| What is the usefulness of a source based on? | The usefulness of a source may be based on
- the content of the source - what does it tell you?
- provenance (the nature, origin and purpose) of the source
- the context of the source - how it fits into what you already know
- and in finding the context you may comment on the accuracy, selectiveness or typicality of the source |
| What measures were taken in surgery to ensure it was antiseptic? | Measured take to ensure antiseptic surgery:
- all medical staff had to wash their hands, faces and arms before entering the operating theatre
- rubber gloves and gowns were worn which decreased the 1890’s rate of infection in wounds
- the air was sterilised as it was pumped over a heating system to kill germs - a method developed from German surgeons in 1880/1890
- the use of steam sterilisation was expelled through an autoclave invented in 1881, which sterilised surgical instruments in boiling steam |
| Who developed the first x ray and when did they develop it | Wilhelm Roentgen a German physicist accidentally developed the first x ray in 1895 |
| How did Wilhelm Roentgen develop the x ray? | The developed meant of x-rays was completely accidental, Roentgen was studying the effects of passing an electrical current through a glass tube covered in black paper. When he noticed that although everything in the room was dark, a screen about a meter from the equipment stared glowing, and he called the rays that could pass through glass ‘x’, which developed to x-rays |
| How quick were the effects of the x ray? | As the importance of using x-rays was understood immediately the effects were also quickly put in motion |
| What’s an example of the immediate effect of the x-ray? | Dr John Hall-Edwards was one of the first doctors to make diagnosis based on information from an X-ray; at Birmingham General hospital, when he located a needle in a woman’s hand.
This potential for carrying out diagnosis before operations is what would help medical treatments on the Western Front, in the future |
| What are some of the many problems that emerged with the early use of the X-ray? | Problems of the early use of the X-ray include:
- taking an X-ray of a hand using the machine took about 90 minutes - it was insufficient and caused open wounds to get further infected
- the health risks associated with X-rays weren’t fully understood; X-ray exposure was harmful as the amount of radiation was about 1,500 times the amount released today, and this exposure could cause hair loss and burns for patients |
| Who is James Blundell? | James Blundell is the individual who is responsible for blood transfusions in which the donor is directly connected to the recipient by a tube as they give blood. |
| What were Blundell’s first experiments in human blood transfusion? | James Blundell’s first experiments in blood transfusions were in 1818 and they were to help woman with his medical care. Specifically woman who lost blood when giving birth. |
| What happens when someone loses blood? | When someone losses too much blood they are likely to go into a condition known as hypovolemic shock and most likely die as Doctors didn’t have the technology to save the patients |
| When was blood loss most common in England and what caused it? | In the late 19th century and early 20th century, blood loss was often as a result of complex surgeries |
| What problems are linked to blood transfusions? | Problems with blood transfusions include:
- Blood clots developing as soon as blood left the body, which clogged the tubes that transferred blood
- Rejection of the transferred blood because the donor and recipient blood weren’t compatible
- Danger of infection from unsterilised equipment |
| What was the attempted solution for blood clots? | Chemicals like sodium bicarbonate were attempted to be found to prevent clotting.
In 1894, Professor Almroth Wright concluded the soluble solution in certain acids could prevent clotting, but side effects, such as convulsion, couldn’t be prevented |
| What was the attempted solution for blood rejection? | In 1901, Austrian doctor Karl Landsteiner discovered three blood groups: A, B and O
In 1902, blood group AB was found
This was used in 1907 by Reuben Ottenberg, who was the first doctor to match the donor and recipients blood type pre-transfusion.
Ottenberg identified blood group O was a universal group |
| What’s was at the very rear of the trenches? | At the very rear were artillery emplacements |
| What are dugouts? | Dugouts are Holes dug into the side of the trenches so men could take protective cover when needed |
| What’s the support trench? | The support trench was located about 80 meters behind the frontline trench and it’s purpose was for the troops to retreat to if the frontline was under attack |
| What’s a reverse trench? | The reverse trench was at least 100meters behind the support trench it’s purpose was so reverse troops could be mobilised for a counter-attack if the frontline trench was captured by the enemy |
| What pattern were trenches dug in? | Trenches were dug in a zig-zig pattern |
| What happens on the frontline trenches? | The frontline was where attacks would me made from |
| What year were trenches evolved in? | Basic trenches were dug in 1914 and a more complex system began to evolve from 1915 |
| How many British troops were lost in the first battle of Ypres - 1914
The second battle of Ypres -1915
Battle of the Somme -1916
Battle of Arras - 1917
The third battle of Ypres - 1917 | - Ypres 1: British lost over 50,000 troops
12th of October to the 11th of November
- Ypres 2: British losses 59,000 men
- Somme: British casualties:57,000 with 20,000 deaths
- Arras: nearly 160,000 British and Canadian
- Ypres 3: British loses 245,000 casualties |
| How did the Germans extend their control around the edges of Ypres Salient? And what were the other effects of this? | The Germans had extended their control around the edge of the Ypres Salient as far as the village of Messines by launching an attack in the British portions to the east and north-east of Ypres
Other effects of this attack were Germans controlling English Channel ports so supplies and reinforcements could be provided |
| When did the Germans capture Hill 60 | The Germans captured hill 60 in December of 1914 which enabled themto have a height advantage so they could be more strategic in the area |
| How did the British take Hill 60? | In April of 1915 the British used offensive mining to take Hill 60 back.
They placed five mines in the tunnels.
When they exploded they blew the tip of Hill 60 off and then the British were able to take this strategically important position |
| When did the second battle of Ypres take place? | The second battle of Ypres took place from April the 22 to May the 25th of 1915 - it was about one month long |
| What is significant about the second battle of Ypres? | It is significant in the history of the First World War as it was the first time the Germans used chlorine gas on the Western Front |
| What new strategies did the British take in the battle of the Somme - 1916 | New strategies the British took include:
- the use of the creeping barrage - which saw artillery launched from the trenches towards the German lines just head of the British infantry as it advanced forwards
- the first use of tanks in warfare - although the use of tanks hand many technical issues so they weren’t very successful |
| What were tunnels, caves and quarries in Arras used for by the British? | The British used tunnels caves and quarries the were dug since Roman times to create an underground network around Arras that acted as shelters against German attack
And they were built to enable safe underground movement |
| How many soldiers could be stationed in the tunnels in Arras? | Up to 25,000 men could be stationed in the tunnels |
| What did the tunnels and quarries in Arras contain? | The tunnels and quarries contained electric lights, running water, a light railway station and a fully functioning hospital |
| When did the British, who hid in tunnels near the German trenches, attack?
And what was their motivation? | 24,000 British troops attacked the German in April of 1917 in the Battle of Arras
Their motivation was to break through the German lines which they achieved in the first few days |
| What happened as the British advanced about eight miles? | After the British advanced eight Miles, the advanced slowed and virtually no further progress was made |
| What was the purpose of the third battle of Ypres - 1917? | The purpose of the third battle of Ypres in 1917 was for the British army to break out of the Ypres Salient because they wanted to remove the German advantages of having higher ground. |
| When did the British launch their main attack in the third battle of Ypres?
And gown many miles did they advance? | The British launched their main attack in the 31st of July, where they marched east from Ypres towards Passchendaele.
The advanced about two miles of the first day |
| What happened after the British advanced two miles in the third battle of Ypres - 1917? | After they advanced two miles the weather soon turned to rain and the ground become waterlogged, so much that many men fell in the mud and drowned
This lasted till November which by then the British had moved back by seven miles |
| When was the battle of Cambrai launched? | The battle of Cambrai was launched on the 29th of October in 1917 |
| What previously new strategy was using in the battle of Cambrai - 1917? | The battle of Cambrai was accompanied by the first large-scale use of tanks
There was nearly five hundred used in this battle
The tanks were able to easily move across the barbed wire and their machine guns were very effective |
| What was the effect of shelling on the landscape? | The constant shelling left the landscape full of craters, holes and it destroyed many roads
Leading to transportation difficulties of injured men on the frontline |
| What was used on farms that caused wound infection? | When the landscape was previously used as farmland, the use of fertiliser was extensive
This meant there was a lot of bacteria in the soil which could lead to infected wounds |
| What were injured soldiers carried on across the frontline and why was this dangerous? | Injured soldiers were carried on stretcher bearers, during the day and night, from the frontline
This was dangerous because they were exposed to shelling and gunfire |
| What did the horse drawn ambulances lead to? | Horse drawn ambulances led to men having their injured made worse by the wagons shaking
The ambulance wagons couldn’t cope with the large numbers of casualties
Which led to shoulders being left to die or being taken prisoner by the Germans |
| What happened once the news of the lack of transportation reached Britain? | Once the news of the lack of transportation reached Britain, the Times newspaper ran a public appeal for donations.
By October of 1914, after three weeks the appeal had raise enough money to buy 512 ambulance wagons |
| When were the first motor ambulances sent to the western front? And why weren’t they successful? | In October of 1914 as a result of work by the Red Cross the first motor ambulances were sent to the western front
Motor vehicles couldn’t operate in much of the muddy terrain of the frontline
So horse drawn wagons continued to be used
And in worse terrain more horses were used to pull the wagons |
| What might wounded men also be transported by? | Wounded men might also be transported by train or by canal in the final stage of their evacuation to the Base Hospitals |
| What are the three main medical problems on the western front? | The three main medical problems on the western front were:
- Trench foot
- Trench fever
- Shellshock |
| What are the main symptoms of trench foot? | Main symptoms include:
Painful swelling to the feet - caused by standing in cold mud and water
Gangrene sets in, in the second stage of trench foot
And gangrene is the decomposition of body tissue due to blood loss |
| What are the main symptoms of trench fever? And how many men did it effect. | Main symptoms include:
Flu-like symptoms with a high temperature
Headaches
Aching muscles
Trench fever affected an estimated half a million men on the western front |
| What are the main symptoms of shellshock? And how many men did it affect? | Main symptoms include:
Tiredness
Headaches
Nightmares
Loss of speech
Uncontrollable shaking and
Complete mental breakdowns
Shellshock was experienced for about 80,000 British by troops |
| What were the attempted solutions to dealing with trench foot? | Attempted solutions include:
- rubbing whale oil into feet for protection
- keeping feet dry and regularly changing socks
- but if gangrene was developed amputation was the only solution to stop it spreading |
| What are the attempted solutions to dealing with trench fever? | Attempted solutions include:
- by 1918 the cause of trench fever was identified as lice
- delousing stations were set up - causing a decline in cases |
| What were the attempted solutions to dealing with Shellshock? | Attempted solutions include:
- there weren’t any solutions that would actually deal with Shellshock because it was believed that
- some soldiers who experienced Shellshock were accused of cowardliness- and many were punished or shot for this
However 2,000 men were treated in the Craiglockhart Hospital in Edinburgh by Wilfred Owen and Siegfried Sassoon |
| What caused 58% of wounds? | Shrapnel and high explosive shells caused 58% of wounds |
| What was responsible for 39% of wounds? | It was found that bullets were responsible for 39% of wounds |
| What was created to protect soldiers heads? | Brodie helmets were introduced in 1915 to protect head injuries
Brodie helmets are made of steel with a strap so they couldn’t be thrown off in explosions
Brodie helmets were responsible for head wounds reducing by 80% |
| What’s the effect of chlorine gas? | - Chronic gas leads to death by suffocation |
| What were the prevention methods towards chlorine gas attacks? | Gas masks were given to all British troops in July of 1915
But before this soldiers developed masks that were made of urine soaked Cotten pads that they pressed against their faces to stop gas from entering their lungs |
| What are the effects of phosgene gas attacks? | Phosgene’s effects are similar to chlorine but it was faster acting, it killed the person exposed to the gas within two days |
| What was the effect of mustard gas? | Mustard gas worked as an odourless gas that worked within 12 hours, causing both internal and external blisters that could pass through clothing and burn the skin |
| What does the RAMC stand for and what was their responsibility? | The RAMC stands for Royal Army Medical Corps it was founded in 1898 and
Their responsibility was to provide medical care |
| What does FANY stand for and what was their responsibility? | FANY stands for First Aid Nursing Yeomanry it was founded in 1907 and their responsibility was to provide frontline support for the medical services by driving ambulances and engaging in first aid
They were the first woman’s voluntary organisation to send volunteers to the western front |
| How many medical officers were there in 1914 compared to 1918 | There were 3,168 medical officers in 1914 compared to 13,063 in 1918 |
| How many other ranks (e.g. private) in 1914 compared to 1918? | There were 16,331 other ranks in 1914 and 131,099 other ranks in 1918 |
| What’s the name of the efficient system to get the wounded from the frontline to a safe area where they could be treated? | The efficient system for treating wounded soldiers safely was called the chain of evacuation |
| What are the main stages in the chain of evacuation? | The main stages in the chain of evacuation include:
- the Regimental Aid Post (RAP)
- Dressing Stations (ADS and MDS)
- Casualty Clearing Stations and
- Base Hospitals |
| Where was the Regimental Aid Post located and how did it work? And what’s the purpose of the Regiment Aid Post? | The Regimental Post aid was generally located within 200m of the frontline in communication trenches or deserted buildings
It worked as wounded men would either walk in themselves or be carried by soldiers - the same process applied to dressing stations
The purpose of the RAP is to give immediate First aid and to get as many back to fighting as possible |
| When would soldiers have to be passed onto the next stage in the chain of evacuation? | The regimental aid post couldn’t deal with serious injuries - soldiers with serious injuries had to be passed to the next stage of evacuation- dressing stations |
| What’ does ADS and MDS stand for?
Where were DS’s usually located?
And who worked in DS’s | ADS stands for advanced dressing stations and MDS stands for medical dressing stations
Dressing stations were usually located in abandoned buildings, dug-outs and hunkers to provide protection from the shelling
Ten medical officers, medical orderliness and nurses worked in dressing stations |
| When were men moved onto the next stage in the chain of evacuation after dressing stations? | Those working at dressing stations belonged to a unit of the RAMC called the Field ambulance.
Men who had been treated would either be returned to their units if they were fit enough to fight again, or they’d be moved onto the next phase in the change of evacuation |
| How abs where were Casualty clearing stations located? | Casualty clearing stations were located a sufficient distance from the frontline to provide some safety against attack, but they were close enough to be accessible by ambulance wagons.
Clearing stations closest to the frontline would specialise in operating on the most crucial injuries such as ones to the chest.
They were set up in buildings and were often located near railways for ease access to the next stage in the chain of evacuation |
| What is a triage? | A triage is a system in which wounds soldiers were divided into three groups.
The categories were:
- the walking wounded - could be patched up and be returned to fight
- those in need to hospital treatment - need to be transported to base Hospitals after testing for immediate life threatening injuries
- those who were so severely wounded that there was no chance of recovery - and the medical resources available were fine to those who were more likely to survive |
| How many societies and nurses in CCS treated casualties? | 379 Doctors and 502 nurses treated more than 200,000 casualties.
They operated on 39% of the admitted men |
| What did FANY open the way for? | There were never more than 450 FANY’s in France, they opened the way for other women who were attached to organisations such as the Voluntary Aid Detachemnts (VAD), to participate in the frontline |
| What are some of the other things FANY did? | Things that FANY did include:
- they drive supplies such as food and clothes to the frontline
- they had a mobile bath unit which provided baths to the soldiers in water heated by the power from the vans engine
- they set up cinemas to help the morale of soldiers |
| Why were base Hospitals located where they were? | Base hospitals were located near the French and Belgian coast so the wounded men who were treated in the base hospitals were close to the ports where they’d transport back home to Britain |
| What are the two types of base hospitals? | The two types of base hospitals are The stationary hospital and the general hospital |
| Why did casualty clearing stations began doing work that base hospitals were supposed to do? | Causality clearing stations were located closer to the front line than any other stage in the chain of evacuation therefore they played an important role in dealing with wounds and if infected wounds become and they weren’t dealt with quickly then gangrene would develop |
| What did base hospitals become responsible for as the casualty clearing stations took over their roles? | Base hospitals became increasing responsible for continuing treatment that begun in CCSs before men were transported to the front line or sent home to Britain |
| What was the effect of a major offensive on base hospitals? | Because of a major offence base hospitals increased and in 1917 three new base hospitals were built with a total of 2,500 beds available |
| What’s an example of some of the responsibility’s that base hospitals equipped? And what effect did this have on Doctors? | Base hospitals experimented with new techniques which were once successful in the CCSs
For example, dividing patients up into different wards in accord to their wound, amputees, head wounds and chest wounds,
This enabled doctors to become experts in the treatment of particular wounds as they were allocated to a specialised ward |
| What’s Thompson’s cave? | Thompson’s cave is an underground hospital in Arras that was built in 1916.
It was a way wounded soldiers could move through the chain of evacuation |
| What are some of the components of the underground hospital in Arras | The underground hospital included:
- waiting rooms for the wounded
- 700 spaces where stretchers could be placed as beds
- an operating theatre
- rest stations for stretcher bearers
- and a mortuary to lay out the dead
And electricity and piper water were supplied to the hospital |
| When was the underground hospital at Arras abandoned? | The hospital was abandoned during the battle of Arras in 1917, when it was hit by a shell which destroyed the water supply |
| What are the main techniques used to prevent infections from spreading? | The main prevention techniques to infection spreading are
- wound excision
- the Carrel-Dakin method
And - Amputation |
| What is wound excision? | Wound excision is the cutting away of dead, damaged and infected tissue from around the air of the wound - needed to be done quick in order to stop infection spreading |
| What is the Carrel-Dakin method? | The Carrel-Dakin method is where a sterilised salt solution was passed through a tube and into the wound
The solution lasted six hours and needs to be made which could sometime be difficult when there were a lot of wounded men |
| When was amputation resorted to?
And how many men had lost limbs by 1918? | If neither wound excision or the use of antiseptics succeeded in stopping the spreading of infection the only way to deal with it was through amputation of wounded limbs
By 1918, 240,000 men had lost limbs |
| Why was the Thomas Splint created? | The Thomas Splint was created because In 1914 and 1915 men with a gunshot or shrapnel wound to the leg only had a 20% chance of survival, because these wounds created a fracture where the Brocken bone pierced the skin which could cause major bleeding into the thigh |
| Who created the Thomas Splint? | Hugh Thomas designed a splint to stop joints from moving and when war broke out Robert Jones, Hughs nephew worked with disabled soldiers in a hospital in London where he started to make use of his uncles Thomas Splint |
| What did the introduction of the Thomas Splint increase the survival rate to? | The introduction of the Thomas splints used from this time increased the survival rate for this type of wound from 20% to 82% |
| What was the use of X-rays? | X-rays were used to accurately identify shell fragments and bullets in wounds which if not removed could cause infection |
| What are some of the problems with the use of X-rays for medical practitioners on the western front? | Problems with X-rays include:
- the tubes in the machines were fragile and they overheard easily which meant that they needed to be left to cool down after an hour of use which was insufficient for the amount of wounded soldiers
- the X-rays took a long time and wounded men having to remain still for several minutes and this could sometimes worsen the wounds |
| What did base hospitals and casualty clearing stations that didn’t have static X-ray machines have as an alternative? | Base Hospitals and casualty clearing stations that didn’t have static X-ray machines instead had mobile units. |
| How did mobile X-ray units work? | A tent was attached to the back of a van with a table where stretchers could be placed and the X-ray machine was set up next to this table. It was linked to the vans engine which powered the X-ray machine, while the equipment for processing the X-ray film was set up inside the van
Though mobile X-ray units weren’t as efficient as static units they wee useful in identifying shrapnel, bullets and preventing wound infection |
