Paper 1 - Medicine Through Time Flashcards
What percentage of soldiers’ time was spent in the front line?
15%
What percentage of soldiers’ time was spent in the support trench?
10%
What percentage of soldiers’ time was spent in the reserve line?
30%
What percentage of soldiers’ time was spent away from the trenches?
45%
How far from the firing line was the command trench?
10-20 metres
How far from the firing line was the support line?
200-500 metres
What was the purpose of communication trenches?
They linked the firing line with the command support and reserve trench.
What was the purpose of the reserve line troops?
They could mount a counter attack if the enemy attacked the front line.
What was the purpose of the parados?
Parapet, but behind the trench - designed to stop bullets carrying on to the next line of trenches and shield men from the blast of a shell exploding behind them.
What was the purpose of rivetting?
The sides of the trench were supported with wood, netting, or corrugated iron to stop them caving in during bad weather or enemy shelling.
What was the purpose of the fire step?
A platform in the side of the trench that allowed men to fire weapons from the trench, as trenches were deep enough that a man could stand upright in it and not be seen. Soldiers slept, sat, and ate on them during a lull in the fighting.
What was the purpose of the parapet?
Earth on top of the trench to allow men to fire from the trench with a rest for his elbows and protection from incoming fire. They were 4-5 feet thick.
What was the purpose of sandbags?
To support the trenches.
What were dug-outs?
Holes boarded with wood, usually reserved for officer accommodation.
What were fortifications?
Trenches were built up over time, especially when soldieries realised the war was going to be long. Used rows of barbed wire.
How long was the Western Front?
400 miles long - stretching from the coast of Belgium, through France and ending near Switzerland (neutral)
When could soldiers attack and why?
Early morning.
Couldn’t during day - too light.
Couldn’t during night - enemy sent up flares, so too light.
What did soldiers do at night?
They were sent to crawl across No-Man’s Land with wire cutters to cut the barbed wire.
How did the terrain on the Western Front impact help for the wounded?
Wounded had to be collected at night or during fire.
Deep mud made movement difficult and dangerous and shell craters were huge and filled with water making transportation hazardous.
Trench system could be very busy and manoeuvring stretchers around corners under fire was difficult.
Many men were wounded at once, slowing everyone down.
How were rifles important in WW1?
Lee Enfield was the standard issue British rifle in WW1.
Could create automatic rapid fire.
Bullets were designed to be more pointed, to inflict deeper wounds.
Had the power to break major bones and pierce vital organs.
Caused major blood loss.
How were machine guns important in WW1?
Could fire up to 600 bullets per minute.
Very heavy, manned by up to 3 men.
Defensive weapon.
Trenches protected soldiers manning machine guns.
Had power to break major bones and pierce vital organs.
How was artillery important in WW1?
Had a range of up to 12 miles.
Big heavy guns which fired large shells designed to cause maximum damage to enemy fortifications.
Resulted in up to 60% of deaths.
Caused psychological damage - ‘shellshock’.
Removed limbs or inflicted major internal damage to the body and head, often causing rapid blood loss.
How was shrapnel important in WW1?
Designed to explode in mid-air.
Flies in all direction.
Caused major blood loss.
How were tanks important in WW1?
Made its debut during the Battle of the Somme.
First tanks were mechanically unreliable and kept breaking down.
How were grenades important in WW1?
Standard issue.
Lots of them.
Why were the new, technologically advanced weapons so significant in WW1?
The tactics used weren’t new, and had been used before with less powerful weapons, resulting in very high casualties.
What percentage of wounds was caused by bayonet wounds, hand grenades, and pistols?
5%
What was the survival rate of soldiers who suffered gunshot wounds to the leg in the early stages of the war and why?
20%
Due to blood loss and the impact of the shock of the wound on the body.
How many men had limbs amputated?
Over 41,000.
What was ‘blast impact’ from bullets, shrapnel and shells?
These objects first hit bones, muscles, or organs but set off a blast effect which destroyed or damaged tissue or even bone for inches around the initial impact.
When and why were steel helmets introduced in WW1?
Summer 1916 due to the amount of head injuries.
How many soldiers suffered wounds to the head and eyes?
Over 60,000.
Why were infections so common in WW1?
Most trenches were on farmland, which farmers spread with manure, containing lots of bacteria, which then got into injuries.
What was gas gangrene and how was it identified?
An infection under the surface of the skin. Nurses noticed it due to the smell and the wound would start to bubble up as the infection would produce gas. It turned white then green, and made a squelching noise when pressed. This then caused blood poisoning (septicaemia).
What was the death rate of mustard gas?
2.6%
When was chlorine gas first used?
22nd April 1915 at second battle of Ypres by the Germans. 5,000 French soldiers died.
What was the first type of gas mask?
A piece of cloth that soldiers urinated on, as urine contains ammonia, which neutralises the gas.
Why was gas in WW1 important?
Good way to reduce enemy’s morale.
Big psychological impact due to the suffering it caused.
What did mustard gas do?
Blistered skin and caused temporary blindness. Contaminated clothes which could be spread and passed on, causing more deaths than chlorine gas and disrupting hospitals.
What did chlorine gas do?
Choked and suffocated.
What colour was chlorine gas?
Green (mainly)
How many casualties and deaths were caused by chlorine, phosgene, and mustard gas?
1.3 million casualties and 90,000 deaths.
Describe the evacuation route.
- Stretcher bearers - carried bandages and morphine, 16 per battalion of up to 1,000 soldiers, took 4 men to carry a stretcher (sometimes 6-8 in thick mud).
- Regimental Aid Post - close to the firing line, distinguished between lightly wounded and those needing urgent medical attention, 1 medical officer and up to 30 orderlies.
- Field Ambulance/Dressing Station - large, mobile unit with medical officers, support staff and from 1915, some nurses, sorted people through triage (serious attention, minor attention, going to die regardless), between a quarter of a mile to a mile away from the front line.
- Casualty Clearing Station - 7-12 miles away from fighting, around 7 doctors with nursing staff, by 1917 were performing more operations than hospitals, contained operating theatres, mobile X-ray machines etc, could deal with 1,000 casualties at a time.
- Base Hospitals - for those most likely to survive, in large converted buildings near railways, many people arrived by rain, barge along canals or ambulance, by 1918 some could have up to 2,500 patients, had operating theatres, X-ray departments, most patients sent back to England via train.
What were symptoms of trench fever?
Severe headaches
Shivering
Eye pain
Joint pain
Rashes
How was trench fever spread?
Lice
How did soldiers try to deal with trench fever?
Disinfecting clothes/bedding
Using bathhouses
Louse repellent gel
Picking lice off clothing
What caused trench foot?
Standing in waterlogged trenches for long periods of time left men’s feet numb, swollen, blistered and turning blue. Tight boots restricted blood flow which added to the problem.
Why was trench foot a serious problem?
If it developed and deteriorated, it could lead to gangrene, which often had to be treated with amputation.
How did soldiers try to deal with trench foot?
Every man had to have 3 pairs of socks and change them twice a day, and rub whale oil into their feet for protection.
Tried to drain trenches using mechanical pumps.
High rubber waders were issued to wear in the worst conditions, and men were split into pairs to look after each other’s feet.
What was shellshock known as during WW1 and why?
NYD.N (Not Yet Diagnosed. Nervous)
The armies didn’t fully understand it, as they didn’t know how to treat it.
Officers didn’t want other soldiers thinking they could mimic the signs of shellshock, in order to be sent home, so they didn’t give it a name or acknowledge it.
What percentage of WW1 deaths were caused by artillery?
60%
What organisation were male doctors part of?
Royal Army Medical Corps (RAMC)
Had little pre-war training.
Which organisations were women part of in WW1?
First Aid Nursing Yeomanry (FANY)
Women were only involved due to the high number of casualties.
Volunteer Aid Detachment (VAD)
Usually richer women, didn’t get paid said it was ‘their duty’.
How many people per day were recovered by stretcher bearers?
12 people per day
What was the Carrel-Dakin Method and what did it treat?
Treated infection and gas gangrene.
Was a system of tubes, keeping a chemical solution flowing through the wound and fought infection/stopped it from developing.
What were some benefits to the Carrel-Dakin Method?
Effective at treating infections.
Continuous, not a one-off treatment.
Reduced the number of amputations that resulted from infection.
What was extensive surgery and what did it treat in WW1?
Treated infection.
From 1915 onwards.
Made sure all shell/bullet fragments/shrapnel were removed.
Cut out all tissue/dead muscle surrounding the would that might become infected.
Didn’t sew up wounds immediately, kept open for use of antibiotics.
What were some benefits to extensive surgery in WW1?
Reduced chances of gas gangrene and tetanus.
What was plastic surgery and what did it treat?
Used to solve problems created by so many terrible wounds caused by bullet and shell damage, especially to the face.
Skin grafts took skin from one part of the patient’s body and grafted it onto the area of the wound, developed by Harold Gillies.
Special hospitals were built for plastic surgery.
How many plastic surgery operations were carried out during WW1?
Over 11,000
What were some benefits to plastic surgery in WW1?
Helped people’s face injuries.
What was the Thomas Splint and what did it treat in WW1?
A splint to help fractured bones heal.
Early in the war, soldiers who had their femur broken by gunfire died in huge numbers.
All regimental officers were taught how to use it, so it was used as near to the front line as possible, in RAPs and Dressing Stations. This meant that when soldiers reached CCSs, they were fit enough to be operated on as they hadn’t lost too much blood, saving their lives.
What were some benefits to the Thomas Splint in WW1?
Pulled the leg lengthways, stopping the bones grinding on each other, so it greatly reduced blood loss.
The Thomas Splint reduced the death rate from this type of wound from 80% to 20%.
What were mobile X-ray machines and what did it treat?
Many casualties were caused by bullets, shrapnel, and tiny fragments of these objects. X-rays made rapid location of these objects possible, enabling surgeons to remove them more easily and completely, reducing chances of infection.
By early 1916, most CCSs and hospitals had X-ray equipment with additional X-ray lorries attached to groups of CCSs.
What were some benefits to mobile X-ray machines in WW1?
Reduced the death rate from infections.
What were blood transfusions and blood storage and what did they treat?
The impact of high explosives and machine gun bullets led to many men dying from blood loss, when the wounds themselves need not have been fatal.
Richard Lewisohn (American) discovered that sodium citrate could be added to blood to prevent it from clotting.
Scientists discovered blood could be stored in refrigerated conditions, and adding a citrate glucose solution allowed it to be stored for several days.
Geoffrey Keynes (British) created a portable machine for storing blood.
When were blood groups discovered?
1901
What were some benefits to blood transfusions and blood storage?
Increased number of transfusions.
First blood depot created before Battle of Cambrai 1917.
Stocks of blood group O were collected and held ready for use as soon as Battle of Cambrai began.
Group O was chosen as it can be given to anyone safely, even if they’re a different blood group.
When was the first blood depot created?
Before the Battle of Cambrai, 1917.
When was the Battle of the Somme?
July-November 1916
How many people died on the first day of the Battle of the Somme?
60,000
How many people died during the Battle of the Somme?
400,000 Allied
450,000 German
How much territory did the British gain during the Battle of the Somme?
Just 5 miles.
When was the Battle of Arras?
April 1917
What did British forces do during the Battle of Arras?
British burrowed tunnels underground, creating accommodation for the soldiers, and a hospital large enough for 700 beds and operating theatres. Tunnels were also used as shelters against artillery fire.
When was the Battle of Cambrai?
October 1917
What happened during the Battle of Cambrai?
British army used over 450 tanks to attack German trenches for the first time. They were very effective for attacking across No-Man’s Land but also further destroyed land, making the transportation of injured men difficult. After initial success, the British were forced back, and there were 40,000 British casualties.
When was the Battle of Verdun?
February-December 1916
How many French soldiers were killed during the Battle of Verdun?
160,000
When was the First Battle of Ypres?
October-November 1914
When was the Second Battle of Ypres?
April-May 1915
When was the Third Battle of Ypres?
July-November 1917
What happened during the First Battle of Ypres?
British troops stopped the German army from capturing ports, like Calais, meaning reinforcements and equipment could keep arriving by ship for the British army.
What happened during the Second Battle of Ypres?
Chlorine gas was used for the first time, by the Germans, but they failed to capture Ypres. Allied casualties are estimated at 60,000, and German at 35,000.
What happened during the Third Battle of Ypres?
British and Allied troops launched a major attack to stop the German army breaking through weakened French defences, and aimed to capture Passchendaele ridge near Ypres, but German defences were strong and the ground turned to mud due to heavy, consistent rain. The ridge was captured, but there were 245,000 casualties.
When did the US join WW1?
6th April 1917
What happened during the 1918 German Spring Offensive?
German army launched a major attack along a 50-mile front, aiming to end the war before US forces arrived, and Germany ran out of food supplies. At first, it was successful, forcing British and Allied troops to retreat, causing 200,000 British casualties. However, the German army couldn’t make a complete breakthrough.
What were the 4 humours?
Black bile
Yellow bile
Blood
Phlegm
What did Hippocrates do?
Created the theory of 4 humours.
What did Galen do?
Built upon Hippocrates’ work.
Wrote over 350 books proving his 4 Humours theory.
Made new discoveries about the anatomy of the body.
Believed it was important to dissect dead bodies (but Church forbid this at the time).
Dissected animals, which have different anatomies to humans, so many of his findings were incorrect.
What was the Theory of Opposites?
People get sick when their humours are unbalanced. Patients should be treated in a way that restores their humours. They should be bled if they have too much blood or made to vomit if they have too much yellow bile.
What was the Theory of 4 Humours?
The body contains four humours (blood, phlegm, black bile, yellow bile) and when you’re healthy, the humours are balanced, and when your humours are unbalanced, you become unwell.
What did Galen and Hippocrates recommend to keep the 4 humours balanced?
Exercise and a good diet.
Why was the Theory of 4 Humours so popular?
It was supported by the Church - doctors didn’t dare search for/start using alternative ideas because it was heresy to go against the Church, and you could be punished.
It seemed to make sense - when a patient was sick, they often saw one of the 4 humours, and sometimes treatments worked, so it seemed rational.
Hippocrates and Galen have good advice - they told doctors to observe patients and write down symptoms, which was reassuring.
How did doctors diagnose patients in the medieval period (1250-1500)?
Charts
Star signs
Theory of Opposites
