Health and the people: c1000 to the present day: Chapter 3 Answers

Part two: The beginnings of change

3 The impact of the Renaissance on Britain

Study Source A.

1 How useful is Source A to an historian studying Renaissance medicine?

Explain your answer using Source A and your contextual knowledge. (8)

Mark scheme

Level	Marks	Explanation
1	1–2	The answer contains a basic analysis of the source. It identifies basic features of the source that are relevant to the question.
2	3–4	The answer contains a simple evaluation of the source, using own knowledge to explain how useful it is with reference to either the content of the source or its provenance.
3	5–6	The answer contains a developed evaluation of the source, using own knowledge to explain how useful it is with reference to either the content of the source or its provenance. It includes knowledge relating to the question and to the broader context of health and people between c1000 and the present day.
4	7–8	The answer contains a complex evaluation of the source, using own knowledge to explain how useful it is with reference to the content of the source and its provenance. It includes knowledge relating to the question and to the broader context of health and people between c1000 and the present day.

Relevant points that could be included

The source shows a detailed drawing of a human skeleton from Vesalius’ famous textbook On the Fabric of the Human Body.

The detailed and precise drawing of a human skeleton is useful in showing the progress made in our understanding of human anatomy during the Renaissance. It reflects the fact that Vesalius was able to dissect humans, when this was frowned upon in the medieval period and anatomical knowledge had to rely on animal dissections.

The illustration comes from Vesalius’ influential medical textbook, which challenged Galen’s ideas of human anatomy. The source reflects the forefront of Renaissance medicine and the experimentation and discovery of the time, coupled with the technological breakthrough of the printing press to help spread ideas.

2 Explain the significance of the work of Ambroise Paré. (8)

Mark scheme

Level	Marks	Explanation
1	1–2	The answer identifies or describes at least one aspect of significance.
2	3–4	The answer contains a simple explanation of one aspect of significance. It includes specific knowledge that is relevant to the question.
3	5–6	The answer contains a developed explanation of more than one aspect of significance. It includes specific knowledge that is relevant to the question.
4	7–8	The answer contains a complex explanation of more than one aspect of significance. It includes specific knowledge that is relevant to the question, and discusses the relationship between the different aspects.

An example of a Level 1 answer

Ambrose Paré helped to improve amputations for soldiers by making them less painful.

An example of a Level 2 answer

Ambrose Paré made advances in amputations for soldiers. He helped to make amputations less painful by using ligatures to stop the bleeding rather than cauterisation. He also made false limbs for soldiers, which were basic but helped to improve soldiers’ quality of life.

An example of a Level 3 answer

Ambrose Paré made advances in amputations for soldiers. He helped to make amputations less painful by using ligatures to stop the bleeding rather than cauterisation. Reducing pain was important at a time when anaesthetics were not usually used in surgery. Paré also made false limbs for soldiers, which were basic but helped to improve soldiers’ quality of life.

When Paré ran out of hot oil during a battle, he just used a cream instead, which helped his patients heal quickly while in less pain. This encouraged him to question accepted wisdom. He inspired English surgeons to question old ideas at a time when it was difficult to challenge the traditional teachings of Galen and Hippocrates. This was significant because it encouraged surgeons to experiment and improve their knowledge of anatomy and medicine.

An example of a Level 4 answer

Ambrose Paré made advances in amputations for soldiers. He helped to make amputations less painful by using ligatures to tie the blood vessels and stop the bleeding rather than cauterisation. Reducing pain was important at a time when anaesthetics were not usually used in surgery and the patient felt everything that was happening to them. It was also significant because it was unusual to prioritise the patient’s comfort. Another way that Paré accidentally helped patients feel less pain was when he ran out of hot oil during a battle in 1537. Instead, he used a cream of rose oil, egg white, and turpentine. This helped his patients heal quickly while in less pain and encouraged him to question accepted wisdom.

Paré wrote books such as his influential Works on Surgery in 1575. His books and teachings inspired English surgeons, such as the famous surgeon William Clowes, to question old ideas at a time when it was difficult to challenge the traditional teachings of Galen and Hippocrates. This was significant because it encouraged surgeons and doctors to experiment, question accepted but wrong ideas, such as the theory of opposites, and improve their knowledge of anatomy and medicine. Paré’s work on treating battlefield wounds also helped others improve medicine and surgery to help wounded soldiers. For example, William Clowes was inspired by Paré to write his own book, Proved Practice.

3 Explain two ways in which medieval surgery and Renaissance surgery were similar. (8)

Mark scheme

Level	Marks	Explanation
1	1–2	The answer identifies or describes at least one similarity.
2	3–4	The answer contains a simple explanation of one similarity. It includes specific knowledge that is relevant to the question.
3	5–6	The answer contains a developed explanation of more than one similarity. It includes accurate knowledge that is relevant to the question.
4	7–8	The answer contains a complex explanation of more than one similarity. It includes accurate and detailed knowledge that relates to the broader historical context but is still relevant to the question.

An example of a Level 1 answer

Medieval and Renaissance surgery were similar because they were both very painful for patients.

An example of a Level 2 answer

Surgery was a painful last resort in both the medieval and Renaissance periods. It used painful techniques such as cauterisation and amputation without any proper anaesthetics. Patients often died from blood loss or infection.

An example of a Level 3 answer

Surgery was a painful last resort in both the medieval and Renaissance periods. It used painful techniques such as cauterisation and amputation, but these often led to infection. For example, it was common in both periods to use cauterisation to stop blood loss from battlefield wounds, and because anaesthetics were risky to use, it was more common to simply hold patients down. Patients often died from shock, blood loss, or infection, and so people tried to avoid surgery if they could.

Another similarity is that surgeons in both periods experimented with new methods and shared their ideas through writing. For example, in the medieval period, John of Ardene developed a safer treatment for anal abscesses and shared his knowledge in the book Practica. In the Renaissance, Ambroise Paré developed a less painful way to stop blood loss from amputations and shared his ideas in the book Works on Surgery. In both periods, there were surgeons who tried to improve surgical techniques.

An example of a Level 4 answer

Surgery was a painful last resort in both the medieval and Renaissance periods. It used techniques such as cauterisation and amputation, but these often led to infection. For example, it was common in both periods to use cauterisation to stop blood loss from battlefield wounds, which was very painful but safe anaesthetics were not developed until the nineteenth century, so it was common just to hold patients down. In both periods, patients often died from shock, blood loss, or infection and so people tried to avoid surgery if they could. It was mainly reserved for the battlefield.

Another similarity is that there were surgeons in both periods who experimented with new methods and shared their ideas through writing, helping to gradually make surgery safer and more effective. For example, in the medieval period, John of Ardene developed a safer treatment for anal abscesses and shared his knowledge in the book Practica. In the Renaissance, Ambroise Paré developed a less painful way to stop blood loss from amputations and shared his ideas in the book Works on Surgery. Surgeons such as these and others (including Hugh of Lucca and Andreas Vesalius) were criticised and mocked by some for their new ideas, and it took time for their advances to filter through to everyday medicine. But they helped to improve surgical techniques and paved the way for surgery to be seen as more useful and less risky in the seventeenth and eighteenth centuries.

4 Has the role of the individual been the main factor in the development of surgery and anatomy?

Explain your answer with reference to the role of the individual and other factors.

Use a range of examples from across your study of Health and the people: c1000 to the present day. (16)

Mark scheme

Level	Marks	Explanation
1	1–4	The answer contains a basic explanation of one or more factors. It includes basic knowledge that is focused on the question.
2	5–8	The answer contains a simple explanation of either the stated factor and/or other factors. It includes specific knowledge that is focused on the question.
3	9–12	The answer contains a developed explanation of the stated factor and other factors. It includes accurate knowledge that is focused on the question, and may suggest that one factor has greater merit than the others discussed.
4	13–16	The answer contains a complex explanation of the stated factor and other factors. It includes accurate and detailed knowledge that is focused on the question throughout the answer, and will suggest which factor has greater merit than the others discussed.

Please note that Question 4 also has four marks available for spelling, punctuation, and grammar (SPaG). As a result, it is important that specialist terms and key names are used correctly in your answers. Always allow time to review your answers to check your writing.

You may have focused on only the medieval and Renaissance periods in your answer if you have not yet revised later periods. However, we’ve provided a full answer here – covering a wider period of history – so you can familiarise yourself with what’s expected in the exam.

An example of a Level 1 answer

Individuals such as Abulcasis and Vesalius helped to develop surgery and our understanding of human anatomy. They experimented with new ideas, and they also shared their ideas with others by writing books. Vesalius wrote the book On the Fabric of the Human Body and lots of other surgeons read this.

An example of a Level 2 answer

Key individuals such as Abulcasis and Vesalius helped to develop surgery and our understanding of human anatomy. They had the courage to experiment with new ideas. For example, Abulcasis experimented with using ligatures to tie off blood vessels, and Vesalius experimented with dissecting human bodies. Vesalius wrote up his findings in the book On the Fabric of the Human Body. This book was read by doctors across Europe, and so even though Vesalius was only one individual, he had a lot of influence.

Another factor that has made a difference is war. This is because innovations often take place during wartime to help soldiers, such as the portable X-ray machine that was invented during the First World War. This made it possible for X-ray images to be taken near the battlefield. Another wartime development was plastic surgery, which Harold Gillies pioneered to help soldiers with serious facial wounds.

An example of a Level 3 answer

Individuals have been important because key individuals such as Abulcasis, Andreas Vesalius, and John Hunter helped to develop surgery and our understanding of human anatomy. They had the courage to experiment with new ideas and challenge accepted wisdom. For example, Abulcasis experimented with using ligatures to tie off blood vessels, and Vesalius experimented with dissecting human bodies. From this Vesalius gained a more accurate understanding of human anatomy and he wrote up his findings in the book On the Fabric of the Human Body. This book was read by doctors and surgeons across Europe, and so even though Vesalius was only one individual, he had a lot of influence and played a key role in improving our knowledge of human anatomy.

Another factor that has made a difference is war. This is because innovations often take place during wartime to help wounded soldiers, such as the portable X-ray machine that Marie Curie invented during the First World War. This made it possible for X-ray images to be taken near the battlefield. Another wartime development was plastic surgery, which Harold Gillies pioneered during the First World War to help soldiers with serious facial wounds by using skin graft techniques.

A third important factor is science and technology. Careful scientific experimentation has led to the discovery of theories such as William Harvey’s theory of circulation and Louis Pasteur’s germ theory. These have helped to develop our understanding of human anatomy (such as how the heart works) and improve surgery (such as germ theory leading to antiseptic and then aseptic surgery). Using technology such as lasers in surgery has made surgery safer and easier to recover from.

Individuals have been the most important factor because surgery would not have developed without their courage and dedication pushing things forwards.

An example of a Level 4 answer

Individuals have been important throughout the history of surgery because key individuals such as Abulcasis, Andreas Vesalius, and John Hunter helped to develop surgery and our understanding of human anatomy. They had the courage to experiment with new ideas and challenge accepted wisdom, and the dedication to work hard for years on their craft. For example, Abulcasis experimented with using ligatures to tie off blood vessels, and Vesalius experimented with dissecting human bodies. From this Vesalius gained a more accurate understanding of human anatomy, and he wrote up his findings in the book On the Fabric of the Human Body. This book was read by doctors and surgeons across Europe, and so even though Vesalius was only one individual, he had a lot of influence. Communication was an important factor here, too, because it helped to spread new ideas, but individuals are more important because, without their hard work, there would be no new ideas to spread.

Another factor that has made a difference is war. This is because innovations often take place during wartime to help wounded soldiers, such as the portable X-ray machine that Marie Curie invented during the First World War. This made it possible for X-ray images to be taken near the battlefield. Another wartime development was plastic surgery, which Harold Gillies pioneered during the First World War to help soldiers with serious facial wounds by using skin graft techniques. The urgent need to help wounded soldiers during wartime led to important developments, but this still required pioneering individuals like Harold Gillies to introduce these new ideas and techniques.

A third factor that has become increasingly important over time is science and technology. Careful scientific experimentation has led to the discovery of theories such as William Harvey’s theory of circulation and Louis Pasteur’s germ theory. These have helped to develop our understanding of human anatomy (such as how the heart works) and improve surgery (such as germ theory leading to antiseptic and then aseptic surgery). Using technology such as lasers and tiny cameras in surgery has made surgery safer and easier to recover from. These developments have definitely helped to improve surgery, but they have still relied on key individuals coming up with new ideas and theories to test and build on. Pasteur’s work was only taken further through the vision of individuals such as Joseph Lister and his discovery of carbolic acid as an antiseptic, and William Halsted’s development of protective clothing leading to aseptic surgery. These individuals exploited technological developments and Pasteur’s work to combat the problem of infection in surgery.

In conclusion, war and science and technology have been important factors, but individuals have been even more important throughout because surgery would not have developed without their courage, dedication, and creativity pushing things forwards. Without their new ideas, surgery could not have developed during wartime and new technology would not have been developed.