to grow pure bacteria cultures and staining to make microbes easier to see. His work shifted focus to treating the cause of disease, not just symptoms, and inspired others to find bacteria for pneumonia and tetanus. His methods are still used today.

How did hospital care improve in eighteenth- and nineteenth-century Britain? How did Florence Nightingale influence this?

In 1700, there were just 5 hospitals in Britain, but many more appeared during the 18th and 19th centuries. Early hospitals remained dirty and dangerous, with untrained staff, no germ theory, and poor hygiene, leading to high death rates. Florence Nightingale transformed hospital care after the Crimean War (1854) by improving cleanliness, dropping death rates at the Scutari Hospital from 40% to 2%. She influenced hospital design (e.g., ventilation, isolation wards, tiled floors) and set up the Nightingale School for Nurses in 1860. By 1900, hospitals were cleaner, used aseptic surgery, and focused on treating the sick. However, access was still limited - the rich had home treatment, while working-class people used voluntary, cottage, and workhouse infirmaries. Pharmacies like Boots (1849) became popular, though many still turned to quack cures and harmful treatments.

How did anaesthetics and antiseptics impact surgery in eighteenth- and nineteenth-century Britain?

18th-century surgery was risky due to pain, infection, and blood loss. Most operations were amputations, done without anaesthetic (except opium), in dirty conditions. 19th-century surgery saw major progress. In 1847, James Simpson introduced chloroform as an anaesthetic, later used by Queen Victoria. It allowed for more complex surgery, but overdoses were common (e.g. Hannah Greener), and blood loss remained a problem. In 1865, Joseph Lister used carbolic acid as an antiseptic, reducing infection and amputation deaths. However, many doubted the Germ Theory and rejected Lister’s method, especially as it damaged skin. Eventually, surgery shifted to aseptic methods: steam-sterilising tools (from 1887), and surgeons wore gloves, masks, and gowns. Pain and infection were now better controlled, but blood loss was still a major issue.

How were vaccinations developed and used in eighteenth- and nineteenth-century Britain?

Edward Jenner developed the first vaccine to prevent smallpox, a deadly disease that killed thousands, especially children. In the 1790s, Jenner noticed milkmaids who caught cowpox didn’t get smallpox, so he tested this by infecting people with cowpox and then exposing them to smallpox – none got ill. Though he couldn’t explain it (Germ Theory didn’t exist yet), in 1798 he published his findings. The Royal Jennerian Society helped promote vaccines, and by 1804, 12,000 people had been vaccinated. After a deadly epidemic (1837–40), the government banned inoculation and began paying for vaccinations. By 1852 smallpox vaccination was compulsory, but it was only enforced from 1872. In the short term, Jenner’s work saved many lives worldwide, though there was some opposition. In the long term, he inspired Pasteur and Koch to find new vaccines, and by 1979, smallpox was wiped out globally.

How did the 1875 Public Health Act help prevent disease?

Living conditions in the Industrial Revolution were poor due to rapid urban growth – by 1850, 85% of people lived in overcrowded towns with no sewage, shared toilets, and no clean water. This led to frequent disease outbreaks, like cholera in 1854. In 1842, Edwin Chadwick’s report showed life expectancy in cities was as low as 15 years, and he blamed miasma from sewage and filth. His work led to the 1848 Public Health Act, but it wasn’t enforced by local councils, so few improvements happened. This changed in the 1860s with Snow’s work on Cholera, Pasteur’s Germ Theory, and the Great Stink (1858). The 1875 Public Health Act finally made it compulsory for councils to provide clean water, sewage systems, toilets, lighting, and parks, and employ public health officers. This was a major turning point and helped prevent future cholera outbreaks in places like London.

How did people attempt to prevent the spread of Cholera in London in 1854? What did Snow do?

Cholera was a deadly disease in Industrial Britain, with major outbreaks in 1831, 1849, and 1854, killing over 20,000 in London in 1854 alone. It mostly affected the poor in overcrowded slums. Since Germ Theory hadn’t been discovered yet, people believed cholera was caused by miasma. Towns tried to clean the streets, but without proper water systems, this had little effect. The 1848 Public Health Act encouraged clean water but wasn’t enforced, so change was slow. John Snow, a London doctor, believed cholera was caused by contaminated water, not air. In 1854, he mapped cholera deaths in Soho and traced the outbreak to the Broad Street water pump. When he removed the pump handle, deaths dropped instantly. He proved the link between cholera and water, but couldn’t explain why, so many ignored his ideas. In the long term, Snow’s work became vital once Germ Theory (1861) was accepted. It inspired a new sewer system and the 1875 Public Health Act, forcing towns to provide clean water.

How has the availability of blood tests, scans and monitors improved diagnosis in modern Britain?

Science and technology have massively improved how diseases are diagnosed. These developments allow doctors to identify specific conditions more accurately and give better, targeted treatment. Patients can also now monitor some illnesses at home. Since the 1930s, blood tests have been used to detect conditions like anaemia, while biopsies help find disease by testing tissue samples. X-rays (from the 1890s) help spot broken bones. CT scans (advanced X-rays) and MRI scans (using magnets and radio waves) are used to find tumours, injuries, or soft tissue damage. ECGs track heart activity, useful after heart attacks. Ultrasounds (or sonograms) use sound waves to look inside the body and diagnose problems like kidney stones. Endoscopes are tiny cameras used to look inside areas like the digestive system, and they can also take tissue samples. Blood sugar monitors help people with diabetes manage their condition from home.

How has the understanding of causes of disease advanced in modern Britain?

In the 20th century, doctors discovered how lifestyle choices affect health. Smoking was linked to lung cancer, heart disease, and gum issues, while second-hand smoke increased asthma in children. Diet also plays a major role - too much sugar causes Type 2 diabetes, and fat leads to heart disease. Alcohol and drug use can damage the liver and kidneys or spread disease through needles. People also became more aware of STIs, like HIV/AIDS, spreading through unprotected sex. Scientists also found that not all diseases were caused by germs - some were hereditary. By 1953, Watson and Crick discovered the structure of DNA, showing it was passed from parent to child. This led to the Human Genome Project (1986–2001), mapping all human genes and helping identify genetic diseases like Down’s Syndrome, Parkinson’s, Cystic Fibrosis, and Alzheimer’s. Doctors can now screen for genetic risks and offer preventive treatments (e.g. mastectomy for breast cancer). Gene therapy can help some, but many genetic conditions still have no cure. DNA research continues to grow and may lead to major future breakthroughs.

How has medicine (excluding magic bullets and antibiotics) advanced in modern Britain?

Even into the early 1900s, many people still relied on traditional remedies, family treatments, and home medical books. Companies like Boots and Beecham’s sold ready-made medicines. However, big changes occurred with the arrival of modern drugs. Old ‘cure-all’ remedies were replaced by medicines like Aspirin (for pain and fevers) and antibiotics like magic bullets and penicillin, which treated specific infections. New drugs were also developed to target genetic conditions like Huntington’s disease. Medicine delivery improved too - pills were mass-produced in capsule form, hypodermic needles allowed fast injections, and insulin pumps helped diabetics manage their condition.

How have magic bullets and antibiotics been developed in modern Britain?

After Koch proved the Germ Theory, scientists searched for treatments to target specific microbes. Paul Ehrlich developed the first Magic Bullet, called Salvarsan 606, in 1909. It was a chemical cure for Syphilis and the first treatment that killed bacteria inside the body, though it was also poisonous. In 1932, Gerhard Domagk discovered the second Magic Bullet, Prontosil, which cured blood poisoning. He even used it to save his daughter. Doctors then created drugs to treat gonorrhoea, pneumonia, and scarlet fever, cutting post-natal infection deaths from 20% to 5%. In 1928, Alexander Fleming discovered Penicillin by accident, but it only worked outside the body. In 1938, Florey and Chain purified it, and during WWII, the US mass-produced it. Penicillin became the first antibiotic and a ‘wonder-drug’, curing diseases like septicemia. Later, streptomycin (1943) cured TB. Antibiotics drastically reduced deaths from disease, especially after childbirth. However, over time, superbugs like MRSA have become resistant, showing the need for continued research.

How has surgical treatment in hospitals changed in modern Britain?

By the 1900s, the main problems of surgery - pain, infection, and blood loss - had been solved. New tech like keyhole surgery (with cameras and small tools), microsurgery (reattaching nerves/vessels), and robotic surgery made operations safer and more precise. Anaesthetics were improved in the 1930s with precise doses. Modern treatments include radiotherapy (for cancer), blood transfusions, dialysis, pacemakers, gene therapy, and stem cells. Prosthetics and 3D printing are also advancing. Deaths from infectious disease have dropped from 25% to <1%, and life expectancy rose to 83 by 2013. However, superbugs, lifestyle diseases, and the lack of cures for cancer and heart disease remain ongoing challenges.

What new approaches to prevention have there been in modern Britain?

With better understanding of disease and prevention, the government took more responsibility for public health. Mass vaccination campaigns became common, starting with diphtheria in 1942, which saved thousands of children. Later vaccines included polio (1956), measles (1968), rubella (1970), and HPV, helping to eliminate or reduce many diseases. However, vaccines like flu require constant updates, and uptake can be affected if parents refuse them. The government also launched lifestyle campaigns to tackle diseases like cancer and heart disease. These included anti-smoking ads, Stoptober, Sugar Smart, and promoting “5 a day” healthy eating. Over-40s now get regular health checks with lifestyle advice. Laws were also passed to improve public health, including the Clean Air Acts (1956 & 1968), the 2007 indoor smoking ban, and car emission limits.

How has the NHS impacted care and treatment in modern Britain?

The NHS was launched in 1948, providing free healthcare to everyone, paid for through taxes. It was the government’s biggest intervention in improving public health. It meant equal access to treatment for all, regardless of class or income. The NHS focused on treatment and prevention, offering check-ups, vaccines, and early diagnosis using modern technology. It introduced high-tech treatments like chemotherapy, transplants, and specialist care, helping to raise life expectancy (up to 83 by 2015). Nurses also gained advanced training, with some now able to prescribe medicine. However, the NHS faces modern challenges: long waiting times, pressure from a growing and aging population, rising lifestyle-related diseases, and increasing costs alongside tighter budgets.

How has lung cancer been fought against in modern Britain?

Since 1900, lung cancer has become increasingly common, now with over 40,000 cases a year and the second most common cancer overall. In 1950, it was proven that smoking causes lung cancer, with 85% of patients being current or former smokers. It remains deadly, with only one-third surviving a year after diagnosis. Modern diagnosis uses CT and PET scans, and bronchoscopes to take biopsies for accurate detection and treatment planning. Treatment includes surgery, radiotherapy, chemotherapy (used since the 1970s), and more recently immunotherapy - boosting the immune system to fight cancer. However, there is still no cure, making it a major focus for research. The government responded to rising deaths with prevention campaigns and laws: banning smoking in public places (2007) and cars (2015), raising tobacco taxes, banning adverts (2005), and requiring health warnings on packaging. The NHS also runs educational campaigns to discourage smoking, especially among the young.

What was the Ypres salient?

An area under British control surrounded by Germans on 3 sides. The Germans held the high ground, while the British were in the low, wetter areas.

What happened at the First Battle of Ypres?

In October 1914, the British defended Ypres from German soldiers, but lost 50,000 soldiers themselves. British victory meant reinforcements and supplies could be delivered on the coast. However, German forces still surrounded Ypres.

What happened at the Second Battle of Ypres?

In April and May 1915, Germany used chlorine gas for the first time in the First World War. British forces lost 59,000 soldiers and Germany moved 2 miles closer to Ypres.

What happened at the Third Battle of Ypres (Passchendaele)?

In July 1917, constant rainfall caused the ground to become waterlogged and many soldiers drowned. British forces lost around 245,000 soldiers. Despite gaining only seven miles of territory, General Haig considered it a success.

What happened at the Battle of the Somme?

In July-November 1916, Britain had suffered 400,000 casualties, with 20,000 dead on the first day alone. Tanks were used for the first time, though they were not effective yet, and Britain used creeping barrage (a slow, moving artillery attack so allied soldiers can follow behind).

What happened at the Battle of Arras?

The chalky landscape of Arras allowed the British troops to expand tunnels, caves and quarries to build a network of tunnels. This included a hospital with 700 stretcher beds, running water and electricity. The 2.5 miles of tunnel could shelter up to 25,000 soldiers. Sheltered British troops attacked nearby German trenches in April 1917. The British gained eight miles of territory, but there were around 160,000 British and Canadian casualties.

What happened at the battle of Cambrai?

In October 1917, over 450 tanks were used by the British in the first large-scale use of tanks. Reduced artillery fire confused the German forces. However, land taken by British forces was quickly reclaimed by Germany. In preparation for the battle, Oswald Robertson stored 22 units of blood in a blood bank. 20 Canadians were treated using the blood and 11 survived. It demonstrated the potential of blood transfusions to save lives.

How were trenches constructed in the British sector of the Western Front?

Trenches were an easy and efficient way of sheltering troops from artillery and machine guns. They were dug 2.5 metres deep and covered around 475 miles from the English Channel to the Swiss Alps. Building trenches in a zig-zag pattern prevented enemy soldiers from firing down the length of the trench. Holes in the side of trenches known as dugouts provided cover for soldiers. Positioning artillery at the back protected it from enemy fire.

How were trenches organised in the British sector of the Western Front?

Frontline trenches were the closest to no-man's-land and were where attacks started from. Soldiers were able to retreat to support trenches which were 80 metres behind the frontline. The launch of counter-attacks came from reserve trenches which were at least 100 metres behind the support trenches. The transport of soldiers, equipment and supplies was through the communication trenches.

What happened at Hill 60 near Ypres?

In April 1915, British forces tunnelled into the side of Hill 60 and placed five mines. The explosion blew off the top of the hill and British forces captured it.

How did the terrain of the British sector of the Western Front provide problems for the transport and communications infrastructure?

Conditions on the Western Front made treating the wounded very difficult. Shelling caused deep craters and destroyed roads, making movement hard. Heavy rain led to flooded trenches and trench foot affected thousands. Stretcher-bearers struggled through mud, barbed wire, and gunfire, suffering heavy casualties themselves. Horse-drawn ambulances couldn’t manage the numbers or terrain, and motor vehicles also got stuck in mud. Railways were often damaged by artillery and became congested, so canal barges were used, offering a slower but more comfortable journey for the wounded.

What problems of ill health arose from the trench environment in the British sector of the Western Front?

Trench life was filthy, cramped, and made worse by extreme weather. Hot summers intensified the smell of sewage and corpses, while cold winters led to flooding and frostbite - there were 6,000 cases in Dec 1914 alone. Trench foot was caused by wet conditions and tight boots, leading to swelling, gangrene, and sometimes amputation. Trench fever, spread by lice from rats, caused flu-like symptoms; delousing and disinfecting clothes were key responses. Shell shock (PTSD), caused by stress and constant bombardment, led to breakdowns. Poor understanding meant sufferers were often punished (e.g. imprisonment) rather than treated, though some were sent home to recover.

What wounds and injuries were there in the British sector of the Western Front?

Bullets caused 39% of wounds - rifles were accurate up to 500m and could pierce organs and break bones. Machine guns were used in no-man’s-land but were less common. Explosions from shells and shrapnel caused 58% of wounds, often damaging limbs and leading to over 41,000 amputations. Shrapnel carried mud and uniform fabric into wounds, leading to deadly infections like gas gangrene and tetanus. Anti-tetanus injections helped, but there was no cure for gangrene. Head injuries led to the introduction of metal Brodie helmets in 1915. Gas attacks caused fear more than deaths (under 5%), but symptoms like blindness and coughing were common; gas masks, issued from July 1915, reduced fatalities.

What did the RAMC do in the British sector of the Western Front?

Founded in 1898, the Royal Army Medical Corps (RAMC) was the branch of the army responsible for medical care. All medical officers belonged to the RAMC. Its membership increased from 9,000 in 1914 to 113,000 in 1918. The RAMC included doctors, stretcher-bearers and ambulance drivers.

What did FANY do in the British sector of the Western Front?

The First Aid Nursing Yeomanry (FANY) were a group of female volunteers who assisted the RAMC. It was the first women’s voluntary organisation to send volunteers to the Western Front. The first 6 women went in 1914 and afterwards more women volunteered to provide frontline medical support. FANY helped by driving ambulances, driving supplies to the frontline and setting up mobile bath units that could bathe up to 40 men an hour. One unit ran the Calais ambulance unit, with 22 drivers and 12 ambulances. FANY paved the way for VAD (Volunteer Aid Detachment) nurses to help medical services.

What was the system of transport in the British sector of the Western Front?

Stretcher-bearers recovered the wounded from no man’s land and trenches - 16 per battalion, working day and night, with 4-6 needed per stretcher. They took soldiers to the Regimental Aid Post (RAP) or Dressing Stations, often working in dangerous and exhausting conditions. For longer distances, horse-drawn and motor ambulances were used, especially after railway lines were damaged by shelling. Ambulance trains, first used in November 1914, sometimes had operating theatres. Canal barges were slower but more comfortable than trains. Hospital ships then took soldiers from the French coast back to Britain.

What were the stages of treatment areas in the British sector of the Western Front?

The Regimental Aid Post (RAP) was the first stop for the wounded, located just 200m from the frontline. Staffed by a Regimental Medical Officer and stretcher-bearers, it gave basic first aid. More serious cases were moved to Dressing Stations, set up by Field Ambulances (RAMC medical teams, not vehicles). There were two types: Advanced Dressing Stations (ADS) closer to the front, and Main Dressing Stations (MDS) further back. These were staffed by doctors, stretcher-bearers, and, from 1915, nurses. Next came Casualty Clearing Stations (CCS), a few miles from the front in buildings near railways. They performed surgeries and sorted patients using triage: return to duty, transfer to hospital, or palliative care. Finally, Base Hospitals near the coast gave specialist care, with X-rays and operating theatres. From there, soldiers were taken back to Britain on hospital ships.

What experiments in surgery and medicine were there in the British sector of the Western Front?

Infection was a major challenge for the RAMC, especially with diseases like gas gangrene due to poor conditions and overcrowded facilities. Three key treatments were used: wound excision (debridement) to remove infected tissue, the Carrel-Dakin method using sterilised salt solution, and amputation if other treatments failed. By 1918, 240,000 amputations had taken place. The Thomas Splint helped treat femur fractures by keeping the leg rigid, reducing bleeding and the need for amputation. X-rays were used to locate bullets and shrapnel but had limitations: they couldn’t detect fabric and often overheated. Mobile X-rays, introduced by Marie Curie, improved access to scanning near the front. Blood transfusions became common from 1915 at Base Hospitals and 1917 in CCSs. Innovations came from figures like Lawrence Bruce Robertson (syringe method), Geoffrey Keynes (portable transfusion kit), and others who developed storage solutions using sodium citrate and citrate glucose, allowing blood to be stored for up to four weeks.

What types of sources can be used for enquiries into injuries, treatment and the trenches in the British sector of the Western Front?

Army records, national newspapers, government reports, medical articles, personal accounts, photographs, hospital records, army statistics