Syllabus Edition
First teaching 2024
First exams 2026
Context of Medicine in the Early 20th Century (Edexcel GCSE History)
Revision Note
Medicine in the 20th Century - Summary
The type and extent of injuries on the Western Front led to a variety of new techniques used to treat wounds and infections. It is important to recognise the foundations of these techniques occurred before the First World War. The work of Joseph Lister on antiseptics and the development of aseptic surgery led to higher survival rates. Doctors in Base Hospitals and Casualty Clearing Stations applied these principles. Geoffrey Keynes improved on the techniques established by James Blundell and Karl Landsteiner’s work on blood transfusions. The use of mobile x-rays on the Western Front was thanks to the work of Wilhelm Röntgen and his discovery of x-rays in 1895. To understand the medical developments in the British Sector of the Western Front, it is important to know what medicine was like before the First World War and in the early 20th century. |
Understanding of Infection and the Move to Aseptic Surgery
Understanding infection
By the end of the 19th century, there was an understanding of what caused infection in surgery:
In 1861, Louis Pasteur’s Germ Theory identified that germs cause decay
Inspired by Pasteur, Joseph Lister used carbolic acid to clean the wound after a leg operation in 1865
Although carbolic acid was only popular for a short time, doctors understood the importance of carrying out aseptic surgery by the early 1900s
Exam Tip
Don’t confuse antiseptic surgery with aseptic surgery.
Antiseptic surgery is the use of antiseptics to destroy harmful germs and bacteria on hands and equipment.
Aseptic surgery is where a completely sterile environment is achieved through a variety of methods including antiseptics, heat and steam.
Aseptic surgery
Joseph Lister’s methods provided the medical community with a greater understanding of the importance of aseptic surgery
By the beginning of the 20th century, the foundations for aseptic surgery had been established:
Worked Example
Describe one feature of aseptic surgery in the early 20th century
2 marks
Answers:
From 1890, rubber gloves were worn (1). This prevented bacteria from being transferred into a patient's wound (1).
Exam Tip
This question previously asked students to describe two features of a given event. This question was out of four marks. However, as of 2025, Edexcel will split this question into two subsections, asking you to describe a feature of two different events. Each subsection is worth two marks.
This answer would receive full marks because it identifies a main feature or characteristic of aseptic surgery in the early 20th century. The feature is supported by a relevant piece of knowledge. The feature provided is short but specific to the focus of the question.
Blood Transfusions & Storage
More complex surgery was possible due to the development of aseptic surgery and x-rays:
Aseptic surgery saved many lives but blood loss was still an issue because:
Blood loss was common during complex surgery
If a patient lost too much blood, they went into shock and died
James Blundell performed the first blood transfusions between 1818 and 1829:
He developed the first basic techniques and equipment
A tube was used between patient and donor to complete the transfusion
Karl Landsteiner discovered the three main blood groups (A, B and O) by 1901
This solved the problem of donors rejecting transfused blood because it did not match their own type
Reuben Ottenberg identified Group O as the universal blood group
Before the First World War, there were still problems with preventing blood from clotting. This made storing blood difficult:
In 1915, Richard Lewisohn added sodium citrate to blood to stop it from clotting
In 1915, Richard Weil discovered sodium citrate allowed blood storage of blood and it could be refrigerated for up to two days
In 1916, Francis Rous and James Turner established citrate glucose allowed storage of blood for up to four weeks
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