Unit 1: Local and Global Citizenship
Section 1: Development Study: Medicine and treatment
Chapter 3: Medicine and public health from Roman Britain to
c13503.1 The Romans and approaches to medicine
Exam practice (page 17) 1. Describe the key features of the
Romans beliefs about the causes of disease. [6]
The Romans believed that disease was caused by an imbalance in
the four humours. They believed that the body was made up of black
bile, yellow bile, blood and phlegm, and that too much or not
enough of one of these would cause illness. A fever, for example,
showed that you had too much blood. This belief was developed by
Galen from the work of Hippocrates, an Ancient Greek doctor. The
Romans also believed that bad air could cause disease. They thought
it was important to build cities and settlements away from swamps
and marshes. This would have helped them avoid diseases like
malarias which were caused by mosquitoes, but they didnt understand
why. The Romans also believed that dirt and sedentary lifestyles
caused disease because they encouraged the population to bathe
regularly and exercise in the bath house. However, they would not
have understood why this kept people healthy.
Exam practice (page 18) 2. How important was the influence of
Hippocrates on Roman medicine? [16]In some ways the influence of
Hippocrates on Roman medicine was extremely important. Hippocratess
teachings included the theory of the four humours, which taught
that the body was made up of four elements and too much of one of
these would cause illness. He also taught the importance of
clinical observation: watching a patient very carefully and keeping
detailed notes of their symptoms and how their illness progressed.
This was very important in Roman medicine because both of these
theories were used by Galen. Galen had been a doctor at a gladiator
school but he ended up in Rome treating the emperors family.
Therefore he had a huge influence on Roman medicine, and because
Hippocrates had a huge influence on him, that meant that
Hippocrates also had a big impact. However, Galen did change
Hippocratess ideas in some ways. For example, he added to the
theory of the four humours to focus treatment on balance the idea
of not just removing too much of one humour, but adding something
when there wasnt enough. For example, if somebody was suffering
from a lack of blood, they might be treated with hot chilli. The
Romans also had some of their own ideas about medicine and the
causes of disease; for example, they thought bad air caused disease
and they had a particularly strong focus on public health. This
didnt have anything to do with Hippocrates. However, overall I
would say that the influence of Hippocrates was particularly strong
in Roman medicine, because Galen used a lot of his theories in his
own work.
Exam practice (page 18) 3. How similar were approaches to
medicine and treatment in Roman Britain and Anglo-Saxon Britain?
[12]There were many similarities in approaches to medicine and
treatment through this time period, even though the Romans left
Britain in the fifth century. Herbal remedies were widely used
throughout the first millennium, for example.The most important
continuity during this time period, however, was the use made of
the works of Galen. Galen advocated the use of the theory of
opposites when diagnosing and treating disease. For example, he
suggested treating a cold with something hot, like chilli;
blood-letting was prescribed for a wide variety of ailments. This
is because Galen believed that illness was caused by an imbalance
in the bodys four humours.Galen was a doctor in Ancient Rome and so
his ideas were used widely in the Roman Empire; when the Romans
left Britain, his books remained in the monasteries and the Church
promoted his work because it fitted in with Bible teachings.
Therefore, treatments based on the works of Galen were similar in
both Roman and Anglo-Saxon Britain. There were some differences,
however. Astrology was much more important by the end of the
twelfth century and this influenced diagnosis of disease and
sometimes its treatment. Furthermore, most aspects of Roman public
health works were lost during the Anglo-Saxon period, and with it
the preventative medical ideas of keeping clean and exercising to
stay healthy.
3.2 Approaches to public health before 1350
Exam practice (page 20)1. Describe the key features of public
health in Roman Britain. [6] The Romans improved public health in
Britain hugely after they conquered the country in AD43. They built
aqueducts to ensure clean water was supplied to their troops and
forts, and this was also shared by the local population who also
benefited from the supply. They also created a system of sewers to
remove dirty water and waste from populated areas, to keep people
healthy. Furthermore, they used the clean water in the bath houses
they built. These were built to Roman design and to begin with they
were mostly used only by the Romans. However, they were made
available for everybody to use for a very small sum of money and
over time more of the local population began to use them too.
Exam practice (page 21) 2. After the Romans left Britain the
progress they had made in public health did not continue. Do you
agree? Explain your answer. [16]When the Romans left Britain it was
difficult for their progress in public health to continue. This was
because they took their knowledge and expertise with them. For
example, there were no longer any engineers left who knew how to
build or maintain aqueducts. This meant that when these structures
broke they couldnt be fixed, and so over time there was less
provision for clean water. The local population used the stone from
the bath houses and other structures to build their own homes as
there was less emphasis on public health. The new rulers of Britain
did not think it was as important as the Romans had. By 1350 there
were some quite serious public health problems in towns, where the
lack of fresh water and drainage was a problem. The government was
not willing to donate funds to fixing this problem. Therefore, the
Romans progress was not maintained. However, some things that the
Romans did had a long term impact. For example, in the Middle Ages
some towns still offered public toilets and baths, in the form of
stewes where the public could go and wash. The Romans had been
careful not to build near swamps and the idea that bad air could
cause disease was still popular. However, I wouldnt call any of
these things progress. The Romans made considerable headway during
their stay in Britain but after they left this was not continued.
In a way it was less important because there were less large
settlements, but public health did not really become a key focus
for government again until the nineteenth century. Therefore, I
agree with the statement.
3.3 The impact of religion
Exam practice (page 23) 1. How far did ideas about the cause of
disease change from the Roman period to the end of the Middle Ages?
[16]The Church played an important role in caring for the sick
during the Middle Ages because it believed that it was part of its
Christian duties. Therefore many monasteries and convents provided
hospitals. They would look after people, give them a bed to sleep
in, food to eat and pray for them to recover. They filled a gap in
provision because they looked after people who didnt have family
members who could care for them. However, the hospitals would not
admit people who had infectious diseases, such as the plague. They
mainly looked after the elderly, the disabled, or people suffering
from non-contagious diseases such as leprosy. There were very
rarely doctors in attendance. Therefore, hospitals provided by the
Church were more like rehab units where people could rest and build
up their strength, or where they went to die. The sick would not go
there for treatment. Overall, the Church played an important role
in caring for people, but not in caring for people who were really
sick.
3.4 The impact of government and war
Exam practice (page 24) 1. To what extent did medicine and
public health change between the Roman withdrawal from Britain and
c1350? [16]
In some ways medicine and public health changed a lot between
the Romans leaving Britain and 1350. In particular, public health
changed. The bath houses and aqueducts which the Romans had built
steadily decayed because there were no engineers to maintain them.
The stone was sometimes taken and used in other building projects
and there was a lot less emphasis from the government on
cleanliness and hygiene. Public health problems increased after the
population of some major towns like London and York began to grow.
Therefore, after the Romans left Britain there was a real change in
public health, and it wasnt a positive one. However, in some ways
it stayed the same particularly in medicine. This is because the
Church liked the teachings of Galen and promoted them in its
universities. Galen had been a Roman doctor and his ideas about the
human body being perfectly designed fitted in with the teachings of
the Bible. Therefore, doctors continued to use the theory of the
four humours and Galens teachings on anatomy, amongst other things,
until well after 1350. Some things did change. For example, the
Church taught that God sent disease; but the teachings of Galen
still formed the largest part of the work of the doctor. Therefore,
I think that public health changed a lot between the Roman
withdrawal from Britain and 1350, but not a great deal changed in
medicine.
Chapter 4: Medicine and treatment c1350c17504.1 Medicine at the
time of the Black Death
Exam practice (page 26) 1. Why was the Black Death such a
problem in Britain from c1350 onwards? [12]The Black Death was a
problem in Britain from 1350 onwards because nobody knew what
caused it. There was no understanding of the causes of disease or
how it was spread, which meant that it spread very quickly and
there was no satisfactory cure. Large numbers of the population
died and in some places there werent enough people left alive to
bury the bodies of the plague victims. The disease was spread by
fleas carried by rats that arrived in Britain on trading ships.
However, nobody knew this and therefore people tried all sorts of
things to avoid catching the Black Death. The most common of these
was prayer, to ask God for forgiveness so he would spare you.
Burning barrels of tar to drive off the bad air which was thought
to spread the disease was also common. Unfortunately these things
didnt work very well and so the Black Death continued to be a
problem in Britain. Finally, the Black Death was a problem in
Britain because there wasnt much effort made by the government to
prevent outbreak of the disease. It did take some action, which
varied through the centuries, for example quarantining houses where
outbreaks had occurred, burning barrels of tar and vinegar in the
streets and killing cats and dogs. However, the government only
ever reacted to outbreaks of the disease, rather than taking
preventative action. Again, this was mainly because it did not know
what caused it.
4.2 Ideas about the causes of disease: the influence of the
past
Exam practice (page 27) 1. How useful is Source A to a historian
who is studying ideas about medicine c1350 to c1750? Use the source
and your own knowledge to explain your answer. [8]This source is
quite useful for telling us about medicine c1350 to c1750 because
it shows details of the four humours, which was the medical theory
most commonly practised at the start of this period. The theory was
created by Galen in Ancient Rome but you can see that this is a
contemporary illustration because it also displays astrological
symbols, which doctors matched with the various humours at the
start of the Middle Ages. Most doctors in 1350 would have been
trained using materials like this because the Church controlled
medical training and supported this idea. Because the picture is
from a medical encyclopaedia it is a reliable representation of
ideas about medicine in the sixteenth century. However, this source
does not tell us anything about medicine after the medical
Renaissance and the decline in the influence of the Church. Galens
theory was discredited at this time and doctors began to look for
more scientific reasons for disease. Therefore, the source is only
useful for telling us about one medical idea from this time. An
historian studying ideas about medicine in this time period would
need more sources of information to get the complete picture.
4.3 The impact of the Renaissance on medicine and medical
training
Exam practice (page 28)1. Why were art and printing so important
in improving medical understanding during the Renaissance? [12]Art
and printing were important in improving medical understanding
during the Renaissance because they helped doctors and medical
professors to share their discoveries and research more efficiently
with each other. Printing made it easier and cheaper to mass
produce copies of medical research and send it further afield,
therefore improving communication among doctors from across Europe.
For example, Vesaliuss collection of books On the Fabric of the
Human Body contained information about the mistakes in the works of
Galen and sold very widely among medical professionals. Art also
had an impact because it helped to create more realistic and
lifelike images of the human body. Vesaliuss books had over 200
illustrations which were drawn from dissections he had carried out
on the human body. This was different from the past, when artists
had drawn in a more two-dimensional style and rarely from life.
This meant that there were a lot more accurate portrayals of the
human body available to doctors, who used this to improve their
understanding of anatomy.
4.4 Medical Megastars: Vesalius and Harvey
Exam practice (page 31)1. Why was Vesalius able to prove Galen
wrong in the sixteenth century? [12]
Vesalius was able to prove Galen wrong in the sixteenth century
because there was a lot of change going on during the Renaissance.
One of the biggest changes was in technology. Printing had been
invented and it was cheap and easy to publish books. This meant
that once Vesalius had carried out his research, he was able to
share it with lots of other doctors and medical students, which
helped to convince a lot of people that Galen had been mistaken.
Another factor that helped Vesalius was changes in art. It has
become fashionable to draw bodies from life, which meant that
anatomical drawings became much more realistic and backed up
Vesaliuss discoveries about Galens mistakes, for example the idea
that blood moves through holes in the heart. A third factor that
helped Vesalius was a change in beliefs. The Church became less
powerful after the Reformation and this made it possible for
Vesalius to acquire and dissect dead human bodies. Galen had not
been able to do this and so it was the most important factor in
helping Vesalius to prove him wrong. This would not have been
possible when the Church was more powerful.
Exam practice (page 31) 2. The bullets below show two key
figures from the medical renaissance. Choose one and describe the
key features of their medical discoveries. Andre Vesalius William
Harvey [6]
The main discoveries of Vesalius were related to human anatomy.
Vesalius did a lot of dissections as part of his job as professor
of surgery at Padua University. He hired artists to create detailed
drawings of the bodies and then published these in the books called
On the Fabric of the Human Body. The books were used all across
Europe by medical students and helped to massively improve peoples
understanding of the human body.
The reason why the work of Vesalius was so important was because
he proved Galen wrong on several points. For example, he showed
that the lower human jawbone was one piece, rather than two, and
that the liver was one large organ rather than having five lobes.
The work of Galen was promoted by the Church for medical training
and the work of Vesalius discredited it, eventually leading to big
changes in the way doctors practised medicine.
Harveys discovery of the circulation of the blood eventually
proved to be very important. However, it took a long time for his
theory to be accepted and this meant that for a long time the
discovery had limited impact. This was because understanding that
blood circulated around the body didnt give doctors any new ways to
treat their patients and therefore Harveys ideas werent widely
used. Doctors continued to bleed their patients in accordance with
what they had been taught during their training and continued to
follow the teachings of Galen. It wasnt until microscopes were
developed and people had the technology to see the smaller blood
vessels that attitudes changed towards the teachings of Galen and
his work started to have more of an impact.
4.5 Public health c1350c1750
Exam practice (page 33) 1. Why did people living in towns have
problems accessing fresh water in the period 13501750? [12]
Between 1350 and 1750 fresh water became a problem because towns
were getting bigger. This placed a lot of pressure on the water
supplies because there were lots more people using water but the
rivers had not grown any bigger so there wasnt any extra water
available. Also, more people were using the rivers to dispose of
their waste and this meant the water became even more polluted.
This made getting fresh, clean water even more of a problem.
The problem was made worse because the authorities at the time
werent willing to take action to make fresh water more available.
Unlike the Romans, who built a complex system of aqueducts and
water pipes to provide clean water to their citizens, government at
this time didnt think it was their job to provide for the masses,
and they certainly werent willing to spend any money on it. Instead
they left it up to private companies who usually charged too much
for most people to afford. This made the problem worse, as the
private water companies were using the same supplies as the rest of
the townspeople and this put even more strain on the supply.
Occasionally people attempted to build new systems for the
provision of clean water; for example, in 1608 Hugh Myddelton began
a project to bring fresh water into London from a river near Ware
in Hertfordshire. However, this was privately funded, cost an
enormous amount of money and took five years to complete.
Technology was not advanced enough and the will to develop it was
not there until much later in the history of Britain.
Chapter 5 Medicine and treatment c175019005.1 Medical Megastars:
Jenner and vaccination
Exam practice (page 35)1. What do Sources A and B show about
changes in attitudes towards vaccination? [8] Source A shows that
vaccination was not popular at first and that people thought having
the vaccination would cause them to sprout cow heads or become
deformed. This was because the smallpox vaccination involved being
injected with cowpox, an animal disease, and people thought this
was unnatural and dangerous. Furthermore, Jenner was not able to
explain why the vaccination worked, which made matters worse.
Therefore there was a very negative attitude towards vaccination.
However, Source B shows that attitudes have changed significantly
because now vaccination is so popular that GPs have run out of it.
This means that lots of people must be volunteering to have the flu
vaccine, showing a significant change in attitude from Source A.
This is probably because, since the germ theory was published, we
understand how vaccination works now and there were vaccinations
available for a wide variety of diseases, including measles and
tetanus. Attitudes are now completely different because we
understand how vaccinations work and can see the benefits of having
them.
5.2 Medical Megastars: Pasteur and Koch
Exam practice (page 37) 1. How much did the understanding of the
causes of disease change between c1350 and c1900? [12]There was a
massive change in peoples understanding of the causes of disease
between 1350 and 1900. In 1350 most people believed that disease
was sent as a punishment from God, for their sins. Another belief
was that the body was made up of four different elements, or
humours, and an imbalance in these led to illness. A third belief
was that disease could be caused by bad air, which wasnt too far
from the truth, but people couldnt explain why. This was because
there was a lack of technology and people were unable to see germs
or bacteria. People continued to believe this for many centuries
and it wasnt really until the nineteenth century that there was a
major change. By 1900, the understanding of the causes of disease
had moved on to a great degree. Developments in science and
technology led to the creation of microscopes. This allowed Louis
Pasteur to observe the impact of microbes and so developed the germ
theory of disease. This had become widely accepted by 1900 and
represented a massive change in peoples understanding. Microbes
responsible for specific diseases were identified and cures and
vaccines started to be developed. Therefore, there was a complete
change in the understanding of the cause of disease between 1350
and 1900.
5.3 Improvements in hospitals and medical training
Exam practice (page 38)1. In what ways did the training of
doctors change during the period c1350c1900? [12] The training of
doctors changed a lot during the period 13501900. This was mainly
due to a change in beliefs and attitudes. At the beginning of the
period, the Church controlled medical training and insisted that
Galen be taught to all medical students. It banned dissection of
human bodies, which meant that doctors could only go on what they
learned from Galens books. Over time, beliefs changed and science
became more important. During the Renaissance, doctors like
Vesalius challenged the authority of the Church by carrying out
human dissections and sharing his work. As new technology such as
the printing press and the microscope became more available,
medical students were able to access lots of new ideas rather than
relying on the old ones. Surgeons like John Hunter encouraged their
students to carry out their own experiments and observations. This
led to a more scientific understanding of illness. By the
nineteenth century, medical students were completing part of their
training in teaching hospitals which gave them hands-on experience
before they qualified. Therefore, the training of doctors changed
during 13501900 because there was a move from a religious to a
scientific focus in training, and from a theoretical understanding
to a practical one.
Exam practice (page 39) 2. Why did medical treatment in
hospitals improve c1750c1900? [12]There were several factors
responsible for the improvement of medical treatment in hospitals
during 17501900. One of these was the increased interest and action
of the government. During the nineteenth century its laissez-faire
attitude changed to an increased interest in medicine and
willingness to get involved in improving the health of the
population. It introduced a Poor Law which meant that local tax
payers were responsible for funding new hospitals and asylums. This
made medical treatment more widely available, thus improving it.
Individuals like Louis Pasteur and Florence Nightingale played a
big part in improving hospitals. Pasteurs development of the germ
theory gave hospitals a greater awareness of the link between dirt
and disease, which led to cleaner hospitals. Nightingale had worked
hard to improve training for nurses and the hospital buildings,
which led to an improved standard of medical treatment. Finally,
there had been a big change in peoples attitudes during this time
period. There were a lot of social reformers who put pressure on
the government to improve standards of living among the poor. This
led to it getting more involved and passing laws to make hospitals
more available and of a higher standard.
5.4 Medical Megastar: Florence Nightingale
Exam practice (page 41) 1. Describe the key features of the work
of Florence Nightingale in the field of nursing. [6]The main
feature of Florence Nightingales work in nursing was to change the
way nurses were trained and how people felt about them. She began
by working with a group of trained nurses in the Crimean war, where
she showed that she could improve conditions and this would cut the
death rate. Her story was published in the British press and this
changed peoples attitudes towards nursing, which before had not
been a very well-respected profession.Nightingale then wrote a
bestselling book called Notes for Nursing and set up a training
school for nurses in 1860, where nurses could learn the profession
and then go on to work in hospitals, sharing Nightingales ideas.
She had a lot of influence over the government and gave advice to
hospital designers to help improve the standard of hospital care by
ensuring the hospitals had plenty of light and fresh air.Overall,
Florence Nightingales work as a nurse was extremely influential and
important because she showed what could be achieved through
training and hard work.
Exam practice (page 41) 2. How much did the role of women in
medicine change between c1350 and c1900? [12]The role of women
changed a lot between c1350 and c1900. In 1350, women were quite
heavily involved in medicine, but not in an official capacity. They
acted as midwives and attended births; local wise women would
provide herbal remedies and advice on curing illnesses; and nuns
took a big part in care of the sick, because hospitals were usually
in convents or monasteries. However, the nuns didnt have any
medical training and would have mostly acted as nurses and said
prayers for the people in the hospital. Women could not officially
become doctors because they were not allowed to attend university.
By 1900 this had changed quite a lot. There was a school for women
who wanted to practice medicine, set up by Elizabeth Garrett
Anderson the first qualified female doctor in England. Nursing had
become more professional after Florence Nightingale set up a school
to train nurses. Therefore, the role of women was much more
professional by 1900. I dont think it is true to say that they had
a much larger role in medicine, because in 1350 most people would
have been cared for at home by women. However, the role of women in
medicine was more official by 1900 as they were allowed to train
and qualify as doctors or nurses.
5.5 Problems of public health c1750c1900
Exam practice question 1 (page 43) 1. Why did diseases such as
cholera spread so rapidly in industrial towns during the nineteenth
century? [12]
Cholera spread so rapidly in industrial towns in the nineteenth
century because people didnt know how it spread. Clean water was in
short supply in nineteenth-century industrial cities. They were
often very overcrowded because people had moved there to find work
in the factories. Therefore small towns became much bigger in a
short space of time, which meant that the new housing was built
without any thought for the supporting water supply and waste
disposal. Cess pits were often dug too close to wells which meant
that there would be contamination. Open sewers ran directly into
the same rivers that supplied the water pumps, which made the
contamination worse. People used the rivers to wash their clothes
and themselves, and then took water out of them to drink and to
cook with. This meant that cholera spread extremely quickly,
because it was very contagious. Because people didnt know how it
spread, they didnt boil their water before drinking it or know
enough to avoid water from wells where lots of people had died. The
cities were extremely crowded and it was impossible to quarantine
people because the disease spread so quickly and there wasnt enough
space. Finally, sometimes government action made the problem worse.
For example, the government ordered the drains in London to be
flushed clean of the filth that had built up in them, because they
thought the strong smell was causing cholera (miasma). However,
this put even more human waste into the water supply and caused the
cholera outbreaks to worsen. Overall, I think the main reason why
cholera spread so quickly was because people didnt know what caused
it.
Exam practice question 2 (page 43) 2. The Industrial Revolution
only made existing public health problems worse it didnt create any
new ones. Do you agree? Explain your answer. [16]In some ways I do
agree with the theory that the Industrial Revolution only made
existing public health problems worse. This is because the biggest
public health problem in the nineteenth century was the lack of
clean water. There were no systems for removing waste and there
wasnt enough clean water available for people to drink, bathe in
and so on. The Industrial Revolution led to massive growth in
cities, as people moved there to work in the factories. This made
water even scarcer, whilst at the same time creating an even bigger
waste problem than there had been before. However, the Industrial
Revolution did make some public health problems worse. For example,
the quality of the air around many cities became a lot worse, due
to pollution from the factories. Respiratory illnesses became more
common due to the dusty conditions in the cloth factories.
Alcoholism also became more of an issue among the population
because a lot of people turned to alcohol to deal with the misery
of their everyday lives. Overcrowding also led to an increase in
dangerous slum housing, built without regulations, due to the
population increases.Overall, I would say that the Industrial
Revolution made existing public health problems worse, such as the
lack of clean water, but it also created some new ones. Therefore I
do not agree with the statement.
5.6 Improvements in public health c1750c1900
Exam practice (page 47)1. Describe the key features of John
Snows investigation into cholera in 1854. [6]John Snow was a doctor
who developed a link between cholera and dirty water in 1854. He
was not able to prove that dirty water caused cholera because germ
theory hadnt been developed at that point. Instead, he mapped out
all the cases of cholera from the most recent outbreak and
investigated the water supplies of homes and businesses where
cholera had not caused any deaths. For example, he discovered that
all the workers at the local brewery drank beer or water from the
brewerys own well, and none of them were affected by the cholera
outbreak. By doing this, he was able to prove that all the people
who had died of cholera had been drinking water from the same pump,
on Broad Street, and he insisted that the handle be removed from
this pump to prevent anybody else from drinking from it. After the
removal of the handle, the cholera outbreak subsided, thus proving
Snows theory that it had been caused by the water in that
particular well.
Exam practice (page 47)2. How important was the work of Edwin
Chadwick in improving public health in towns in the nineteenth
century? [16]Edwin Chadwick was very important in improving public
health in towns in the nineteenth century. To begin with, he wrote
the Report on the Sanitary Conditions of the Labouring Population
in 1842 which gave details of the public health problems that
existed at the time, and showed how dirty conditions led to the
rich paying higher taxes, because the poor were too sick to work.
He made recommendations about how public health could be improved,
that were later included in the first Public Health Act which was
passed in 1848. This act created a Board of Health to encourage
local authorities to improve conditions, of which Chadwick was a
member. Therefore, his work was extremely important because it led
to the first Public Health Act.However, the first Public Health Act
didnt have a lot of impact, and it was only passed at that time
because there had been a cholera epidemic. The government didnt
really want to force local authorities to make improvements because
it cost a lot of money. It wasnt until 1875, after the link had
been made between dirt and disease, that a second Public Health Act
was passed which forced local authorities to improve conditions.
This was passed partly because working class men had the vote which
convinced MPs they had to do something to improve their conditions.
Overall, although Chadwicks work took a very long time to improve
public health, it did form the basis of the reforms that the
government pushed through. I dont think these would have become
enforced by law if attitudes hadnt changed thanks to more people
having the vote and the discovery of germ theory, so Chadwick could
not have done it on his own, but I think his work was very
important.Exam practice (page 47)3. How useful is this extract
(Source A) to a historian studying ongoing public health problems
in the nineteenth century? Use Source A and your own knowledge to
explain your answer. [8]Source A makes it clear that the ongoing
public health problems in the nineteenth century were partially a
result of peoples attitudes at the time. The source is from a
letter published in a newspaper, so although it is a personal
opinion, it is extremely useful for telling us about what people
thought of public health measures in the nineteenth century. I can
see that the writer is suspicious of being forced to clean up and
this helps to explain why cholera and other diseases were such a
problem. However, Source A is limited in its utility because it
does not tell us the reason why people didnt want to clean up germ
theory had not yet been published so people didnt realise the
importance of keeping clean. Before Pasteur published his theory in
1861, nobody knew for sure what caused disease and therefore no
steps were taken to tackle it. The government did not intervene and
people continued to drink and wash in contaminated water. Because
washing in dirty water often caused illness, people associated
washing with disease. This is the reason why Source A was written
and so we need to know this information in order to better
understand what the source is telling us. Therefore, Source A is
useful for showing us peoples opinions at the time, but we need
more information to explain why people felt this way.
Chapter 6 Medicine and treatment c1900 to present day6.1 New
drugs: from prevention to cure
Exam practice (page 49) 1. How important for the prevention of
disease was Edward Jenners discovery of a smallpox vaccination in
1796? [12]Jenners discovery of a smallpox vaccination was very
important for the prevention of smallpox. Before this, some people
had tried the method of inoculation exposing themselves to mild
cases of smallpox to avoid the disease, but nobody had made the
link between milder forms of pox and a resistance to smallpox.
Jenners discovery was picked up by the British government who
offered the vaccination to everybody for free and eventually made
it compulsory. People like Napoleon promoted the use of the vaccine
abroad. Many lives were saved as a result. Jenners work also showed
that vaccination could succeed, which inspired other scientists.
Therefore, Jenners work was important. However, it was not
especially important for preventing diseases other than smallpox.
This is because Jenner did not understand how the vaccine worked
and therefore the theory could not be applied to other diseases.
Furthermore, the smallpox vaccine is a special case and later
vaccines worked in a different way, which meant other scientists
could not use the same method as Jenner. Therefore, his discovery
was not very important for the prevention of disease other than
smallpox.
Exam practice (page 49) 2. The table below shows two new medical
treatments. Choose one and describe the key features of its
development. Salvarsan 606 Prontosil [6]
Research teams played a very important part in developing
Salvarsan-606. Firstly, the team was made up of scientists from a
variety of backgrounds. Some were chemists and others were doctors.
This gave them a wide variety of skills to bring to the task.
Secondly, as a research team they attracted funding from the
government which helped them to focus solely on the development of
the magic bullet, rather than having to do other things as well to
cover their costs. Thirdly, research teams allowed young scientists
to work closely with their older and more experienced colleagues.
Paul Ehrlich, for example, had worked on Robert Kochs research team
before he became part of the Salvarsan-606 team. Finally, it was
important to have more than one person checking the results. This
was particularly important in the case of Salvarsan-606 because the
working compound was actually identified by Dr Hata. The other
scientists had discarded it and said it didnt work, but he proved
that it did. So, if it had only been Paul Ehrlich working on the
development he might not have discovered it. Prontosil was the
first sulphonamide drug and was developed by Gerhard Domagk in
1932. It was used to treat blood poisoning. Domagk worked for a
German chemical company and tested thousands of chemicals on
animals to try and treat blood poisoning. He finally came across
Prontosil, a red dye, and he discovered that, if he mixed it with
other substances, it would slow down blood poisoning in mice.Domagk
was forced to test Prontosil on humans in 1935 because his daughter
pricked her finger on a needle and got blood poisoning. Domagk
injected her with the drug and she made a full recovery. His
successful discovery was published and, in 1939, he won a Nobel
Prize.
Exam practice (page 50) 3. How useful is this speech to a
historian studying the development of penicillin? [8]Source A is
useful to a point when studying the development of penicillin. It
is from a speech by Alexander Fleming, who discovered the mould
growing in a petri dish in his lab and observed that it was killing
the bacteria around it. Therefore it is likely to be quite reliable
because it is an account of his own work. However, the source is
limited because it only tells us about the discovery of penicillin:
it does not tell us about its development. Although Fleming
discovered the drug he was not able to develop it for human use,
due to lack of funding; this happened later, in the 1930s, when
Florey and Chain found his research and tested the mould further.
Although Fleming won a Nobel Prize for penicillin in 1945, which is
presumably when he gave this speech, we need to look at more
evidence than just this source to get the full story of the
development of penicillin. Therefore I do not think the source is
very useful on its own.
6.2 The discovery of DNA and its impact
Exam practice (page 51) 1. Describe the key features of the work
of Watson and Crick on DNA. [6]Watson and Crick were the first
scientists to discover that DNA had a double-helix structure which
could unzip to make copies of itself. Watson, a chemist, and Crick,
a physicist, had teamed up to try and create a model of DNA. They
used the work of Rosalind Franklin, a chemist, who had used x-ray
crystallography to get a picture of a DNA molecule. They used this
picture to inform their study and teamed up with another expert in
x-ray photography, Maurice Wilkins, who helped them to complete
their model of the DNA molecule. They published their work in 1953
and were awarded the Nobel Prize in 1962, along with Wilkins.
Exam practice (page 52) 2. In what ways did the discovery of the
structure of DNA change medicine after 1953? [12]The discovery of
the structure of DNA has led to some important changes in medicine
since 1953, because it has allowed scientists and doctors to
develop treatments and sometimes even cures for genetic disorders.
For example, the Human Genome Project was completed in 2001 mapping
the purpose of every gene in the human body. This helps doctors to
test people for particular genes to identify diseases which might
be hereditary. This sometimes makes it possible for parents to
avoid passing on genetic disorders to their children by using IVF.
It is also possible to test unborn babies for genetic disorders
such as Downs syndrome. More recently, the discovery of the
structure of DNA has led to developments in gene therapy, for
example using stem cells to treat disabilities like blindness. If
DNA had not been discovered, this sort of treatment would not be
possible. Therefore, the structure of DNA had a big impact on
medicine. However, so far this impact has mainly been limited to
genetic disorders and not to other illnesses.
6.3 The development of the NHS
Exam practice (page 53) 1. Why was it possible for the NHS to be
launched in 1948? [12]The NHS was launched in 1948 due to
government action, changes in peoples attitudes towards healthcare,
and the work of individuals such as Aneurin Bevan. The government
had begun to move towards national health care when it passed the
National Insurance Act in 1911. However, the Act did not include
unemployed people and over time the government began to take more
action to ensure everybody had the same provision. Peoples
attitudes towards healthcare had changed as a result of the Second
World War. Poor health among the evacuees had created more demand
for nationalised provision, and more people had been able to access
free healthcare during the War, which meant they felt entitled to
continue getting it afterwards. This encouraged the government to
launch a free service. Finally, Aneurin Bevan, who was Minister for
Health at this time, was able to convince doctors and local
authorities that the NHS was a good idea and that they should
support it. Without their support, the government would have found
it very difficult to offer all the services it did.
Exam practice (page 54) 2. Choose one of the following and
describe the work he did which led to the creation of the NHS.
William Beveridge Aneurin Bevan [6]
William Beveridge was very important in the creation of the NHS,
because he wrote a report which recommended it. He was commissioned
to write a report on what government action could be taken to
improve peoples standard of living, and he recommended that a
free-at-point-of-service health system be introduced. Beveridge had
been very important in the creation of the National Insurance
scheme in 1911 and so he was able to use his prior knowledge to
help come up with a plan for funding the NHS, and what provision
should be included within it. Without Beveridges report, we might
have had a very different system in place today.
Exam practice (page 54) 3. How useful is Source A to a historian
studying Bevans role in the creation of the National Health
Service? [8]
Source A is very helpful in showing us how Bevan won over the
doctors, who were initially resistant to the idea of the NHS. Punch
was a satirical magazine and so it shows Bevan giving doctors
medicine labelled National Health Service; in reality, Bevan won
the doctors round with concessions and stirring speeches.
Therefore, the source is useful in showing that Bevan was
responsible for this aspect of setting up the National Health
Service, but it is not entirely reliable in its portrayal of how
this was achieved. In addition to this, the cartoon does not show
Bevans wider role in creating the National Health Service. As
Minister for Health he was instrumental in getting the bill through
Parliament and bringing the organisation into existence. The source
is not useful for showing us this wider involvement.
Exam practice (page 54)4. Why did the standard of medical
treatment improve so rapidly during the twentieth century? [12]The
main reason why the standard of medical treatment improved so
rapidly during the twentieth century is due to the massive
improvements in science and technology that were made. For example,
the development of new drugs such as Salavrsan-606 meant that it
was easier to treat patients for illnesses such as blood poisoning.
The development of penicillin in the 1940s led to better treatments
for infections and disease like meningitis, which meant that people
were a lot more likely to survive these diseases than they had been
in the past. Later on in the century, new technology such as the
dialysis machine meant that people were able to receive treatment
when their kidneys failed. Transplant surgery was also developed
which meant that kidney failure and other illnesses involving major
organs could now be treated. Watson and Cricks discovery of human
DNA eventually led to gene therapy being developed which also
improved medical treatment. Science and technology played a huge
part in improving medical treatment so rapidly, but a lot of these
things were funded and provided by the NHS, which was launched in
1948. Therefore, you could also say that the government was a
really important factor in improving medical treatment during the
twentieth century.
6.4 The impact of new technologies
Exam practice (page 56) 1. In what ways has technology affected
the treatment available to patients in hospitals since 1900?
[12]Technology has had a massive effect on the treatment available
to hospital patients since 1900. There have been a lot of new
inventions which have led to improved treatment. For example,
x-rays allow doctors to set broken bones more precisely. Other
types of scans help doctors to diagnose and treat cancer, and are
helpful during pregnancy in monitoring the health of the baby and
the mother. Treatments like radiotherapy and chemotherapy can also
be used to treat cancer. This has improved the survival rate for
this disease. Furthermore, the development of keyhole surgery,
using fibre optic cameras to see inside a patient and perform the
operation without having to make a big incision, has rapidly
improved the recovery times because major operations can now be
carried out more quickly and with less trauma to the patient. It is
also easier to monitor the health of patients in hospital thanks to
blood pressure machines and quicker blood tests. Overall,
technology has had a really positive effect on the treatment
available to patients in hospitals.
Exam practice (page 57)2. What do Sources A and B show about
changes in the way doctors in Britain treat blood loss? Explain
your answer using Sources A and B as well as your own knowledge.
[8] The treatment of blood loss has changed significantly since
Source A was published in the seventeenth century. This source
shows a doctor attempting a blood transfusion from a lamb to a
human. This was published after Harvey had published his work on
circulation and therefore doctors understood that blood circulated
around the body; however, they did not yet know about blood types
and therefore many transfusions between animals and humans, such as
this one, were tried.Source B shows a complete change in how blood
loss is treated in the present day. The discovery of blood groups
by Landsteiner in 1901 meant that doctors were now able to offer
patients blood of a matching type, which meant that lost blood
could now be replaced. The development of methods of storing blood
during the First World War meant that blood loss was no longer the
problems for surgeons that it had been previously.
Exam practice (page 59)1. Public health problems had largely
been solved by the twentiethcentury. Do you agree? Explain your
answer. [16]In some ways I agree with this statement. This is
because the biggest public health problem pre-1900 was probably the
lack of clean water and the problem of waste disposal. This was
particularly a problem after the Industrial Revolution, when cities
grew much bigger and more crowded. However, this problem had
largely been solved by 1900. New technology and funding from local
and national governments had led to the provision of clean water
and a network of sewer systems to allow waste to be removed. The
germ theory of disease had proved that illness is caused by
microbes, which encouraged the government to put measures in place
to prevent outbreaks of diseases such as cholera. It had also
introduced vaccination programs for diseases such as smallpox which
helped to improve public health.However, there were other problems
which continued into the twentieth century. For example, standards
of living among the poor were still very low. There was a lot of
slum housing and families living in cramped conditions. Their diets
were usually very poor. The government realised this was a problem
when it tried to recruit soldiers for the Boer War and found that a
lot of the volunteers were medically unfit. There were other
problems of epidemics, such as measles and polio: these could not
be tackled until vaccines were developed later in the twentieth
century. There was also the problem of expensive health care, which
was not fully solved until the introduction of the NHS in 1948.
Overall, I would say that the biggest problem of public health had
been solved by 1900 but there were more issues that needed tackling
after 1900.
2. The governments role in improving public health was
moreimportant during the nineteenth century than the
twentiethcentury. Do you agree? Explain your answer. [16]The
government was very important in improving public health in both
the nineteenth and the twentieth centuries. In the nineteenth
century, it passed the Public Health Acts of 1848 and 1875, which
made local councils responsible for the public health systems in
their cities and make provision for clean water and the removal of
sewage. These acts had a massive impact on public health,
particularly the second one which forced the changes through rather
than just recommending them. Nineteenth-century Britain was filled
with overcrowded cities where public health was a big problem, due
to the lack of clean water and good drainage, so solving these
problems made an enormous difference to health. Other measures like
the sewer system in London, new building regulations and compulsory
vaccination against smallpox also helped to improve public health.
In the twentieth century, the government continued to offer
vaccination programs against diseases like diphtheria and whooping
cough. It introduced the NHS which maintains lots of public health
campaigns, for example family planning clinics and vaccination
against possible epidemic illnesses like swine flu. The government
also has propaganda campaigns to alert people to dangers to their
health. For example, cigarette packets carry health warnings and
all alcohol advertising must include a message about drinking
responsibly. There are also campaigns encouraging people to
exercise more. These things will lead to better health among the
population and better life expectancy. Therefore, the governments
role in improving public health has been important in both
centuries. However, I think it was more important in the nineteenth
century because the conditions were much worse then, so they had a
bigger step to make. Also, in the nineteenth century the
governments attitude changed completely from laissez-faire to
wanting to get involved in public health; this laid the foundations
for its actions in the twentieth century.3. How important was the
work of Aneurin Bevan in launching the NHS in 1948? [16]The work of
Aneurin Bevan was really important in launching the NHS in 1948,
because he was Minister for Health and so it was his
responsibility. Bevan was very supportive of the NHS and made lots
of speeches to encourage other people to be supportive too. He
inspired people to register for the NHS which increased the demand
for doctors, encouraging them to sign up too. He was able to make a
compromise with the doctors to ensure that they would work for the
NHS, as they could continue to practice medicine privately as well
to maintain their wages. Without the work of Bevan, the NHS may
have been a flop because if the doctors had not signed up there
wouldnt have been enough medical provision for all the
patients.However, other things were important in the launch of the
NHS, too. William Beveridge, a civil servant, had written a report
on how to improve living conditions in Britain and he had
recommended the creation of a National Health Service in the first
place, so without that there wouldnt have been a cause for Bevan to
champion. The changing attitudes of the population after the Second
World War were also important: the middle classes particularly were
keen on the idea of health care for everybody which put pressure on
the government to provide it.However, I think that without the
vision and drive of Bevan the NHS might not have been so successful
so quickly. Therefore, I think Bevans work was very important.
Section 2 Historical Source Enquiry: SurgeryChapter 7 The
transformation of surgery c184519187.1 Dealing with pain
Exam practice (page 61)1. Look at Source A. What was the purpose
of this representation? Use Source A and your own knowledge.
[8]Both of these letter extracts were published in the Lancet
shortly after James Simpson began using chloroform during
operations. They both show a negative view of it: both extracts
suggest that it is part of Gods design to suffer from pain and that
chloroform gets in the way of this. The purpose of the source is to
discourage people from using chloroform during operations,
suggesting that doing so is acting against the Christian religion,
because pain is a blessing of the Gospel.It seems a bit unusual
that a medical journal would publish objections on religious
grounds; however, at the time, many in the medical profession were
extremely suspicious of chloroform. In 1848, before these letters
were published, Hannah Greener had died of a chloroform overdose
whilst having a routine surgery on her toenail, and so many doctors
were reluctant to use it. Objecting on religious grounds might
discourage people further from trying the anaesthetic.
Exam practice (page 61)2. Look at Source B. What was the purpose
of this representation? Use Source B and your own knowledge. [8]The
purpose of this source is to encourage people to use chloroform as
an anaesthetic. Queen Victoria was an extremely influential person
during her reign and the fact that she used, and liked, chloroform
during child birth would set an excellent example for other women
who might have worried about using it.At this time, only a few
years after the discovery of chloroform, there were many objections
to it from other doctors. Some were concerned about getting to
dosage right and used the example of Hannah Greener, who died after
being given too much, as an excuse not to administer the drug.
Others objected on religious grounds, claiming that pain was Gods
blessing and suffering through it, particularly in childbirth, was
character building. Therefore, supporters of chloroform would have
welcomed Queen Victorias positive comments and ensured they were
published widely, in order to increase support for the use of the
anaesthetic.
7.2 Dealing with infectionExam practice (page 63)1. Why were
surgeons resistant to Listers new methods? Explain your answer
using Source A and your own knowledge. [10]Many surgeons were
resistant to the use of Listers carbolic spray because, firstly,
they found it difficult to accept that they had a role to play in
preventing infection. Most surgeons operated in the same clothes
they wore outside and some even took pride in their blood-stained
aprons. When Lister suggested a link between dirty clothing and
unwashed hands in the operating room, many doctors found this hard
to accept, as demonstrated in Source A. Secondly, surgeons were
against using carbolic spray because they did not like its smell.
It dried out the hands and caused the skin to crack, and it made
operations longer and more expensive because additional preparation
and materials were needed. Since speed was still important in
nineteenth century surgery, because the problem of blood loss had
not yet been solved, it seemed like a mistake to slow down the
operation even further. Finally, even though Lister developed his
spray after germ theory, many people still did not accept it.
Because they did not believe that the air was full of microscopic
germs, surgeons refused to believe that the spray could possibly
reduce the rate of infection in the operating rooms. Therefore, the
method could not be accepted until people fully accepted germ
theory.
7.3 Dealing with blood lossExam practice (page 65)1. How
reliable are Sources A and B as evidence of the changes in blood
transfusions by 1918? Explain your answer, using Sources A and B
and your own knowledge. [10] The sources are quite reliable when
considering how blood transfusions had changed by 1918, because
both Sources A and B make it clear that the First World War had
something to do with it. From my own knowledge I know that the
terrible wounds caused by shrapnel and other fighting during the
First World War caused the methods used for transfusing patients in
the field to develop more quickly: Source A shows army nurses
packing blood and Source B explains that transfusion was given in
rush conditions. Furthermore, Source A seems reliable because it is
a photograph taken at the time and shows that blood was able to be
stored and transported, which was a new development in blood
transfusion, which fits with what I know; it was probably used by
the army to show the use of new medical technology, as they would
have wanted soldiers to feel confident that they could be treated
for blood loss. Additionally, Source B is a contemporary source
from a medical journal written by a doctor who was using the new
methods; to be published in this journal he would have needed to
have evidence of his work, which makes his account
reliable.Therefore, I feel that the sources are very reliable when
it comes to considering changes in blood transfusion by 1918.
7.4 Factors influencing developments in surgery
Exam practice (page 67)1. Source C suggests that better
communication, using journals such as the Lancet, was the main
reason for the development of surgery. How far do you agree with
this interpretation? Explain your answer, using your own knowledge
and Sources A, B and C. [16+3 for SPaG)Source C explains that
Lister used the Lancet, a medical journal, to publicise his
findings and this shows how important improvements in
communications were in the development of surgery. If Lister had
not been able to share his ideas, then others would not have
started to make use of them; aseptic surgery probably would not
have been developed as quickly and the risk of infection would not
have been low enough to allow plastic surgery to take place safely.
Journals such as the Lancet encouraged other doctors to test new
methods and encouraged more discussion among medical professionals.
On the other hand, Source A shows how important the First World War
was in the development of surgery, particularly plastic surgery. Dr
Howard Gillies developed this method of using pedicle tubes to help
to repair the facial injuries of soldiers who had been disfigured
during the war. If the war had not taken place, then this type of
surgery might not have been developed. Also, war was extremely
important in the development of blood transfusions: a method of
storing and transporting blood was developed during the First World
War due to the desperate need for transfusions on the front line.
Therefore, war was clearly extremely important. However, in order
to perform surgery such as Gillies, it is important to have
antiseptic conditions so that no infection can take hold in the new
skin being grown. Therefore, the development of antiseptic surgery
might be considered more important than the development of plastic
surgery, and this picture in Source B shows how important new
technology was in Listers fight to keep surgeries scrupulously
clean and remove the chance of infection. Lister had tried wrapping
wounds in carbolic acid-soaked bandages and also washing his hands
and instruments in it, but it was not until he started to use a new
spraying mechanism to mist a fine spray of the acid in the air that
he really saw a drop in his mortality rates. This shows that
technology also played an important role in the development of
surgery. Overall, though, I think that communication played a vital
role in the development of surgery. This is because Listers work
with the new technology only became popular when other doctors read
about it and started using it, and to begin with it was very
unpopular because there werent enough results to prove its
effectiveness. Furthermore, work with blood transfusions during the
First World War was only possible after Landsteiner discovered
blood groups in 1901 and published his work on this for everybody
to read. Even though Source C is from an article celebrating the
Lancet and will clearly be painting it in a very positive light, I
still think that it was the key element in ensuring surgery
developed so far by 1918.
Section 3: The American West c18401895Chapter 8: Inhabitants and
early settlers8.1 The Plains Indians: their beliefs and way of
life
Exam practice (page 69)1. Why were the buffalo so important to
the Plains Indians? [12]The buffalo were vitally important to the
Plains Indians because they relied on them to provide for every
aspect of their lives. For example, the buffalo provided the
Indians with most of their food. The buffalo hunt would take place
two or three times a year. Some of the meat would be eaten fresh,
and the rest would be dried or smoked so that it would keep for a
long time. Although the Indians also hunted other animals and ate
plants and berries they gathered on the Plains, the buffalo was
their main food source. Secondly, the buffalo provided the Indians
with the materials they needed to clothe and house themselves.
Clothes would be made from the skin, which the Indian women tanned
using buffalo brains. They would also use this tanned hide to make
the tipi, which the Indians lived in. This was a key part of their
lifestyle as it could be packed up and moved very quickly, and also
it didnt require a lot of wood, which was scarce on the Plains.
Overall, the buffalo were important to the Plains Indians for a lot
of reasons, but I think they were most important because they
provided the Plains Indians with food, shelter and clothing.
Exam practice (page 70)2. Describe the Plains Indians beliefs
about warfare. [9]The Plains Indians did not fight wars for the
same reasons as the white Americans. White Americans fought wars
over land, but because the Plains Indians did not believe anybody
could own the land, they fought for different reasons. For example,
they would fight to win horses, or to gain honour and win a wife.
This meant that battles were usually very short, and the emphasis
was not on killing. Warrior bands would defend their village from
attack for long enough to allow the women and children to pack up
and escape. Because the object of the battle was not to kill, the
bravest act an Indian could perform in a battle was counting coup.
This involved touching your opponent with a stick or with your
hand. This showed that you were braver than they were.
Exam practice (page 71)3. Choose one of the following and
explain how it helped the Plains Indians to live successfully on
the Great Plains. The social structure of tribes Attitudes to land
and nature [9]The social structure of the tribes was very important
in helping the Plains Indians to live successfully. They were very
well-organised and made sure everybody was taken care of. For
example, polygamy was allowed because there were more women than
men: this made sure all the women were provided for. Also, the tipi
was owned by the woman, which meant she would always have a place
to live, even if her husband was killed during a buffalo hunt.
Indian tribes were split into smaller bands. Each band was led by a
chief, who took advice from a council of elders and medicine men.
This meant that major decisions were discussed carefully and every
mans voice was heard. Everybody had their job within Indian
society. The men would form a warrior society responsible for
organising the hunt, while the women looked after the tipi and made
clothing and other necessities. The elderly played an important
role in looking after children, but they would stay behind to die
when they became too weak to keep up. This helped the Indians to
live successfully on the Plains, because everybody was clear about
what their role was and everybody worked together to make it a
success.
8.2 Migrants and settlers in the West: early settlers
Exam practice (page 73)1. Why did early settlers move to Oregon
in the 1840s? [12]Early settlers moved to Oregon in the 1840s due
to various push and pull factors. Firstly, they were tempted west
by the pull factors. Fur trappers, who had travelled in Oregon a
lot from the 1820s onwards, reported that there was perfect
farmland and a never ending supply of furs and fish for people that
went to Oregon. Also, the government passed a law which said that a
farmer who squatted on a piece of land, built and house and cleared
the trees was entitled to buy it for a low price, which encouraged
more people to move there. This meant that farmers were more
willing to take a chance. Secondly, settlers were forced west by
the push factors. In the 1830s the United States was in an economic
depression. There werent enough jobs in the East and wages fell.
This meant that food prices also fell so farmers in the East were
not able to break even. They also felt quite crowded in the East as
populations had risen dramatically. This meant that they started to
look towards the unsettled land in the West to get away from it all
and make a new start.
Exam practice (page 73)2. Describe the problems of law and order
in California mining towns from 1849. [9]There were many problems
of law and order in California mining towns after gold was
discovered in 1849. The main reason for this was because there
wasnt enough law enforcement. The population of the towns grew
quickly and because it took so long for law enforcers to travel
from the eastern states, there were not enough people to keep law
and order among the miners. There was a lot of racism in the mining
camps. There were groups of black, Mexican, Asian and Indian miners
who were very unpopular among the white miners. Claim jumping was a
common problem and led to law and order problems, because to begin
with claims to certain areas were not properly recorded and it was
easy to start mining on somebody elses land. This caused big law
and order problems. However, both of these problems could have been
tackled if there had been more law enforcement officials in the
mining towns.
Exam practice (page 73)3. Describe the effects of the discovery
of gold in California in 1849 on the growth of the American West.
[9]The discovery of gold in 1849 had both positive and negative
effects on the growth of the American West. One good thing was that
it encouraged more people to move to California. This meant that
the area became settled quickly, and the increased migration opened
up the routes west and encouraged the American government to fund
the development of the transcontinental railroad. This was really
key in helping the Americans to achieve their Manifest Destiny and
settle the whole of the continent. The increase in people caused
problems of its own because California wasnt properly set up for
the new communities. Life was hard and there wasnt much law
enforcement, which created law and order problems. Mining towns
sprang up out of nowhere, often without proper housing or
sanitation, which caused health problems. Also, many of the new
miners were not trained and did not find any gold, which meant that
there was a lot of poverty.
8.3 Migrants and settlers in the West: the journey west
Exam practice (page 74)1. What can you learn from Source A about
the journey across the Plains? [4]From this source, I can learn
that the journey across the Plains would have taken a long time.
This is because Marcy recommends allowing the animals almost as
much time resting and grazing as they spend pulling the wagons. I
can also infer that sometimes it was difficult to find good grazing
land for the animals because Marcy mentions the animals turning out
on the best grass than can be found.
Exam practice (page 76)2. What can you learn from Source B about
the dangers facing travellers as they crossed the Plains? [4]From
this source, I can learn that travellers across the Plains faced
danger from Indian attacks. In the source, Jane Gould explains that
she has heard about an attack and then she sees some dead people
who have been mutilated by the Indians. I can infer that Jane Gould
became very anti-Indian because of what she saw. Living in constant
fear of attack must have taken its toll on the settlers.
Exam practice (page 76)3. What can you learn from Source C about
the problems faced by wagon trains? [4]From this source, I can
learn that wagon trains faced attacks from Indians. In the source
you can see Indians attacking with tomahawks, machetes and bows and
arrows. They are on horseback and they look very fierce. However, I
can also see that the wagon trains did a good job of defending
themselves against Indian attacks because they had more
sophisticated weapons than the Indians, such as rifles.
Exam practice (page 76)4. Describe the difficulties faced by
people migrating west in wagon trains in the 1840s. [9]Travelling
west in a wagon train was a very dangerous and difficult journey.
The pioneers faced many dangers, which included bad weather,
stampedes, Indian attacks, lack of supplies and water and getting
lost. Bad weather was particularly difficult to deal with because
it was very unpredictable. Settlers would try to leave for the
journey in April to get across the mountains before the first
winter snows, but sometimes they were not successful. There were
also high winds and scorching heat, which was difficult to deal
with when there wasnt a lot of water. Getting lost was also a
problem. Many wagon trains were led by experienced guides but even
they tried short cuts or took wrong turns. This could lead settlers
a long way out of their way and result in them running out of
supplies. The Donner party is a good example of a group who were
unlucky enough to experience all these things. They tried to take a
short cut but it took longer than expected, and they lost a lot of
their supplies. Then they got snowed in in Sierra Nevada and over
half of them died.
Exam practice (page 76)5. Getting lost was the biggest problem
faced by people migrating west. Do you agree? Explain your answer.
[16]Getting lost was certainly a big problem facing the first
people migrating west. This was because there werent many points of
reference on the trails, which made it difficult to navigate. Most
wagon trains were led by experienced guides, like mountain man Jim
Bridger, who knew the route well and could find the best way
through the Rockies and the Sierras. However, some groups took
their chances with less experienced guides, such as the Donner
party, who followed a short cut recommended by a trail guide called
Lansford Hastings. Tragically, this short cut took a lot longer
than expected and the Donner party ended up getting snowed in and
resorting to cannibalism. However, getting lost was less of a
problem as more settlers made the journey west, because the routes
became more established. Even today you can still see ruts in the
rock on some parts of the trail, which have been left behind by
wagons. A much bigger problem that faced the people migrating west
were the harsh weather conditions, which could not be predicted or
protected against; the settlers also faced trouble if they ran out
of supplies because there were very few places along the way to
restock. Furthermore, disease and injury were common and could
prove to be deadly cholera was not uncommon, due to poor
sanitation. Overall, I would say that getting lost might have been
the biggest problem for some of the first travellers west, but most
settlers faced other, much bigger problems on the journey.
8.4 Case Study: the Mormons
Exam practice (page 78)1. What can you learn from Source A about
the attitudes of gentiles towards the Mormons? [4]From this source,
I can learn that the gentiles had a negative attitude towards
Mormons because they practised polygamy. For example, the
cartoonist has depicted some of Brigham Youngs supposed wives as
small, suggesting that he married some very young women before his
death. The cartoon also suggests that Brigham Young was rich he has
a fancy carpet on the floor and the window blinds are monogrammed
with his initials. The cartoonist might be suggesting that Young
made a lot of money out of being the leader of the Mormons.
Exam practice (page 80)2. Why was Brigham Young so important to
the Mormons successful settlement at Salt Lake City? You may use
the following in your answer. The Mormon Church shared out the
land. 1849: The Perpetual Emigrating Fund was set up.You must also
include information of your own.[12]Brigham Young was so important
in the Mormons successful settlement at Salt Lake City because it
was his idea in the first place. He chose to lead them there
because at the time it was not part of the United States and so
they were able to practise polygamy there. He planned the journey
well and ensured that everyone was provided for. Once they arrived
at the Great Salt Lake, Brigham Young continued to be important
because he was an inspiring leader. The Mormons listened to him as
they believed he was inspired by God. He made sure the land was
carefully shared out among the Mormon families: the biggest
families had the biggest pieces of land. He also ensured an
irrigation system was in place to make sure everybody had fair
access to the water. Finally, Young was important because he came
up with a plan to make sure the whole area was settled with
Mormons: the Perpetual Emigrating Fund. This fund made loans to
Mormons who wanted to travel to live in the area. Young sent
missionaries to Europe to encourage people to convert and move to
the new Mormon territory of Utah.
Exam practice (page 80)3. Why did the Mormons move to the Great
Salt Lake in 1845? [12]The Mormons began their journey to the Great
Salt Lake in 1845 due to persecution. They had become very
unpopular in the eastern states for many reasons. One of these was
that they practised polygamy, which many gentiles felt was immoral.
The non-Mormons were also worried that by practising polygamy, the
Mormons would be able to increase their population very quickly by
having lots of children. There was a lot of fear among the
non-Mormons that the Mormons were trying to take over the world,
and this was not helped by a rumour that their leader, Joseph
Smith, intended to run for president. For this reason, Joseph Smith
was shot during an attack by a mob of 200 people. Lots of Mormons
began to fear that their town, Nauvoo, would also be attacked and
so they started to look for a new place to live where they could
follow their own rules. Therefore, the Mormons were pushed west by
persecution. The Mormons were also pulled west to the Great Salt
Lake because in 1845, this area was still under the control of
Mexico. That meant that the Mormons could legally practise
polygamy. The Great Salt Lake was also a very remote place which
nobody else wanted at the time. The new Mormon leader, Brigham
Young, thought it was the perfect place to go because they would be
free from persecution and able to build their own society according
to their own rules. Therefore, the Mormons were pulled west by the
remoteness of the location Brigham Young chose.
Exam practice (page 80)4. Describe the key features of the
Mormon journey to the Great Salt Lake. [9]The Mormons were able to
make a success of their journey to the Great Salt Lake because
their leader, Brigham Young, planned it very carefully. First of
all, he organised the wagons into groups of 100, with a captain in
charge. Each group of 100 was split into ten groups of ten, each
looked after by a lieutenant. This was very well-organised and made
it clear who was in charge. It meant there was very little room for
argument. Secondly, Young himself went with the first wagon train
and stopped every so often to build a rest camp for the people
coming on afterwards. The biggest of these was on the banks of the
Missouri River and it was called Winter Quarters. There were 1000
cabins built and this is where the Mormons spent the winter. This
helped them to avoid the worst of the weather and gave them a place
to rest and refuel. Finally, after winter had passed, Young led a
smaller Pioneer Band to the Great Salt Lake to start the settlement
for the other Mormons. He included a mixture of farmers and
craftsmen. This meant that when the Mormons reached the Great Salt
Lake they were not arriving in a barren wasteland. Overall, the
Mormon journey to the Great Salt Lake was a successful one, thanks
to Brigham Young.
8.5 Migrants and settlers in the West: settlers on the
Plains
Exam practice (page 81)1. What can you learn from Source A about
the idea of Manifest Destiny? [4]From this source, I can learn that
the artist felt very positive about the idea of Manifest Destiny.
The train and wagon train are both heading forwards towards a green
and unspoilt land. In the foreground you can see people working
hard to build their town, and the train is full of people which
shows that lots of people were eager to settle on the Plains.
Exam practice (page 82)The government was the biggest factor in
encouraging people to move to the Plains after 1860. Do you agree?
Explain your answer. [16]The government encouraged a lot of people
to move to the Plains after 1860. This was because it offered
people free land under the Homestead Act of 1862. Settlers could
claim 160 acres of land as long as they agreed to live on it and
farm it for five years. This was a good deal for people who didn't
own anything in the East and so it encouraged a lot of people to
move onto the Plains. Later on, the Timber Culture Act offered
settlers another 160 acres of land as long as they agreed to plant
40 acres of it with trees, and the Desert Land Act offered 640
acres of land in states where rainfall was particularly low.
Therefore, the government was extremely important because it gave
the land away to people, encouraging them to move to the Plains.
However, the railroads were also very important. Once the railroad
had been completed, the railroad companies advertised heavily to
let people in the East know about the opportunities available to
them on the Plains. They also sold their spare land off very
cheaply. It was easier to travel to the Plains and to get supplies
once the railway had been finished. Therefore, the railroad was
also an extremely important factor in encouraging people to move to
the Plains. Overall though, I think that the government was the
most important, because it passed the Homestead Act in 1862,
whereas the railroad was not completed until 1869. So, although
both were important, the government had more impact on settlement
during the 1860s.
8.6 Farming on the Plains
Exam practice (page 84)1. Why was it so difficult for the
homesteaders to settle on the Plains in the 1860s? [12]There were
two main difficulties faced by homesteaders trying to settle on the
Plains in the 1860s lack of wood, and lack of water. They faced
lots of problems, but most of them stemmed from these two big
issues. Lack of water was the main one. This made it difficult for
the homesteaders to grow crops. This problem was made worse by the
fact that they were trying to grow the same sort of crops that they
grew in the East, for example soft wheat, which couldnt stand up to
the harsh Plains conditions. Also, because there was so little
rain, the ground was really hard and dry, and the ploughs they
brought with them couldnt stand up to the soil and broke. This made
preparing the ground for crops very difficult. Furthermore, the
lack of water made it difficult to keep clean and to give animals
enough to drink. Secondly, they faced a lot of problems because
there wasnt much wood. For example, they were unable to build
fences around their crops. This meant that they were easily
trampled and/or eaten by wild animals and their own cattle. Also,
there wasnt enough wood to build houses, which meant that they had
to build them out of baked mud bricks, or sods. These were
difficult to keep clean, especially when there wasnt much water
around. Although the main issues were lack of wood and water,
homesteaders who tried to adapt did the best, and so perhaps the
biggest issue of all was lack of experience and an unwillingness to
try new things.
Exam practice (page 84)2. Technology was the most important
factor in solving problems faced by homesteaders in the 1870s and
1880s. Do you agree? Explain your answer. [16]Technology was very
important in helping homesteaders solve the problems they faced in
the 1870s and 1880s. Most of their problems were caused by a lack
of wood and a lack of water. The invention of the self-governing
windmill helped homesteaders to solve the problem of water
shortages because it enabled them to pump water up from deep
underground to water their crops. They were also able to use their
new ploughs, such as the sod buster, to plough their fields quickly
shortly after it had rained, which trapped a layer of water under
the soil so it couldnt evaporate. This was known as dry farming.
When barbed wire was invented in 1873, the homesteaders used this,
rather than wood, to fence off their crops. Using barbed wire
helped them to get around the wood shortage problem. However,
things other than technology were also important. For example, the
government introduced the Timber Culture Act in 1873 which allowed
homesteaders to double their land claim if they planted 40 acres of
trees. This eventually increased the amount of wood available on
the Plains. Also, the homesteaders started to grow different crops
which coped better with the dry conditions of the Plains, for
example, Turkey Red Wheat which was grown in Russia. Overall, I
think that the main reason for the homesteaders success was hard
work and adaptability. It was not easy to be a farmer on the Plains
and some of the problems, such as extreme weather conditions and
plagues of locusts, couldnt be solved. Homesteaders got round this
by growing a surplus in good years and adapting to their
surroundings as much as they could. For example, they burned
buffalo chips instead of wood. Technology certainly helped them to
succeed on the Plains, but a number of the new inventions were
created by homesteaders who were trying to adapt to their new
surroundings, which shows that it was hard work and determination
that was really the secret of their success.
Exam practice (page 84)3. Describe the contribution made by
women to settling on the Plains. [9]Women were highly valued on the
Plains because they kept house and made sure everybody was fed and
clothed. This was very important on the Plains, where life could be
exceedingly hard. They were responsible for keeping a kitchen
garden and growing vegetables and fruit. They would also fish and
hunt small game to help feed the family. They would make and mend
clothes and gather buffalo chips to keep the house warm and provide
a fire for cooking. However, it was not just in the home that women
were important. They were also vital for building the community of
the Plains. A large number of single women were recruited to be
school teachers in Plains townships, for example. Also, women
helped to build a network of communication among homesteads and
organised social events to celebrate births and harvests, which
helped to build the community spirit upon which Plains life was
built.
Chapter 9: Development of the Plains9.1 The construction of the
railroads
Exam practice (page 86)1. What can you learn from Source A about
the building of the railroads? [4]From this source, I can learn
that the railroad builders had to hire thousands of Chinese
labourers to work on the Transcontinental Railroad. I can infer
that this was because there were not enough workers in the West to
complete the job. Twelve thousand is a lot of workers, so the
project must have been very difficult. I can infer that it was
easier to hire Chinese workers who travelled to the West Coast
across the Pacific, than it was to hire railroad workers from the
East.
Exam practice (page 86)2. Why was it so difficult for the
railroad builders to complete the transcontinental railroad?
[12]The transcontinental railroad builders faced a lot of problems
whilst they were building their railroad. The first of these was
the different types of land they had to cover. The railroad had to
cross several mountain ranges as well as deep valleys and long
deserts. New techniques had to be used to blast through solid rock
just to get the railroad out of California. The blasters used
nitro-glycerine which was very dangerous, and accidents happened.
Therefore the terrain made it very difficult for the railroad
builders. Another problem faced by railroad builders was a shortage
of workers. This might have been linked to the dangers of the job,
which might have put people off. Also, conditions were very poor,
because railroad workers lived in shacks by the side of the rails
or in railway carriages on the rails they had just completed.
Conditions were horrible and pay wasnt good. This meant that fewer
Americans were willing to sign up to work on the railroad. In the
end, the railroad builders were only able to complete their railway
by bringing in extra labourers from China and Ireland. Overall, the
main difficulties facing the railroad builders were the terrain and
the shortage of workers.
Exam practice (page 87)3. Choose one of the following and
explain how the building of the transcontinental railroad changed
their lives. The homesteaders The Plains Indians [9]The
transcontinental railroad changed the lives of the homesteaders
because it made it easier for them to get supplies from the East.
New farming equipment could more easily be purchased and goods
could be shipped to markets in the East where they might fetch a
higher price. This meant that it was easier for the homesteaders to
make a success of their farms after the transcontinental railroad
had been completed. The transcontinental railroad also increased
the number of homesteaders living on the Plains. This was because
the railroad companies advertised heavily about how amazing life on
the Plains was, to encourage people to move West and use the
railroad. Furthermore, the railroad companies sold off the land
they had been granted to build the railroad but didnt need. They
sold this land very cheaply to homesteaders looking to start a new
life on the Plains. Therefore, the railroads changed the lives of
homesteaders by increasing their numbers and therefore building
bigger communities on the Plains.
9.2 The rise and fall of the cattle industry
Exam practice (page 89)1. Describe the factors that led to the
spread of cattle ranching onto the Plains. [9]There were several
reasons why cattle ranching spread to the Plains. The main reason
was that there wasnt enough space in Texas. This is because during
the American Civil War, the cattle in Texas bred uncontrollably and
by the end of the war there were about 5 million of them, and there
wasnt enough grass to go round. This meant that the cattle ranchers
had to look to the Plains to find enough grazing land for their
herds. Once they had started to graze their cattle on the Plains,
the ranchers discovered that the low winter temperatures killed the
ticks which caused Texas Fever, and that encouraged more ranchers
to keep their herds on the Plains. Therefore, the weather was
another factor which led to the spread of cattle ranching to the
Plains. Finally, the transcontinental railroad encouraged more
ranchers to move to the Plains. It provided an easy way for the
ranchers to transport their cattle to the markets in the East. It
was easier to raise the cattle on the Plains than it was to raise
them in Texas and drive them north to the railway. Therefore, this
was another important factor in the spread of cattle ranching to
the Plains.
Exam practice (page 89)2. Why did open range ranching decline
after 1883? [12]The cattle industry declined after 1883 for two
main reasons. Firstly, demand had declined. Secondly, there had
been a run of particularly bad weather. These two factors combined
to force a decline in the cattle industry. By the 1880s, demand
from the East for beef had started to fall. This meant that the
price paid for each cow fell too, so ranchers didnt want to sell
their cows. They kept their cows alive on the open range, hoping
that the price would increase. This meant there was even less grass
to