GCSE History: Medicine in Britain and the Western Front Flashcards

Overview of the Pearson Edexcel GCSE (9–1) History Examination

The Pearson Edexcel GCSE (9–1) History examination for Paper 1, Paper Reference $1HI0/11$, focuses on the thematic study and historic environment of medicine in Britain. Specifically, it covers Option 11: "Medicine in Britain, $c1250$–present" and "The British sector of the Western Front, $1914–18$: injuries, treatment and the trenches." The examination took place on Wednesday, 15 May 2024, in the morning session, with a total duration of $1\text{ hour } 15\text{ minutes}$. The total mark available for the entire paper is $52$, which includes credits for spelling, punctuation, grammar, and the use of specialist terminology. Candidates are instructed to use black ink or ball-point pen and are provided with a dedicated Sources Booklet for Section A.

Section A: The British Sector of the Western Front ($1914–18$)

Section A addresses the historic environment of the British sector of the Western Front, focusing on injuries, treatment, and trench life. This section carries a total of $16\text{ marks}$. The first question requires a description of two features of the new techniques utilized in the treatment of wounds on the Western Front for a total of $4\text{ marks}$. This requires identifying a specific medical advancement or technique and providing descriptive detail for each.

Question 2 is divided into two parts focusing on historical enquiry using primary sources. Part (a) asks students to evaluate the usefulness of Sources A and B for an enquiry into the work of medical staff in the Casualty Clearing Stations (CCS) on the Western Front, worth $8\text{ marks}$. Evaluation must consider both the content of the sources and the historical context. Part (b) requires a follow-up plan based on Source A to further investigate CCS medical staff, worth $4\text{ marks}$. This plan must include a specific detail from Source A to follow up, a research question, the type of source to be used, and an explanation of how that source would facilitate the enquiry.

Source Analysis: Medical Staff in Casualty Clearing Stations (CCS)

Source A is an account published in $1933$ by May Tilton, a senior nurse who served at a CCS on the Western Front in $1917$. Tilton characterizes the environment as physically and emotionally taxing, noting that staff worked "night after night" amidst the "thunderous noise of raging battles." The atmosphere was physically repulsive, described as full of the "stink of blood, antiseptic and gas." Tilton details the range of duties including cleaning wounds, bandaging, and providing emotional support to the wounded. She provides a specific anecdote of a patient with a "frightfully smashed up leg that fell to bits" upon being moved, who died before morning. The danger to medical facilities is highlighted by her mention of a big shell striking near the CCS at $3:00\text{ AM}$, resulting in the deaths of $14$ gunners in the vicinity.

Source B provides an alternative perspective from a $1986$ interview with Effie Garden, who was also a nurse in a CCS in $1917$. Garden focuses on the technical and organizational aspects of CCS work. She describes a team-based approach where each team managed two treatment tables simultaneously. This allowed for continuous workflow: while one patient was bandaged, the next received anaesthetic. During active battles, shifts were extreme, running from $1:00\text{ AM}$ to $5:00\text{ PM}$, though hours were shorter during lulls. Garden notes that while their specific CCS was designated for head injuries, they treated diverse wounds. Significantly, she mentions being tasked with using a scalpel to remove small pieces of shrapnel and clean minor wounds, a responsibility delegated to nurses to allow surgeons more time for critical, life-threatening cases.

Section B: Medicine in Britain, $c1250$–Present

Section B covers the broad thematic study of British medicine and carries a total of $36\text{ marks}$. Question 3 requires an explanation of one way the treatment of infectious diseases differed between the medieval period ($c1250\text{--}c1500$) and the modern period ($c1900\text{--}\text{present}$), worth $4\text{ marks}$. Question 4 is a deeper causal explanation, worth $12\text{ marks}$, asking why there was little change in English medicine during the medieval period ($c1250\text{--}c1500$). Candidates are encouraged to discuss the influence of Galen and the role of monastery hospitals, alongside their own knowledge.

For the final portion of Section B, candidates must choose between Question 5 and Question 6. Both questions are worth $16\text{ marks}$ for the content and an additional $4\text{ marks}$ for spelling, punctuation, grammar, and specialist terminology, totaling $20\text{ marks}$ for the chosen question. Question 5 asks for a judgment on the extent of progress in medical knowledge during the Renaissance period ($c1500\text{--}c1700$), suggesting the inclusion of William Harvey and the Great Plague ($1665$). Question 6 asks for an evaluation of whether individual roles were the most important factor in preventing illness from $c1700$ to the present day, suggesting the use of Edward Jenner and modern anti-smoking campaigns as evidence.

Institutional and Individual Factors in Medical History

The examination prompts highlights several key figures and institutions that shaped British medical history. In the medieval era, the stability of medical practice was maintained by the dominance of the physician Galen and the care provided by monastery hospitals. The Renaissance period is marked by potential progress in knowledge, exemplified by the anatomical and physiological discoveries of William Harvey, contrasted by the challenges of major health crises like the Great Plague of $1665$. Moving into the modern era, the focus shifts toward prevention, catalyzed by individuals like Edward Jenner, whose work on the smallpox vaccine laid the foundation for immunology, and institutional efforts such as public health anti-smoking campaigns targeted at lifestyle-related illnesses. The exam structure emphasizes the transition from superstitious or early anatomical theories to empirical, individual-driven, and state-sponsored medical interventions.