End of lesson quiz for Lesson 28 - Medicine Through Time

What was a problem with x-ray units on the Western Front?

In which area was there most development in blood transfusions during the war?

What was the Carrel-Dakin method used to treat?

Which individual pioneered new techniques in plastic surgery?

Why was local anaesthetic better to use when performing brain surgery on soldiers with head injuries?

How far did war on the Western Front give rise to new techniques in medical treatment?

﻿Hi, I'm Miss Holland and welcome to lesson 29 of Medicine Through Time. So in today's lesson, we're going to continue with our inquiry, and we are going to look at the system that was put in place to help wounded soldiers on the Western Front. As usual, you will just need a pen and some paper to make notes with for today's lesson. So if you'd like to take a moment to make sure you have everything you need, you have turned off any notifications, and if you can try and find a nice quiet place to work where you won't be disturbed. So let's write down today's title, and that is how were wounded soldiers helped on the Western Front? Okay, let's start today's lesson. Before we begin, let's see what you can remember. How were the following medical conditions either treated or prevented on the Western Front? So pause the video, have a go at the task and then resume it once you're ready. Okay, well done everyone, let's see what we came up with. So trench fever, soldiers would be sent to hospital to recover mostly, also to prevent it delousing stations were set up from 1918. Infected wounds, we know that antiseptics such as carbolic acid we used and also the carrel-dakin method was developed to use on more serious infected wounds. An injury to the femur, so the thigh bone. The leg would be secured using a Thomas splint until surgery to help keep it in place so it didn't lead to further injury. Shrapnel injuries to the brain. Remember Harvey Cushing's methods of using local anaesthetic and magnets were really successful in this type of brain surgery. And then facial disfigurement. Soldiers would undergo skin grafts to reconstruct the face using methods developed by the likes of Harold Gillies. So in today's lesson, we're going to focus on how wounded soldiers were helped. So we're going to begin by looking at the methods of transportation and the problems that they faced, we're then going to have a look at two organisations that were tasked with looking after wounded soldiers. We'll then discuss what we mean by The Chain of Evacuation, and then you'll have your comprehension and source questions, and your exit quiz. In a previous lesson, we have already seen the awful conditions of many of the trenches. So you can imagine there are plenty of difficulties in helping wounded men. When a soldier had been injured fighting, their best bet was to get from the front lines to the beginning of the chain of evacuation, which we'll look at soon, as quickly as possible as staying in no-man's-land was very dangerous and carried the risk of infection if that soldier was wounded. Men could either help themselves and each other away from the front line if they were able to walk or even crawl. However, men who were very badly injured and who couldn't walk would have to wait for stretcher bearers to receive them. But due to the uneven and often muddy terrain, this could take some time and would also be dangerous for the stretcher bearers who were exposed to enemy fire. At the beginning of the war, horse-drawn ambulances were also used to move wounded soldiers. But this was met with further with great difficulty, as they couldn't cope with the amount of wounded men and the waggons they pulled shook too much, putting injured soldiers at further risk. So, by the end of 1914, motor ambulances were being used to transport the soldiers to different parts of the chain of evacuation. But even these still struggled to move through the muddy terrain and there were often massive backlogs of motor ambulances. When soldiers were finally being transported to base hospitals, they would be moved via ambulance trains or barges, which could transport great numbers of soldiers in a more effective way. Ships would also be used to transport soldiers from France back to Britain. So we now need to have a look at two organisations that were involved with the helping and the processing of injured soldiers on the Western Front. The first one we're going to look at is the RAMC, and this stood for the Royal Army Medical Corps. This was part of the army that was responsible for medical care. The RAMC consisted of everything from doctors to stretcher bearers that we saw in the last slide, orderlies, ambulance drivers, and they also ran or helped to run the different sections of the chain of evacuation. The RAMC also had sanitation units, which were responsible for overseeing the hygiene of men in the trenches. For example, carrying out foot inspections, and that was really important because we saw in a previous lesson how dangerous the likes of trench foot could be. The numbers of the RAMC also increased throughout the war. In 1914, they started from around 9000 and this is had grown to 113000 by 1918, showing the demand for this group. The second group we need to look at is the FANY, which stands for the First Aid Nursing Yeomanry. This was a women's voluntary organisation set up to support the medical care of the RAMC on the front lines. The first FANYs arrived in France in October 1914, but consisted of only around four women. By the end of the war, this number had increased to around 450. So nowhere near the numbers of the RAMC, but still it had increased. FANYs carried out responsibilities such as keeping the morale of the troops up. So for example, they set up cinemas. They also drove supplies to the front lines, cleaned clothing and wards, cooked meals, and ran mobile baths. They also redressed wounds. However, as the demand and number of wounded soldiers increased, FANYs were allowed to drive ambulances from 1916, which you can see an image of on the slide. And this took them right up to the front lines. So pause the video in a moment to complete the following task. You need to summarise the main roles of the Royal Army Medical Corps and First Aid Nursing Yeomanry in your own words, and then you can resume once you're ready. Okay, well done everyone. So let's move on to look at the chain of evacuation. We're now going to move on to look at something called the chain of evacuation. The chain of evacuation is a term given to the system that was used to deal with wounded soldiers on the Western Front. So as you can see on the diagram, these are the various processes that soldiers would go through. So the first point of call was a Regimental Aid Post, you then had the Advanced Dressing Station and the Main Dressing Station, Casualty Clearing Stations and Base Hospitals. It's important to remember, as we go through each of these stages, that the chain of evacuation did differ depending on where you were in the Western Front. And this system wasn't always followed in this exact order. For example, in some areas of the Western Front there may have been only one Dressing Station. So we're going to go through each section now and find out the roles of each post. The first point of call for injured soldiers was a Regimental Aid Post. This was very close to the frontline and would often be in the communication trench or close by. You can see in the image below that they weren't purpose-built structures, they were where they could find shelter. The Regimental Aid Post was not designed for dealing with serious injury and the men who went there were either patched up and sent back to the front line, or they either walked or were carried by stretcher bearers to the Dressing Stations. The Regimental Aid Post would be run by the Regimental Medical Officer and would be assisted by stretcher bearers, all of who were mostly part of the Royal Army Medical Corps. The RMO could dress wounds and administer pain relief, but nothing more as they lacked the equipment to do so. It was too close to the fighting, and normally, they were overwhelmed with the number of wounded soldiers to attend to. So when soldiers arrived at the Dressing Stations, these were further away from the front line, but still not that far. So for example, the advanced Dressing Stations were roughly 400 metres from the Regimental Aid Post, and the main Dressing Station was about 1/3 a mile back. However, remember not all areas had two Dressing Stations. The Dressing Stations were run by around 10 medical officers, stretcher bearers and other men like orderlies, which meant it could accommodate more men than the Regimental Aid Post, but only up to about a week. However, like the Regimental Aid Post, no operations were carried out at the Dressing Stations unless it was absolutely necessary. As you can see in the image, Dressing Stations were located in abandoned buildings, or wherever there was some form of shelter. And if not, tents would have to be used. The Dressing Stations were a division of something called the field ambulance, and this was a unit that helped deal with wounded men. The next stage was casualty clearing stations, which were located even further away from the front line. Originally, casualty clearing stations were designed to be where soldiers would be accommodated and sorted into those that needed to be sent to base hospitals, making sure that soldiers were ready to be transported, so for example bandages had been changed and pain relief administered. At casualty clearing stations, wounded soldiers were assessed and categorised into the walking wounded, those who needed treatment at a base hospital and those who were so severely wounded, they either needed immediate treatment or they couldn't be helped. And this was known as triage. The casualty clearing stations could accommodate around 1000 men when needed to. However, as the war progressed, it was realised that some soldiers couldn't wait to get to a base hospital to be treated. For example, if they had a really severe infection, then by the time they got to the base hospital, it would be too late. So, the casualty clearing stations began to undertake more operations and treatments, acting in some cases more like a base hospital and this continued up until 1918 when casualty clearing stations were forced back by the fighting and base hospitals once again took over the majority of operations. The final stage of the chain of evacuation was base hospitals, and these were located close to the coast so that wounded soldiers could be more easily transported back to Britain on hospital ships. Soldiers would arrive at base hospitals by ambulance, trains and barges. Base hospitals were much larger than the casualty clearing stations and could accommodate around 2500 men. They were usually set up in civilian hospitals or in converted buildings like schools or hotels. Another difference is they would have specialist wards for different injuries and illnesses, and doctors specialised in different areas and experimented with new techniques and treatments. They also often had operating theatres, X-ray machines and laboratories. Soldiers would be treated at base hospitals until they were either well enough to return to fighting or were sent back to Britain. So for example, those who required further specialist facial reconstructive surgery were sent back to Britain. So let's see what you can remember about the different parts of the chain of evacuation. to decide which part of the chain evacuation each term belongs to. So pause the video, have a go at the task, and then resume once you're ready. Okay, well done everyone, let's see what we came up with. So the different terms are colour coded to the different sections of the chain of evacuation. So again, if you'd like to pause the video, check through your answers, and then resume once you're ready. Okay, so hopefully you've marked those answers, we're now going to move on to your main task for today. We're going to read through source A about how wounded men sought medical aid. Like in the previous lesson, parts of your questions will be based on the analysis of this source. Let's have a read of it together. So this is by Robert Sherriff, an officer in the British Army recalling his experiences in his autobiography. "How badly we were wounded we didn't know. "We were covered with blood and mud. "The company commander took one look at us and said, "'Get back as best you can, and find a dressing station.' "We began the long trek back, struggling through the mud "through the stench. "Here and there were other walking wounded, mainly in pairs, "supporting themselves pitifully with arms "around each other's shoulders. "Many were so badly wounded that they could barely "drag themselves along, "but to save themselves was their only hope. "There was no one else to save them. "It seemed hours before we reached a dressing station. "It was a ramshackle tin shelter amid a dump of sandbags "that had once been a gun emplacement. "The doctor was treating anybody who managed "to find his way there. "A lot of men were lying around, "and some stretcher bearers were sorting out the living "from the dead. "The doctor swabbed the wounds on our hands and faces "and tried to see through the holes in our uniforms "where pieces had gone in. "'You don't seem to have got anything very deep,' he said. "'Can you go on?'" Okay, so that's the source that you are going to focus on with the next section. So really think about what does this source tell us about how wounded men were helped. What were the issues in dealing with wounded men on the Western Front? So let's have a look at today's questions together. The first three are comprehension and the last two are source questions. Question one, can you describe two problems with transporting injured soldiers on the Western Front? Question two, can you describe the chain of evacuation in your own words? Question three, can you explain two changes to the system in place to help wounded soldiers on the Western Front as the war progressed? So for this question, think about a couple of things that maybe changed as the war went on and there was more demand. Question four, read through source A again. Explain two things you can learn about how wounded soldiers were helped on the Western Front and support with quotes. Question five, why is source A useful for finding out about how wounded soldiers were helped on the Western Front? So remember in previous lessons when we've tackled usefulness questions, so our three kind of things we need to ask ourselves. What does source A tell you, what can you learn from it? How can you support source A with your own knowledge, and what about the provenance? Where does the source come from, and how does this affect the usefulness of the source? Pause the lesson now. Okay, well done everyone. So let's go through the answers, and as usual, don't worry if you haven't got everything down word for word. So question one, two problems with transporting injured soldiers on the Western Front. You could have had that the terrain made it difficult to move soldiers, and that it was dangerous for stretcher bearers. But let's go into more detail for a good answer. So the terrain, the ground was uneven with shell holes and often very muddy, making it difficult to carry soldiers. Several stretcher bearers were needed. Horse-drawn ambulances, which were used at the start of the war also struggled with the terrain. And it was dangerous. Stretcher bearers often found themselves under enemy fire, injured men had to wait laid in the mud to be retrieved unless they could get themselves to the Regimental Aid Post, which meant infection could start to take hold. Question two, can you describe the chain of evacuation in your own words? So the difference between an acceptable answer and a good answer is the level of detail that you have got in there. So let's read through the good answer together. Injured soldiers would first either walk or be carried by stretcher bearers to the Regimental Aid Post. They would be assessed by a medical officer before being either sent back to the front line or onto the Dressing Stations. Soldiers could spend up to a week at the Dressing Stations before moving to a casualty clearing station if required. More treatment could be given there and more operations took place as the war continued. Those requiring further treatment would go by train or barge to a base hospital where more specialist treatment took place until either soldiers recovered or were sent back to Britain. Question three, can you explain two changes to the system in place to help wounded soldiers on the Western Front as the war progressed? So you could have had that women undertook more responsibilities in the First Aid Nursing Yeomanry and also casualty clearing stations carried out more operations. Though again, let's go into more detail for a good answer. So the responsibilities of women increased. Due to the increasing number of casualties, women also carried out roles such as driving ambulances, and the number of FANYs increased throughout the war. And then the role of casualty clearing stations changed. They began to carry out more critical operations. For example, on infected wounds as the army realised that by the time some soldiers got to base hospitals for treatment, it was too late. Question four. So if you've read through source A again, hopefully we have learned that there weren't really enough stretcher bearers for the number of wounded at times, and Dressing Stations were makeshift structures. But how can we support that with quotes? So if we are saying that we have learned there weren't enough stretcher bearers to retrieve all the injured soldiers, we could use the quote "to save themselves was their only hope. "There was no one else to save them," to support that. And the fact that Dressing Stations were close to the front line and could be makeshift structures that were not designed for complex treatments. Well, how do we learn that? Let's have a look at the quotes. "It was a ramshackle tin shelter amid a dump of sandbags "that had once been a gun emplacement." So that tells it was close to the front line, that it wasn't a purpose-built structure. And question five, why is source A useful for finding out about how wounded soldiers were helped on the Western Front? So first of all the content, what can we learn? So kind of similar to what we've said in the last question. Source A tells me the walking wounded had to find their own way to the start of the chain of evacuation if they were physically able to. It also tells me that the first parts of the chain of evacuation were close the front lines and could be dangerous. So how does that source support our own knowledge? Well, we could say that we know that there were stretcher bearers to carry the wounded to the Regimental Aid Post and the Dressing Stations. However, the numbers were limited, and many men had to wait in no-man's-land to find their own way to get help. And that supports the description of soldiers struggling and trying to carry each other to the Dressing Station. And then what about the provenance? How does that affect the source? So our source was an autobiography of the experiences of an officer in the army. We could say that this makes the source useful because it is likely to be an accurate account of how injured soldiers sought help on the Western Front as the author experienced this process first hand. Fantastic learning everyone. You've done really well today. It might be a good idea as well if you have time to create your own annotated copy of the chain of evacuation. So don't forget to finish this lesson by completing the exit quiz, and join me in the next lesson for a big overview of medicine on the Western Front and medicine through time.

End of lesson quiz for Lesson 29 - Medicine Through Time

What was the first part of the chain of evacuation?

Which part of the chain of evacuation was run by the Field Ambulance?

How did the role of FANYs change as the war progressed?

Why did casualty clearing stations carry out more operations as the war progressed?

What is 'triage'?

How were wounded soldiers helped on the Western Front?

We will learn what sources from the time tell us about medical aid on the Western Front.

In this lesson you will learn about the system put in place to help wounded soldiers, known as the chain of evacuation, and the different units responsible for helping wounded soldiers.

History

Y10 History

Key Stage 4

Year 10

Miss

Medicine through time, c.1250-present day

UNIT

How much medical progress did ancient Greece and Rome make?

What did people think about where disease came from in medieval Britain?

How did people in medieval times try to prevent and cure diseases?

Who did people go to for medical help in medieval times?

What can the Black Death tell us about medieval medicine?

Explore the enquiry: How much medical progress was made during medieval Britain?

Why was there greater medical progress between 1500-1700?

Why did ideas about causes of disease change between 1500-1700?

How did individuals change medical understanding between 1500-1700?

How did ideas about the cause of disease change between 1700-1900?

Why did ideas about the cause of disease change between 1700-1900?

How did ideas about causes of disease change after 1900?

Explore the enquiry: How quickly did ideas about causes of disease change and why did ideas change over time?

Did ideas about prevention and treatment change between 1500-1700?

How did approaches differ in dealing with the Great Plague compared to the Black Death?

When did vaccination really start to make a difference to health in Britain?

How far did John Snow change ideas about the prevention of disease?

How and why did ideas about responsibility for public health change?

How did hospitals change over time and improve prevention and treatment of illness and disease?

Why were there improvements in surgery?

Did the NHS transform medicine in Britain?

How far did treatment advance in the 20th century?

How important was the role of chance in the discovery and development of penicillin?

How has the use of science and technology changed ideas around the treatment and prevention of lung cancer?

Explore the enquiry: How quickly did ideas about prevention and treatment of disease change and why did ideas change over time?

How were trenches designed and why did battles on the Western Front lead to medical advancement?

What medical conditions were there on the Western Front?

Explore the Enquiry: How far did WW1 accelerate medicine and treatment in the 20th century?

What new theory came about in the early 1700s?

How did Pasteur prove that microbes were in the air?

How did Koch make it easier to study microbes?

What did Roger Bacon and Henri de Mondeville have in common?

What was the main symptom of the Black Death?

The following question is about the Black Death.

It is estimated that ??? of the population of England died.

What was the 'scientific method'?

Which two diseases did Sydenham identify the difference between?

How did Charles II help the Royal Society?

What area of medicine did Vesalius develop?

What area of medicine did Harvey develop?

Which period saw the most rapid change in the ideas about the causes of disease?

What was 'transference'?

What became the main explanation for plague in 1665?

What was a Quack Doctor?

In which year did the British government enforce compulsory vaccination?

Why did the government invest in Joseph Bazalgette to modernize London sewers?

What book did Nightingale publish in 1859?

What effective anaesthetic did James Simpson discover in 1847?

What was carbolic acid?

Who discovered penicillin?

What happened in 1861?

What was the 'Enlightenment'?

In which street did John Snow carry out his experiment and remove the handle of the water pump?

Which scientist finally isolated the bacteria that caused cholera and proved John Snow was right?

What was 'miasma'?

Why did the Church promote Galen's ideas?

Lesson overview:How were wounded soldiers helped on the Western Front?

Medicine through time, c.1250-present day: