Syllabus Edition
First teaching 2024
First exams 2026
Experiments in Surgery & Medicine on the Western Front (Edexcel GCSE History)
Revision Note
Advances in Surgery During the First World War - Summary
The type and extent of injuries on the Western Front led to the use of many new techniques to treat wounds and infections. The number of casualties allowed doctors and surgeons to perfect their methods. Many key individuals were pivotal in the evolution of blood transfusions. There were also new techniques devised in brain surgery and plastic surgery. The contribution to medicine and surgery led to the successful treatment of new types of injuries and meant men could return to society after the war. |
New Techniques in Wound & Infection Treatment
The RAMC struggled to treat soldiers with infections such as gas gangrene:
Contaminated conditions on the Western Front made it difficult to perform aseptic surgery
Dressing stations and Casualty Clearing Stations (CCSs) were often overcrowded. This made aseptic surgery less achievable
There were several methods of treatment used to help those with infection:
Technique | Description |
|---|---|
Wound excision or debridement | Cutting away dead or infected tissue from around the wound. This was done to stop the infection spreading. The wound was then stitched back up |
Carrel-Dakin Method | Chemical antiseptics like carbolic lotion failed to treat gas gangrene By 1917, sterilised salt solutions were passed through the wound instead The solution only lasted for six hours |
Amputation | If debridement or the Carrel-Dakin method failed, amputation was used By 1918, 240,000 men had lost limbs. Removing the limb prevented the infection from spreading to the organs |
The Thomas Splint
Wounded soldiers with compound fractures often died from blood loss or infection during transportation:
Fractures to the femur were particularly serious
The splint used to keep their leg rigid was ineffective
Difficult terrain made it more likely that broken bones would damage the muscle when the injured soldier was being transported
The infection spread before the soldier arrived at a CCS
The use of the Thomas Splint helped to reduce these problems
Placed on a soldier's leg they could then be safely carried on a stretcher
Kept the injured soldier’s leg rigid by pulling the bones and joints back together
Reduced the chance of internal bleeding
It became less necessary to use amputation
Exam Tip
Don’t confuse the Thomas Splint with a tourniquet:
The Thomas Splint was used on a soldier’s leg who was placed on a stretcher.
A tourniquet is used to prevent blood loss, and an injured soldier could move with it on.
Worked Example
Describe one feature of the use of the Thomas Splint.
2 marks
Answers:
The Thomas Splint was used to stop the movement of a soldier’s fractured femur (1). Excessive moving caused heavy bleeding (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.
Mobile X-Rays
X-rays enabled doctors to locate bullets and shrapnel before surgery
They did have some drawbacks:
X-rays could not detect objects like clothing fragments
Injured soldiers had to remain still during an X-ray
X-rays overheated quickly which made them less reliable
Three machines were used in rotation to solve this problem
Base Hospitals and some CCSs used unmoving X-rays:
Marie Curie had equipped 20 mobile X-rays for the French army
Close to the frontlines, six mobile X-rays were used
The quality of the scans was not as good
The ability to travel to injured soldiers across the Western Front was very convenient
The Battle of Cambrai & Blood Bank
Blood transfusions in the British sector
Blood transfusions were used from 1915 in Base Hospitals and 1917 in CCSs
Many key individuals contributed to the development of blood transfusions on the Western Front from 1915-16:
Key individual | Discovery |
|---|---|
Lawrence Bruce Robertson | Used a syringe to transfer blood from the donor to the patient |
Geoffrey Keynes | Designed a portable blood transfusion kit for use at the frontlines: Stored blood could not be used as there was no refrigeration. Added a device to help prevent the blood from clotting. |
Richard Lewisohn | Added sodium citrate to blood to prevent blood from clotting |
Richard Weil | Discovered that sodium citrate allowed blood to be refrigerated and stored for two days |
Francis Rous and James Turner | Added citrate glucose which allowed storage of blood for up to four weeks |
The blood bank at Cambrai
During the Battle of Cambrai in 1917, Doctor Oswald Hope Robertson stored 22 units of universal blood in glass bottles
The blood was:
Collected 26 days before being used
Stored in ammunition boxes packed with ice and sawdust
Of 20 Canadian soldiers treated for shock from blood-loss, 11 survived
It demonstrated the potential of blood transfusions to save lives
Worked Example
How could you follow up Source A to find out more about the use of blood transfusions on the Western Front?
In your answer, you must give the question you would ask and the type of source you could use.
4 marks
Source A: From an account written after the First World War by Charlie Shepherd. Charlie Shepherd was a soldier who fought in the war. Here he is describing his experiences in a hospital on the Western Front in 1915.
I was in the hospital. They wanted a volunteer to give blood for a transfusion. I volunteered and they checked that I was the same blood group as the soldier who needed blood. |
Answers:
Detail in Source A that I would follow up: ‘they wanted a volunteer to give blood for a transfusion’. (1)
Question I would ask: What would happen to the patient if a volunteer could not be found to give blood? (1)
What type of source I would look for: RAMC records from 1915 for hospitals carrying out blood transfusions. (1)
How this might help answer my question: The records would show how many injured soldiers died from blood loss or shock rather than from a fatal injury. (1)
Exam Tip
For a written source, ensure that you select a short quote and write this into the 'Detail in Source A that I would follow up' section of the answer.
Advances in Surgery
Head wounds accounted for 20% of all wounds in the British sector of the Western Front
Injuries were mainly the result of bullets and shrapnel
Why were injuries to the brain such an issue in World War One?
How did the treatment of brain injuries improve?
A large number of brain injuries and facial injuries led to new medical developments:
Type of surgery | Key individual | Medical development |
|---|---|---|
Brain surgery | Harvey Cushing | An American neurosurgeon. He used magnets to remove metal shrapnel from the brain. Local anaesthetic did not swell the brain during surgery like a general anaesthetic. He had an operation survival rate of 71% compared to the average of 50%. |
Plastic surgery | Harold Gillies | A New Zealand doctor specialised in ENT. He became interested in facial reconstruction during the war. Gillies used skin grafts to help restore an injured soldier’s face. He helped develop a specialist hospital in Kent, called the Queen’s Hospital. By 1917, 12,000 surgeries had been carried out here. |
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