Fill in the gaps… ………….was a very real problem especially over the winter of 1914-15. Standing in cold mud and water in tight army boots caused the foot to swell. The skin also began to shrivel and in the worst cases, to rot and to die! The British Army went to war wearing …………… and there were a lot of head injuries. As a result, steel helmets were introduced in late …………. Interestingly, this led to an increase in the number of head injuries recorded (16% of all wounds) because more men survived their head wounds because they were now wearing a helmet! Wounds to the ……………………..were the most common injuries, making up 67% of all wounds. These were caused by exploding shells. The wounds were a result of shrapnel or shell fragments and in the worst cases would lead to ……………. Less than 12% of all recorded wounds were to the chest, stomach or back. This is because ………………………………………………… Special ……… ......... Stations were set up close to the front to deal with these dangerous wounds. …………. affected all soldiers in the trenches. The lived in the seams of the men’s clothes and were almost impossible to remove. As well as being irritating, they could also cause trench fever, which had flu-like symptoms.

Trench Foot was a very real problem especially over the winter of 1914-15. Standing in cold mud and water in tight army boots caused the foot to swell. The skin also began to shrivel and in the worst cases, to rot and to die! The British Army went to war wearing soft caps and there were a lot of head injuries. As a result, steel helmets were introduced in late 1915. Interestingly, this led to an increase in the number of head injuries recorded (16% of all wounds) because more men survived their head wounds because they were now wearing a helmet! Wounds to the arms and legs were the most common injuries, making up 67% of all wounds. These were caused by exploding shells. The wounds were a result of shrapnel or shell fragments and in the worst cases would lead to amputation. Less than 12% of all recorded wounds were to the chest, stomach or back. This is because soldiers who were wounded in this area died before reaching medical care. Special Casualty Clearing Stations were set up close to the front to deal with these dangerous wounds. Lice affected all soldiers in the trenches. The lived in the seams of the men’s clothes and were almost impossible to remove. As well as being irritating, they could also cause trench fever, which had flu-like symptoms.

Medicine Through Time and The Western Front

1st Feature. Description. 2nd Feature. Question 1: Describe two features of the support trench system on the Western Front. (4 marks) 1st Feature. Description. 2nd Feature. The support trenches were 3-4 hundred yards behind the front line. They provided additional supplies and men in case of attack. Support trenches were safer than the front line. Support trenches were rarely targeted by enemy snipers and were less likely to have been hit by artillery.

Q1: Describe TWO features of… The trench system Stretcher bearers Ambulances Trench foot Gas attacks FANY Casualty Clearing Stations Mobile X –Ray Units Base Hospitals The underground hospital at Arras The Thomas Splint Blood transfusions The blood bank at Cambrai Plastic surgery Dressing Stations RAMC

Question 2 (a) How useful are Sources A and B for an enquiry into the problems involved in performing operations on the Western Front? Explain your answer, using Sources A and B and your knowledge of the historical context. (8 marks) Judgement: Content of both sources supported by RAD own knowledge: Provenance of both sources supported by own RAD own knowledge: Sources A and B are both very useful for an enquiry into the problems of performing surgery on the Western Front. Source B is slightly more useful due to its provenance. The content of Source A is useful in the way it suggests there were problems because of the high number of casualties and limited number of medical staff. This is shown is the source where is says “there were not enough nurses to treat the men”. Source A is about a casualty clearing station, where the wounded were taken and most surgery was done; there would be a lot of pressure on the medical staff so the source seems to reflect the situation accurately. The content of Source B is also useful because it suggests many injuries were severe since men were already dying when they were brought into the ward, bloodless is shown to be a major problem as the source says “there was blood everywhere”. Blood banks were set up for the Battle of Cambrai, 1917, showing how the army tried to anticipate the need for transfusions and improve patients’ chances of survival. This supports the idea that blood loss was a big issue. The provenance of both sources makes them useful for this enquiry. The chaplain writing Source A was a religious man rather than medical staff; we don’t know how much experience he had of such conditions and he might have been particularly sensitive to suffering and death, which could affect the reliability of his account about the extent of suffering and therefore the usefulness of the information. Robertson, writing Source B, was a surgeon and therefore can be seen as an ’expert witness’ which gives added weight to the information in Source B about the problems faced by surgeons. Therefore, Sources A and B are both very useful for an enquiry into the problems of performing surgery on the Western Front due to their content. Source B is slightly more useful due to its provenance- it is written by a surgeon who would know in detail the problems of surgery on the Western Front.

Question 2 (a) How useful are Sources A and B for an enquiry into the problems involved in performing operations on the Western Front? Explain your answer, using Sources A and B and your knowledge of the historical context. (8 marks) Judgement: Content of both sources supported by RAD own knowledge: Provenance of both sources supported by own RAD own knowledge: Sources A and B are both very useful for an enquiry into the problems of performing surgery on the Western Front. Source B is slightly more useful due to its provenance. The content of Source A is useful in the way it suggests there were problems because of the high number of casualties and limited number of medical staff. This is shown is the source where is says “there were not enough nurses to treat the men”. Source A is about a casualty clearing station, where the wounded were taken and most surgery was done; there would be a lot of pressure on the medical staff so the source seems to reflect the situation accurately. The content of Source B is also useful because it suggests many injuries were severe since men were already dying when they were brought into the ward, bloodless is shown to be a major problem as the source says “there was blood everywhere”. Blood banks were set up for the Battle of Cambrai, 1917, showing how the army tried to anticipate the need for transfusions and improve patients’ chances of survival. This supports the idea that blood loss was a big issue. The provenance of both sources makes them useful for this enquiry. The chaplain writing Source A was a religious man rather than medical staff; we don’t know how much experience he had of such conditions and he might have been particularly sensitive to suffering and death, which could affect the reliability of his account about the extent of suffering and therefore the usefulness of the information. Robertson, writing Source B, was a surgeon and therefore can be seen as an ’expert witness’ which gives added weight to the information in Source B about the problems faced by surgeons. Therefore, Sources A and B are both very useful for an enquiry into the problems of performing surgery on the Western Front due to their content. Source B is slightly more useful due to its provenance- it is written by a surgeon who would know in detail the problems of surgery on the Western Front.

“I could only transfuse an occasional patient.” Qu 2b) How could you follow up Source B to find out more about the problems involved in performing operations on the Western Front? In your answer, you must give the question you would ask and the type of source you could use. (4 marks) Pick a quotation from the source that you could ask a good historical question about. Ask a valid historical question. Select a source that would contain useful information for a historian studying this question. BE SPECIFIC…where/when would the source need to come from to be useful? Explain how that source would help you answer the question. “I could only transfuse an occasional patient.” Why were blood transfusions such a problem on the Western Front? Army medical records about how blood was stored and transported to the hospitals. This would help me to see if the problem was about the actual transfusion process or about the quantity of blood available.

Medicine Question 2b) – Practice Question for you to try… Source A: From the writings of Henry Buckle, a soldier on the Western Front. He wrote a diary while he was in the trenches and typed it up after the war. Here he describes his situation after being injured in 1915. I am lying in the barn with a damaged leg, the result of being too near a bursting shell. My leg is not bleeding but it got sort of buried in the trench and twisted up. My sergeant was also injured. Our stretcher people were busy so I told them we could manage to get back by ourselves. It took us all night to get back here to the barn, with lots of sit-downs. The RAMC staff keep coming in but don’t seem able to mend me up. The Medical Officer has been in and says I shall have to go to a Field Hospital for a week. How could you follow up Source A to find out more about the system for dealing with injured soldiers on the Western Front? In your answer, you must give the question you would ask and the type of source you could use. Complete the table below. Detail in Source A that I would follow up: Question I would ask: What type of source I could use: How might this help answer my question:

Medicine through time and Western Front 2(b) Study Source A How could you follow up Source A to find out more about the system for dealing with injured soldiers on the Western Front? In your answer, you must give the question you would ask and the type of source you could use. Complete the table below. Detail in Source A that I would follow up: “The RAMC staff keep coming in, but don’t seem to be able to mend me up.” Direct Quotation from the source. Question I would ask: How quickly were injured soldiers treated after a major injury? Question linked to the quote. What type of source I could use: Army Medical records, from a dressing station. Specific…WHERE are the medical record from? How might this help answer my question: Army Medical (RAMC) records from a dressing station would give the date and time of treatment. This would give details of how men were treated, how bad their injuries were and how long they had to wait. Explain linking to the question you asked and the type of source you selected.

Pain, infection, blood loss. Topic 1: Surgery in the 20th Century What were the 3 barriers to effective surgery in the 18th and 19th centuries? Pain, infection, blood loss. Name 2 early forms of anesthetic. Alcohol, ether, chloroform. What is the difference between aseptic and antiseptic? Without germs vs killing germs When did Joseph Lister first use Carbolic Acid Spray to prevent infection in surgery? 1865 When were x-rays first used? Wilhelm Roentgen discovered them in 1895, first radiotherapy departments, 1896. Give 3 problems with early x-rays. Harmful exposure to x-rays, glass parts were fragile, 90 minutes to take 1 image, large and bulky machines. When was the first blood transfusion? James Blundell, 1818. When were blood groups discovered? Karl Landsteiner, 1901. When was it discovered that adding sodium citrate to blood stopped it clotting? Richard Lewisohn, 1915 Who discovered that a citrate glucose solution allowed blood to be stored for weeks at a time? Rous and Turner, 1916.

What were the start and end dates of The First World War? . 1914-1918. Topic 2: The geography and environment of the Western Front Topic 3: The timeline and tactics of the First World War What were the start and end dates of The First World War? . 1914-1918. After which battle did the two sides reach stale-mate and trench warfare begin? The Battle of the Marne. What pattern were the trenches dug in? zig-zag i. How far behind the front line trenches were the support trenches? ii. And reserve trenches? 80 metres 100 meters What was no-mans-land? Unclaimed land between allied and enemy frontline trenches. Soldiers wore a ……helmet. Brodie. What is a salient? Military term for fighting position that juts out into enemy territory. When was the First Battle of Ypres? Oct-Nov 1914. What was Hill 60 and how did the British reclaim it from the Germans in April 1915? Man-made hill near Ypres- reclaimed using tunnels and mines. When was the Second Battle of Ypres? April-May 1915. When was the Battle of the Somme? July –Nov 1916. How many British casualties were there after day 1 of The Somme? Over 57,000 Which weapon and tactic were used for the firs time at The Somme? Creeping barrage and tanks. The natural chalky soil of…..was ideal for building ……. In the quarries and caves. Arras. Tunnels. When was the Battle of Arras? April-May 1917. What was the other name for the Third Battle of Ypres, July 1917? Passchendaele. What was the major environmental obstacle in this battle? Liquid mud. The Battle of Cambrai, October 1917 was the first large scale use of which new technology? Tanks.

Stretch Bearers; RAP, ADS and MDS, CCS then Base Hospital. Topic 4: Medical problems and solutions on the Western Front Put the Chain of Evacuation in the correct order: Regimental Aid Post (RAP); Stretcher Bearers; Base Hospital; Advanced Dressing Stations (ADS) and Main Dressing Stations (MDS); Casualty Clearing Stations (CCS) Stretch Bearers; RAP, ADS and MDS, CCS then Base Hospital. Name 3 medical vehicles used on the Western Front. Horse-drawn and motor ambulances. Train, barge and ship ambulances. Name the 3 main types of gas used in attacks. Chlorine, Phosgene and Mustard gas What does RAMC stand for? Royal Army Medical Corps What does FANY stand for? First Aid Nursing Yeomanry What is shrapnel? Pieces of exploded shell or bullet which cause injury and infection What was shell shock? Mental illness induced by the trauma of mechanised warfare What caused Trench Fever? Lice What is gangrene? Rotting flesh from infection What was the other name for the underground hospital as Arras? Thompson’s Cave What is wound excision or debridement Cutting away infected skin before stitching up a wound. Carrel-Dakin method used a …….solution placed in the wound through a tube to treat gas gangrene. Salt solution- Carbolic solution did not work on gas gangrene What was the Thomas Splint? Splint to keep leg fractures from gunshot wounds straight. Which type of blood group is universal? O Where was the first ‘blood bank’ used on the Western Front? Cambrai- Battle of Cambrai in 1917. Who developed new brain surgery methods? Harvey Cushing What was Harold Gillies a pioneer in? Plastic Surgery

Breath deeply. Timing= roughly 1 mark in one minute. E. g Breath deeply. Timing= roughly 1 mark in one minute. E.g. 4 mark question = 5 minutes of writing. Read the questions carefully, twice. Answer the question they ask you! Highlight important parts of the questions. Make a quick plan for 16 mark questions. Include as much Relevant, Accurate and Detailed Knowledge as you can. Check back over your work in the last few minutes of the exam. Be positive and have faith in yourself! You’ve got this!

Topic 1: Surgery in the 20th Century What were the 3 barriers to effective surgery in the 18th and 19th centuries? Name 2 early forms of anesthetic. What is the difference between aseptic and antiseptic? When did Joseph Lister first use Carbolic Acid Spray to prevent infection in surgery? When were x-rays first used? Give 3 problems with early x-rays. When was the first blood transfusion? When were blood groups discovered? When was it discovered that adding sodium citrate to blood stopped it clotting? Who discovered that a citrate glucose solution allowed blood to be stored for weeks at a time?

Topic 2: The geography and environment of the Western Front Topic 3: The timeline and tactics of the First World War What were the start and end dates of The First World War? . After which battle did the two sides reach stale-mate and trench warfare begin? What pattern were the trenches dug in? i. How far behind the front line trenches were the support trenches? ii. And reserve trenches? What was no-mans-land? Soldiers wore a ……helmet. What is a salient? When was the First Battle of Ypres? What was Hill 60 and how did the British reclaim it from the Germans in April 1915? When was the Second Battle of Ypres? When was the Battle of the Somme? How many British casualties were there after day 1 of The Somme? Which weapon and tactic were used for the firs time at The Somme? The natural chalky soil of…..was ideal for building ……. In the quarries and caves. When was the Battle of Arras? What was the other name for the Third Battle of Ypres, July 1917? What was the major environmental obstacle in this battle? The Battle of Cambrai, October 1917 was the first large scale use of which new technology?

Topic 4: Medical problems and solutions on the Western Front Put the Chain of Evacuation in the correct order: Regimental Aid Post (RAP); Stretcher Bearers; Base Hospital; Advanced Dressing Stations (ADS) and Main Dressing Stations (MDS); Casualty Clearing Stations (CCS) Name 3 medical vehicles used on the Western Front. Name the 3 main types of gas used in attacks. What does RAMC stand for? What does FANY stand for? What is shrapnel? What was shell shock? What caused Trench Fever? What is gangrene? What was the other name for the underground hospital as Arras? What is wound excision or debridement Carrel-Dakin method used a …….solution placed in the wound through a tube to treat gas gangrene. What was the Thomas Splint? Which type of blood group is universal? Where was the first ‘blood bank’ used on the Western Front? Who developed new brain surgery methods? What was Harold Gillies a pioneer in?

Resources

Relevant, Accurate, Detailed Contextual Knowledge Provenance/NOPA: Nature, Origin, Purpose, Audience. Content: quotations/what can you see?

Relevant, Accurate, Detailed Contextual Knowledge Provenance/NOPA: Nature, Origin, Purpose, Audience. Content: quotations/what can you see?

Relevant, Accurate, Detailed Contextual Knowledge Provenance/NOPA: Nature, Origin, Purpose, Audience. Content: quotations/what can you see? The FANY with the ambulances in Calais, January 1917

Relevant, Accurate, Detailed Contextual Knowledge Provenance/NOPA: Nature, Origin, Purpose, Audience. Content: quotations/what can you see?