How to do Question 1c on Medicine Paper One?

1. How to do Question 1c on Medicine Paper One? Year 11 Revision

2. WHY DO A REVISION SESSION ON JUST ONE QUESTION? • Because this question regularly catches students out, no matter what grade they are working towards. • It is worth 12 Marks – 30% of the whole exam – not the highest scoring question, but still a significant proportion of Medicine Paper 1 (15% of Paper 1 – Germany & Medicine). • Doing well or badly on this question could be all the difference between the grade you want and the grade you get!

3. What is this question all about? (PAST QUESTIONS) • Study Source 13 and use your own knowledge. What impact did the National Health Service have on public health care in the middle of the twentieth century? Explain your answer, using the source and your knowledge. • Study Sources E and F and use your own knowledge. Do you think the more important changes in public health provision happened in the nineteenth century or in the twentieth century? Use these two sources and your own knowledge of change in both centuries to explain your choice. • Study Source G and use your own knowledge. ‘Individuals were not as important as research teams for progress in the prevention and treatment of diseases in the twentieth century.’ Do you agree? Use the source and your own knowledge to explain your answer. • Study sources F & G. How did the role of government in improving the health of the nation in Britain change in the period c.1850-c.1950? Use these sources and your own knowledge to explain your answer.

4. What is this question all about? • It is about understanding the IMPACT (EFFECT AND SIGNIFICANCE) of particular events, people or factors in the history of medicine. OR • HOW CHANGE HAPPENED in a particular field of the history of medicine (e.g. public health; development of modern drug treatments). • You will always be given at least one source to include in your answer – this must be clearly referred to in your answer along with your own knowledge. • In both of the above cases you have to be able to understand the ‘BIG PICTURE’, putting what happened in its context. To do this you must: • Know the content of the course in detail (dates, names and events). • Be able to link these details together in detailed explanations. THIS IS NOT EASY TO DO – THAT IS WHY SO MANY STUDENTS GET CAUGHT OUT BY THIS QUESTION.

5. Role of GOVERNMENT in medicine c.1850 – c.1950? Broad Street Pump Case (Local Government), 1854 1848 and 1875Public Health Acts Bazalgette’s construction of London’s sewers (1865) ‘The Liberal Reforms’ (1902-11) NHS (1948) Clean Air Act (1953) Some examples to get us started: What kind of evidence should you use for these topics?

6. Role of WAR in development of medicine c.1500 – c.1950? Paré’s discovery of a replacement to cauterisation - French Army in Italy (1536) Napoleon had French Army vaccinated to keep them healthy (1800-1815) Franco-Prussian War (1870-71) - encouraged productive rivalry of Pasteur and Koch Boer War (1898-1902) highlighted poor health of British nation World War One - inspired Fleming’s work World War Two – created urgent demand for penicillin; led to foundation of NHS Some examples to get us started: What kind of evidence should you use for these topics?

7. Improvements in PUBLIC HEALTH Health in the 20th Century? ‘The Liberal Reforms’ (1902-11) Council housing and slum clearance in 1920s and 30s NHS (1948) Clean Air Act (1953) Some examples to get us started: What kind of evidence should you use for these topics?

8. Importance of new TECHNOLOGY in medicine in the 19th Century? Improvements to microscopes in first half of 19th Century – made Pasteur & Koch’s work possible. Steam engines (industrial revolution) used in pumping stations of new water supply systems from 1860s onwards Lister’s Carbolic Spray Pump (1867) – antiseptic surgery Use of X-Ray machines (1895) Some examples to get us started: What kind of evidence should you use for these topics?

9. How should you organise your answer? • Make a STATEMENT at the start which declares what you think the importance of the factor is OR what happened in this period. • Then present the EVIDENCE that backs this up (including the source/s you have been given), EXPLAINING why particular factors, events or individuals are more important than others. (You may have to explain why other important changes are still of less significance than the one you are arguing.) • Try to discuss points in their chronological order – it simply makes the story easier to follow. Give no more than 3 examples, thoroughly explained.

10. Study Source D. Why did Jenner’s discovery of vaccination against smallpox have so little impact on the treatment of other infectious diseases in the 19th Century? Use the source and your own knowledge to explain your answer. Source D: Letter to Jenner for Thomas Jefferson, President of the USA (1802) Medicine has never before produced any single improvement of such utility. You have erased from the calendar of human afflictions one of the greatest. Mankind can never forget that you have lived. Future generations will know by history only that the loathsome smallpox has existed, and by you has been *extirpated. *extirpated = completely destroyed Past Question

11. MARK SCHEME • LEVEL 1 (1-4)Simple statement from source or own knowledge. • LEVEL 2 (5-8)Developed statement supported by sources and relevant own knowledge. • LEVEL 3 (9-12)Reasoned judgement supported by appropriately selected information. • Use of Source D in the answer: Jenner’s great achievement was discovering a safe way to protect people against a widespread killer disease. He could not explain why vaccination worked and knew nothing about germs. Pasteur and Koch’s work on ‘vaccines’ would only widen the number of diseases for which there were safe immunisation procedures from the 1880s onwards. Many doctors, unlike President Jefferson, were reluctant to accept Jenner’s methods and preferred instead to stick to methods they already used such as innoculation.