Syllabus Edition

First teaching 2024

First exams 2026

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Health Problems in the Western Front Trenches (Edexcel GCSE History)

Revision Note

Zoe Wade

Written by: Zoe Wade

Reviewed by: Bridgette Barrett

Illnesses Caused by the Trenches - Summary

Trench conditions on the Western Front led to many illnesses which required either treatment or prevention.

Heavy rainfall led to flooded trenches and prolonged contact with water for soldiers. Overflowing toilets and a failure to remove sewage effectively led to the contamination of food and drinking water. Rats thrived in the hot and damp conditions during the summer, which led to lice infestations.  The use of artillery and machine guns meant that soldiers had poor sleep and could not rest.

As a result, many serious illnesses arose in the trenches such as trench foot, trench fever and shell shock. These illnesses reduced morale among troops and led to an increase in casualties.

To understand the medical developments in the British Sector of the Western Front, it is important to understand the main examples of illnesses and how they were treated and prevented.

Ill Health Due to the Trench Environment

  • Trenches were unhygienic and cramped

  • Extreme weather made conditions in the trenches worse: 

    • Hot summers worsened the smell of sewage and dead bodies

      • Contaminated water and food caused dysentery

    • Cold winters led to flooding and frostbite

      • There were 6,000 cases of frostbite in December 1914 

  • Trench conditions caused many illnesses:

Illness

Cause

Symptoms

Treatment and Prevention

Trench foot

Prolonged exposure to wet and damp conditions caused by heavy rainfall

Poor blood circulation due to tight boots

Swelling of the feet

Numbness, foul smells and blue or purple skin caused by gangrene

Changing socks and adding duckboards kept feet clean and dry

Whale oil rubbed into feet created a waterproof barrier

Amputation was sometimes necessary to prevent sepsis or further infection

Trench fever

Rats were attracted to the food and waste in the trenches

Lice were identified as the cause in 1918. They attached themselves to rats and then soldiers

Flu-like symptoms such as headaches, muscle pains and a high temperature

Drugs like quinine were unsuccessful

Clothes were disinfected

Delousing stations were set up

Shell-shock (PTSD)

Cramped and stressful conditions in the trenches

Violence and artillery bombardments, especially during the night

Tiredness, nightmares, headaches, shaking and mental breakdowns

Now referred to as PTSD, shell shock was not understood well during the war. This led to many people being punished by imprisonment, fines or loss of rank

Rest and treatment back in Britain for those worst affected

An illustration highlighting trench illnesses. Top: Soldier with shell-shock, rifle beside him, mentions 80,000 cases. Bottom: Hair with lice, mentions 500,000 cases of trench fever.
An illustration showing how common certain illnesses were in trenches
Soldiers' feet in muddy trench conditions; text reads "75,000 Allied troops" and "Prolonged contact with water caused trench foot".
An illustration showing the causes and numbers of trench foot cases

Worked Example

Describe one feature of ill health among soldiers that arose from the trench environment.

2 marks

Answers:

The soldiers often developed trench foot (1). They had to stand in wet and muddy trenches (1).

Examiner Tips and Tricks

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.

Make sure you read the question carefully before selecting a feature to write about. The above question asks you to describe features of ill health (also known as illnesses) caused by the trench environment. Discussing injuries caused by weapons would not be relevant to the focus of the question.

Worked Example

How could you follow up Source A to find out more about the problem of trench foot?

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 Captain Impey. Captain Impey was an officer in the Royal Sussex Regiment, which served on the Western Front. Here he is describing the conditions in the trenches and the problem of trench foot.

The trenches were wet and cold and some of them did not have duckboards covering the mud on the floor of the trench. Many trenches also did not have dug-outs where soldiers could shelter while they slept. The battalion lived in mud and water.

These conditions caused many men to develop trench foot. Altogether about 200 men with trench foot had to be evacuated from our section of the trenches.

Trench foot was a new illness and it was virtually important to provide dry socks for the troops. Rubber boots were provided for the troops in the worst positions in the trenches. One section of the trench was kept as an area where men were sent, two at a time, to rub each other's feet with grease. They would do this at least once a day.

Answers:

  • Detail in Source A that I would follow up:Rubber boots were provided for the troops.’ (1)

  • Question I would ask: Was this effective in preventing trench foot? (1)

  • What type of source I would look for: Diaries from a range of different soldiers serving in the First World War (1)

  • How this might help answer my question: Extracts from a range of diaries could give us individual soldiers’ descriptions of the condition of their feet, explaining whether rubber boots were successful. (1)

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Zoe Wade

Author: Zoe Wade

Expertise: History

Zoe has worked in education for 10 years as a teaching assistant and a teacher. This has given her an in-depth perspective on how to support all learners to achieve to the best of their ability. She has been the Lead of Key Stage 4 History, showing her expertise in the Edexcel GCSE syllabus and how best to revise. Ever since she was a child, Zoe has been passionate about history. She believes now, more than ever, the study of history is vital to explaining the ever-changing world around us. Zoe’s focus is to create accessible content that breaks down key historical concepts and themes to achieve GCSE success.

Bridgette Barrett

Author: Bridgette Barrett

Expertise: Geography Lead

After graduating with a degree in Geography, Bridgette completed a PGCE over 25 years ago. She later gained an MA Learning, Technology and Education from the University of Nottingham focussing on online learning. At a time when the study of geography has never been more important, Bridgette is passionate about creating content which supports students in achieving their potential in geography and builds their confidence.