GCSE History podcasts - Medicine through time

Anouska: Hello, and welcome to the Bitesize GCSE History podcast.

Alice: This is the series designed to help you tackle your History GCSE. I'm Alice Loxton, author and historian.

Anouska: And I'm Anouska Lewis, history podcaster. We’re here to help you dive a little deeper into the history of medicine.

Alice: Every episode, we’ll explore the key events, people, and concepts for your exam, as well as some exam skills.

Anouska: Sometimes you’ll hear actors reading real historical accounts or imagined conversations based on historical evidence.

Alice: And at the end of every episode, we’ll do a quick quiz to make sure you’ve caught all the key details.

Anouska: If you want to hear other episodes in this Bitesize GCSE History series, make sure you download the BBC Sounds app.

Alice: We start this story around the year 1250. Medieval Britain was not an easy place to live, was it Anouska?

Anouska: No, it wasn't. If you were living back then, chances are you'd have worked long days in agriculture, harvesting crops.

Alice: Famine was a major concern, during which people suffered from malnutrition and disease.

Anouska: If you lived in a town or city where there was overcrowding and poor hygiene, diseases spread quickly. A lot of people died before reaching adulthood. So, what were some common theories about the causes of disease?

Alice: Well at that time there wasn’t much scientific knowledge, so the causes of illness were a bit of a mystery. But Catholicism was the dominant religion and the Church taught that disease was sent by God as a punishment for sin.

Anouska: Astrology was another way people explained illness. Alice, what’s your star sign?

Alice: Ooh well I’m an Aquarius, why do you ask?

Anouska: Well, doctors at the time were called physicians, and they would study the planets and stars to treat their patients.

Alice: That’s very different to how doctors work today, isn’t it.

Anouska: Definitely.

Alice: There was limited medical progress in Britain during the Middle Ages, so ideas about medicine came from existing, ancient medical theories, and spiritual influences.

Anouska: These old medical texts had been followed for centuries, and they were written by physicians like Hippocrates.Hippocrates: Hello!

Anouska: And Galen.

Galen: Hi there!

Anouska: They were writing in ancient Greece and Rome many centuries before the medieval period.

Alice: Well, let’s have a look at some of the most popular medical theories. You might want to grab a pen to write these down.

Anouska: First up it’s the theory of the four humours, which came from ancient Greek physician, Hippocrates. He believed our bodies were controlled by four humours. No not jokes, but liquids. I’ll let him explain.

Hippocrates: My theory states that the body is made up of four humours; blood, phlegm, black bile, and yellow bile. These four humours must remain in balance to avoid illness.

Alice: According to Hippocrates, an excess of any of the humours could affect a person’s character and could also lead to disease.

Anouska: Later, Galen, a Roman physician, developed the ideas of Hippocrates. He advised patients on how to keep their humours in balance.

Galen: The four humours must always be balanced and the excess fluid removed. For example, if a patient has too much blood, some of their blood must be removed.

Alice: That sounds logical. If it was believed that a patient’s blood was out of balance, bloodletting would take place. Basically, removing some of their blood.

Anouska: And they’d do this by cutting into a vein, putting leeches on the patient, or by placing heated cups on a cut. Some basic procedures like this were done by barber surgeons.

Alice: Like barbers cut our hair today, back then barber surgeons cut people’s hair and cut into their bodies for surgery. So, this four humours theory was a really popular one at the time. Another was miasma theory.

Anouska: Your what theory?

Alice: Miasma means poisoned air. People in medieval Britain believed that bad air, caused by rotting waste in the streets or dirty water, led to disease.

Anouska: So now we know what people believed the causes of disease were, how did they treat them?

Alice: Well firstly, they tried to prevent illness from happening in the first place. If God sent diseases, they thought it would help to please God by living a good life, free from sin.

Anouska: By going to church regularly, praying, and fasting - that’s not eating for a period of time - they could show God how sorry they were for any sins, and so avoid disease.

Alice: And to counteract miasma, people wanted to keep the air clean. They would clean the streets and carry bunches of nice-smelling herbs and flowers.

Anouska: Ooh lovely! There were also attempts to improve sanitation, with better waste and sewage disposal.

Alice: Make sure you head to the GCSE History section of the BBC Bitesize website. You’ll find even more examples of historical disease prevention there.

Anouska: So, people were looking after their spiritual health and keeping the air around them clean. But they needed to look after their physical health too.

Alice: A set of instructions called the Regimen Sanitatis, or ‘Rule of Health’ began circulating during the medieval period, offering advice on good health. Its guidance included things like:

Actor: Make sure you get a good night’s sleep - but don’t nap during the day. Keep clean - wash first thing in the morning. Make sure you get some fresh air during the day and always rest after eating.

Anouska: A lot of that sounds obvious to us now but it wasn’t then! Feel free to rewind that section and make some notes if you need to.

Alice: But people still became unwell. So, what happened then?

Anouska: Well, there were hospitals, and the number actually increased during the medieval period. Most hospitals were owned by the Church and connected to monasteries or convents where monks and nuns would care for the patients.

Alice: Medieval hospitals provided food, warmth and prayers for patients to recover.

Anouska: Medieval physicians studied the theories of Hippocrates and Galen at university.

Alice: But most people wouldn’t be able to pay for a physician or hospital treatment, so instead, they were looked after at home by members of the community.

Anouska: These were usually female family members with treatments passed down through generations.

Alice: Herbal remedies were also popular, combining ingredients like herbs, spices, plants, and animal parts. And sometimes, if people had enough money, they would visit apothecaries where herbal mixtures would be made for them.

Anouska: Let’s hear an example of a traditional medieval remedy. This one’s for treating a cough.

Actor: Take sage and rue and cumin and powder of pepper. Boil them together in honey and use a spoonful in the evening and another in the morning.

Anouska: Would you try that one Alice?

Alice: Hmm maybe if I was around in Medieval Britain!

Actor: Case study: The Black Death

Alice: In 1348, Britain was hit by a new disease called the Black Death, or the plague. And it affected everyone, rich and poor.

Anouska: It spread really quickly. Patients would develop a fever as well as painful swellings on the body, called buboes. These swellings would start in the groin, under the armpits or on the neck, but then spread across the body. A huge number of people died from the plague.

Alice: The Black Death was terrifying. People were dying really quickly, and those in medieval Britain tried some of the remedies we've already discussed, both to cure the plague and prevent it from spreading.

Anouska: They tried herbal remedies, cleaning the air, fasting, praying to God, and attempting to balance the four humours.

Alice: But it wasn’t just individuals trying to prevent the plague. Some local authorities put measures in place too. For example, temporary isolation, or quarantine, was introduced to prevent the disease spreading.

Anouska: The response to the Black Death teaches us a lot about medieval medicine. When preventing and treating the plague, people relied on religious beliefs, superstition, and old theories about the causes of disease.

Alice: And since these theories were ineffective, a lot of people died, and it was clear that more practical and scientific approaches were needed in the future.Anouska: It’s time now to test our knowledge. Feel free to grab a pen to write your answers down.

Alice: First question, who were the two ancient physicians who developed the four humours theory. It was Greek physician Hippocrates and, later, Roman physician Galen.

Anouska: What was the miasma theory? The miasma theory proposed that poisoned or unclean air caused illness.

Alice: And finally, in 1348 a new disease hit England. What was it called? The Black Death. It’s a useful case study of how people tried to prevent and cure disease in the medieval period. Thank you for listening to this episode of the Bitesize History podcast.

Anouska: There’s lots more information on the BBC Bitesize website, and you can listen to the rest of this series on BBC Sounds.

Alice: Next time, we'll be taking a look at how scientific approaches to medicine have developed.

Anouska: See you next time!

Alice: Hello, and welcome to the Bitesize GCSE History podcast, where we explore the key events, people, and concepts to help tackle your History GCSE exam. I'm Alice Loxton, author and historian.

Anouska: And I’m Anouska Lewis, history podcaster. In this series, we’re diving into the history of medicine.

Alice: Sometimes you’ll hear actors reading real historical accounts or imagined conversations based on historical evidence.

Anouska: And we’ll end every episode with a quiz to make sure that you’ve caught the key details.

Alice: In the last episode we looked at how people approached disease in medieval England.

Anouska: And in this one we’re looking at what changed, and what stayed the same, as we move across the next 200 years.

Alice: Let’s do it. I recommend grabbing a piece of paper and making some notes as we go.

Anouska: Let’s take ourselves back to Britain between the years 1500 and 1700.

Alice: It’s a period known as the Renaissance - that’s French for ‘rebirth’.

Anouska: Rebirth of what?

Alice: Well, it was a time characterised by new ways of thinking. People were questioning old beliefs and, in medicine, they were exploring new scientific ideas.

Anouska: Crucially, new discoveries were being made about the causes of disease. But why now? Humanism was on the rise during the Renaissance period. It was a philosophy that believed people could, and should, come to their own conclusions about the world around them.

Alice: Instead of accepting the idea that God was responsible for everything, including disease, humanists explored other possibilities.

Anouska: The printing press was also crucial in challenging medieval ideas. Invented in the 15th century - that’s the 1400s - it meant books could be printed en masse, rather than written out by hand, and it took the job of copying books away from the Church.

Alice: So access to books increased, ideas spread more easily, and the Church had less control over what was published. More people than ever were able to read and write too.

Anouska: So now, scientists could publish theories that challenged medieval beliefs.

Alice: Let’s meet some of the scientists exploring these new ideas.

Vesalius: Hi! I’m Andreas Vesalius. I’m an anatomist and, not to brag, but I made some pretty big discoveries about human anatomy.

Alice: During the Renaissance, Vesalius discovered loads about what actually happens inside our bodies. But to do this, he needed to be able to see inside.

Anouska: Inside?

Alice: Yes, he needed to cut people open and look inside their bodies.

Anouska: Rather him than me! While carrying out his dissections he discovered that Galen had got some things wrong.

Alice: And to be fair, Galen had been carrying out his dissections on animals, not humans, so I can see how he might have made some mistakes.

Anouska: Vesalius disproved quite a few of Galen’s claims, including Galen’s theory about how blood flowed through the heart. However, he couldn’t yet explain how blood did move between the heart’s chambers.

Alice: Now I know this is all very sciency, but stay with us, and remember to keep that pen next to you to jot down key terminology.

Anouska: There’s lots more information on the BBC Bitesize website, and you can listen to the rest of this series on BBC Sounds. So, in 1543, Vesalius published his discoveries on human anatomy. His book was called On the Fabric of the Human Body. Who’s next?

Paré: Ambroise Paré, Bonjour! I am a famous Renaissance surgeon and, I don’t want to toot my own horn, but some of my patients do include French kings.

Alice: Paré’s contributions were in the world of surgery. His story starts in the 1530s where he was treating soldiers in the French Army who had gunshot wounds.

Anouska: Traditionally, physicians would use boiling oil to stop bleeding on a wound like that. But one day, Paré ran out of oil, so he came up with an alternative ointment made up of egg white, rose oil, and turpentine. He found that it actually worked better at healing gunshot wounds.

Alice: Sometimes soldiers would have amputated limbs, and Paré began using ligatures for their wounds.

Anouska: What’s a ligature?

Alice: Well ligatures are what we call the pieces of material tightly bound on a patient's limb to seal the blood vessels. And they were effective at stopping the bleeding.

Anouska: But germ theory wasn’t understood yet, so patients had a high chance of infection which often led to death. We’ll learn more about that in the next episode.

Alice: Paré was a pioneer in surgical techniques. He showed that there could be better outcomes when traditional beliefs and methods were challenged.

Harvey: Is it me next?

Anouska: Oh hello William! Go on, introduce yourself.Harvey: My name is William Harvey. You may have heard of one of my patients… King Charles I. I made crucial discoveries about blood circulation.

Alice: William Harvey’s discovery was to do with how blood flowed around the body.

Anouska: At this point, there were various incorrect theories. For example, Galen’s theory was that blood was made in the liver.

Alice: Harvey’s experiments proved that blood is repeatedly circulated around the body and is pumped around by the heart.

Anouska: Major breakthrough! And finally…

Sydenham: Hello! I’m Thomas Sydenham. I’m a doctor who believes in the power of observation.

Alice: Sydenham believed it was important to closely observe a patient’s symptoms to be able to then treat their disease.

Anouska: That would seem pretty obvious to us today but before him, physicians had relied on what they read in medical books. For Sydenham, it was important to observe patients and treat each person on an individual basis.

Alice: Sydenham also believed that every disease was different and that it was really important to work out which illness a patient had before treating them. He worked out that scarlet fever and measles were different, which people didn’t know at the time.

Anouska: He published his ideas in 1676, in a book called Observationes Medicae, which means Medical Observations. Let’s hear an extract from it.

Sydenham: We should have known the cures of many diseases before this time if physicians had not been deceived in their disease and had not mistaken one species for another.

Alice: So, Sydenham is saying that doctors keep muddling up different diseases and making it hard to find proper cures. For him, it was essential to understand exactly which disease a patient had.

Anouska: Some scientists like these were supported by an organisation called The Royal Society.

Alice: Founded in 1660, its motto was ‘Nullius in verba', meaning ‘Take nobody's word for it'. In other words, don’t just believe old ideas - test them yourself!

Anouska: The society was keen to find new scientific theories through experimentation, debating ideas, and sharing discoveries.

Alice: Today, the Society is still going, publishing scientific journals across the world. All of these discoveries were really important in moving medicine forward, away from the classical ideas of people like Galen and Hippocrates.

Anouska: So medical theories were developing, but did anything actually change for everyday people?

Actor: Case study - The Great Plague.

Alice: In the last episode we looked at the Black Death, which reached England in 1348. In your exam you may be asked to demonstrate change and continuity, so it's worth making some notes here on how things changed or continued since then.

Anouska: Plagues came and went in the 300 years after the Black Death and in 1665 there was another outbreak. Again, symptoms included painful, swollen buboes across the body.

Alice: The Great Plague had a devastating impact. It’s estimated about 100,000 people died from it in London alone.

Anouska: Despite the advances in scientific thinking since the Black Death, in practical terms not much had changed. People continued to believe the plague was caused by bad air, or miasma. They thought the air could be cleaned by lighting fires or by carrying nice smelling flowers.

Alice: Religion was still a big factor too - people believed God had sent the plague as a punishment for sin.

Anouska: And people still prioritised prevention. They stayed at home to avoid spreading the disease. In some villages, they soaked their coins in vinegar believing that this would prevent passing the disease on when buying food.

Alice: Not much had changed in the way of treatment either. People would still try to balance the four humours. For example, they may remove excess blood from a patient, known as bloodletting.

Anouska: Herbal remedies were still popular and, similar to the Black Death, quarantine, or isolation, was a feature of the Great Plague.

Alice: The village of Eyam in Derbyshire has been remembered for their strict quarantine measures. When the plague reached them in 1665, villagers decided to stay and not flee. This successfully contained the spread of the disease.

Anouska: So, the key takeaway here is that, although scientific ideas were starting to change, the practice of medicine had not changed much for everyday people. The Great Plague case study is a good example of that.

Alice: Let’s put our knowledge to the test now with a quick quiz.

Anouska: Grab a pen to write down your answers. First up, what was the physician Andreas Vesalius known for? He made key discoveries about human anatomy and disproved old theories like those of the ancient physician Galen.

Alice: Which physician made major discoveries about blood flow in the body? The answer is William Harvey.

Anouska: And finally, in what year did the Great Plague arrive in England? The year was 1665, and it killed over 100,000 people in London alone.

Alice: Thank you for listening to this episode of the Bitesize History podcast.

Anouska: Make sure to head to the BBC Bitesize website. You’ll find loads of resources on other GCSE History topics and subjects like English, science, and maths.

Alice: See you next time!

Anouska: Bye-bye!

Alice: Hello! You’re listening to the Bitesize GCSE History podcast with me, Alice Loxton.

Anouska: And me, Anouska Lewis! We’re two history podcasters here to help you through your GCSE exam on the History of Medicine.

Alice: In this series, you might hear actors reading real historical accounts or imagined conversations based on historical evidence. And stay tuned for the quiz at the end.

Anouska: If you want to hear other episodes in this Bitesize GCSE History series, make sure you download the BBC Sounds app. We’ve now made it to the 19th century, Alice. Cities are growing, the industrial revolution is here, and petticoats are all the rage.

Alice: The influence of religion is decreasing, and people are looking to science for answers about medicine. There’s a lot still to learn.

Anouska: We start this story at the very end of the 18th century, in 1796 to be precise, with a discovery that would go on to save thousands of lives.

Actor: You’ve heard of big pox. You’ve heard of medium pox. Now introducing smallpox.

Alice: A scientist called Edward Jenner has created a vaccine to stop people catching smallpox, which was a deadly disease that killed thousands of people. But how did he do it?

Jenner: Hello! Edward Jenner here, and do I have a story for you! I was working as a country doctor in Gloucestershire, when I noticed that milkmaids who caught cowpox, a mild disease transmitted from cows, never caught smallpox. How curious I thought! I wondered if cowpox could prevent smallpox. But I needed to test it. I took a sample of cowpox from an infected milkmaid and inserted it into a healthy boy's body. He experienced some mild symptoms but then, you’ll never believe it, he made a full recovery! Later, when I exposed him to smallpox, he didn’t catch the disease.

Anouska: Success! Jenner realised that by inserting cowpox into humans, he could protect them from smallpox. He called this method vaccination, from ‘vacca’, the Latin word for cow.

Alice: But Jenner didn’t really know why the vaccine worked. That discovery would come later.

Anouska: 35 years after Jenner’s discovery, a huge outbreak of disease began in Britain. It was the year 1831 when the disease cholera arrived. People could die really quickly from it, some in less than a day.

Alice: As cities had grown, so had populations. Overcrowding meant hygiene was poor, and there was more waste being left in the streets.

Anouska: Let’s hear a letter printed in The Times newspaper in 1849. It was written by a group of residents in Soho, London during the second cholera outbreak.

Actor: We live in muck and filth. We ain’t got no privies, no dust bins, no water supplies and no drain or sewer in the whole place. We all of us suffer and if the Cholera comes, Lord help us.

Anouska: So, we know that conditions were poor in the city and people were worried.

Alice: John Snow, a doctor working in London, discovered the cause of cholera. He noticed that people drinking from a particular water pump near his office were all becoming unwell.

Anouska: He discovered that sewage had been leaking into it, proving that contaminated water caused cholera. But he didn’t yet understand why. This is where Louis Pasteur comes in.

Alice: Weird question Anouska, have you ever smelt a carton of milk to check if it's okay to drink?

Anouska: Many, many times. And when it smells bad, it is gross.

Alice: It is. It sours, doesn't it. Well, Louis Pasteur was a French scientist with an interest in fermentation. And in the mid-1800s, he was investigating why drinks go bad and how to prevent this from happening.

Anouska: I’d grab a pen to make some notes for this section. During the 19th century - that’s the 1800s - Pasteur used better microscopes to observe the microbes within liquids that would cause them to go off.

Alice: This discovery became known as ‘germ theory.’ The word ‘germ’ comes from the idea that these microbes appeared to grow, or ‘germinate’.

Anouska: Pasteur conducted experiments to figure out why this happens. He would heat liquids to a certain temperature to kill the microbes within and stop liquids from going off. This became known as pasteurisation.

Alice: So, Louis Pasteur introduced pasteurisation. And if germs could make food and drink go bad, he thought they might also cause disease in humans.

Anouska: Pasteur's ideas weren't immediately accepted in Britain, but there were some scientists who took his research a step further. Joseph Lister, a surgeon from Scotland, read Pasteur’s germ theory and felt inspired.

Alice: He experimented with applying carbolic acid to wounds, dressings and surgical instruments. And he discovered this killed germs and reduced the chances of patients dying from infection.

Anouska: Joseph Lister had created the first ever antiseptic and he published his results in 1867. This led to huge changes in surgery.

Alice: Operating theatres and hospitals were kept really clean, staff wore face masks and gloves, and surgical instruments were sterilised with antiseptic.

Anouska: Lister documented the death rate of amputations. From 1864 to 1870, the death rate dropped from 46% to 15%, thanks to the use of antiseptics.

Alice: Which is pretty incredible. Another breakthrough in surgery came from James Young Simpson, who created the first successful anaesthetic in 1847.

Anouska: He used chloroform as pain relief, to help women in childbirth and patients having painful operations.

Alice: And it got the royal seal of approval when Dr John Snow, who we heard about earlier, gave it to Queen Victoria during the birth of two of her children.

Koch: Hallo, mein Name ist Robert.

Anouska: That’s Robert Koch, a scientist who built on Pasteur’s germ theory. Tell them about yourself Robert!

Koch: Well, I’m a German doctor and I was very influential in the field of bacteriology, which is the study of bacteria. I discovered that different germs can cause different diseases.

Alice: So, Koch developed a way of growing bacteria with agar jelly in a Petri dish. He then used a dye to stain the bacteria so it could be seen with a microscope.

Anouska: With this method, individual bacteria could be identified, leading to the discovery of the bacteria that cause anthrax in 1876,

Alice: The bacteria that cause tuberculosis in 1882,

Anouska: And the bacteria that cause cholera in 1883.

Alice: It was now accepted that bacteria caused disease, so the next step was to work out how to remove the bacteria when someone was ill.

Anouska: But that’s still a way off. It wasn’t until after 1900 that effective treatments were developed.

Alice: Well, you can’t rush genius! Listen to our episode on modern medical advances for that. But in the meantime, let’s look at how care and treatment changed in this period.

Anouska: For many of us today, the hospital is where we go when we’re unwell and need help.

Alice: But it hasn’t always been that way. Before the development of antiseptics by Joseph Lister and hospital hygiene measures, people would sometimes become more unwell, or even die, in hospital.

Anouska: Overcrowded wards, poor toilets, and a lack of cleanliness meant infection was rife.

Alice: But in the mid 1800s an English nurse called Florence Nightingale sought to improve hospital conditions.

Nightingale: Hello, I’m Florence and I’ve always seen nursing as my calling. In 1853, I was a senior nurse in London when something very big happened.

Alice: She’s right. In 1853, Britain went to war with the Russian Empire in Crimea.

Anouska: During the Crimean War, there was national outcry about the condition of army hospitals. So, Florence Nightingale convinced the British government to send her out to care for injured soldiers.

Alice: She was horrified by the conditions. Medical staff were overworked, there wasn’t enough food or medicine, and the hospitals were dirty, leading to unnecessary infections.

Anouska: Nightingale worked hard to improve conditions, including making sure there was regular hand washing,

Alice: regularly cleaning wards,

Anouska: making sure bedding was clean and good meals were provided,

Alice: and making improvements to ventilation and sewerage. So, what difference did these measures make?

Anouska: Well amazingly, within six months, the number of injured soldiers dying in hospital fell from 40% to just 2%. Nightingale returned to Britain a national hero.

Alice: Florence Nightingale’s impact on nursing was huge. She influenced the way hospitals were designed. For example, she recommended that new hospitals be built with plenty of windows to let in fresh air.

Anouska: She also influenced training. In 1860, she set up the Nightingale Training School for Nurses at St Thomas' Hospital in London and brought more respect to the profession of nursing.

Alice: Another nurse who made a big impact during the Crimean War was Mary Seacole.

Anouska: Born in Jamaica, she travelled to Britain and volunteered to help injured soldiers in Crimea.

Alice: However, the British War Office refused her application, so Seacole paid for her own travel to Crimea. She established the British Hotel and treated wounded soldiers on the battlefield.

Anouska: What a go-getter!

Alice: Soldiers affectionately called her ‘Mother Seacole’. I recommend checking out our episode on pioneering women in medicine. You can listen on the BBC Sounds app - just search for Bitesize GCSE History.

Anouska: You know what time it is! It’s time for a quick quiz to see how much we can remember!

Alice: Feel free to pause this whilst you write down your answers. First up - who invented the first vaccine, which was used to cure smallpox? The answer is Edward Jenner. He discovered that inserting cowpox in a human could prevent smallpox.

Anouska: Next question - which theory did Louis Pasteur discover? It’s germ theory! He discovered the link between germs and disease.

Alice: Medical developments have made a huge difference to the way patients receive care, haven’t they Anouska?

Anouska: They really have. Remember, you can listen to these episodes as many times as you need. And there are Bitesize podcasts on other subjects like English and science, just head to the BBC Sounds app.

Alice: We’ll see you next time.

Anouska: Bye!

Anouska: Welcome to the Bitesize GCSE History podcast, helping you prepare for your exam on the History of Medicine. I’m Anouska Lewis, history podcaster.

Alice: And I’m Alice Loxton, historian and author. In each episode we bring you the key facts, events, and people that have changed science and medicine as we know it.

Anouska: You may hear actors reading imagined conversations based on historical evidence, and there will be a quiz at the end so stay tuned.

Alice: In this episode, we’re going back in time to a century known for its huge social, political, and economic changes.

Anouska: Women will get the vote, there will be two world wars, and technology will advance like never before.

Alice: Grab your notebook and a pen to make some notes. We’ve made it to the 20th century, and a lot is about to happen. By 1900, people finally understood what caused common diseases, thanks to the advances of scientists like Louis Pasteur and Robert Koch.

Anouska: By the end of the 19th century - that’s the 1800s - when someone was ill, their doctor would observe them, consult medical textbooks, and diagnose them based on their symptoms.

Alice: But over the course of the 20th century this approach changed. Technological advances led to major breakthroughs in diagnosing and treating illness - so let's have a quick look at some of the key innovations.

Anouska: First used in the 1890s, X-rays were a key diagnosis tool in the 1900s. X-rays pass beams of invisible radiation through your body to show what’s going on inside. This helps diagnose problems like broken bones.

Alice: Invented in the early 1900s ECGs, which is short for electro cardiograms, use electrical impulses to track heart activity and can help investigate heart conditions.

Anouska: This next one is really cool, Alice. Ultrasound scans, which began in the mid 1900s, use sound waves to create a picture of the inside of someone’s body.

Alice: That’s really amazing! And ultrasounds help investigate symptoms, monitor conditions, and check babies’ development during pregnancy.

Anouska: Since the 1970s, CT scans have been used to create detailed images of the inside of the body, by combining X-rays with computer processing. In the 1980s MRI scans further advanced the ability to see inside the human body, using strong magnetic fields and radio waves.

Alice: These new testing methods and technological advances often removed the need for surgery, so treatment could be quicker and more comfortable for patients.

Anouska: It also meant diagnosing patients was more accurate than before. But that didn’t mean scientists had all the answers. If you want to hear other episodes in this Bitesize GCSE History series, make sure you download the BBC Sounds app.Alice: Some people can be born with what we call genetic, or hereditary conditions. They’re caused by genetic variations and passed on from parents.

Anouska: Genetic conditions puzzled doctors throughout the first half of the 20th century. But the discovery of DNA had a huge impact on understanding many of these conditions.

Alice: In 1953 a group of scientists discovered the structure of DNA. It was a great example of collaboration in science, so let’s meet the key players.

Rosalind: I’m Rosalind Franklin,

Maurice: and I’m Maurice Wilkins.

Rosalind: We managed to take high quality X-ray images of deoxyribonucleic acid, also known as DNA.

Maurice: Another pair of scientists, Crick and Watson, used these images to build a model of what they thought DNA looked like.

Francis: Hello! My name is Francis Crick.

James: And I’m James Watson. We worked out that DNA is shaped like a double helix, like a twisted ladder, which can unzip itself to make copies. It’s where information about a person is stored, like their eye colour or blood type.

Francis: This helped other scientists understand the causes of genetic diseases like cystic fibrosis and sickle cell anaemia.

Anouska: And it didn’t end there! Starting in 1990, the Human Genome Project saw scientists from all over the world work together. They were mapping all the information inside a person's DNA, also known as the human genome.

Alice: This huge amount of data has allowed scientists to identify differences in DNA that indicate genetic disease.

Anouska: For example, scientists identified genes that can lead to some types of cancer, which has since led to better treatments.

Alice: So, all of these incredible advances improved the diagnosis of disease, but what about treatment? Let’s look at four examples. It might be a good idea to make some notes here.

Anouska: Number 1 - high energy X-rays allow doctors to kill cancer cells in the body. This is an effective cancer treatment known as radiotherapy.

Alice: Number 2 - the invention of smaller and more portable machines helps during surgery. For example, if a patient has a heart bypass, a machine performs the functions of the heart for them while surgeons operate on their heart.

Anouska: Number 3 - robotics are involved in treatment now too! Surgeons can use computers to control instruments inside the body during operations. This is great for procedures like brain surgery, where precision is really important.

Alice: And number 4 - using tiny cameras and narrow surgical instruments, surgeons can perform keyhole surgery with just a tiny cut. This helps patients heal quicker.

Anouska: We’ve come a long way. But let’s go back to the early 1900s to talk about the Magic Bullet - which, in my opinion, is one of the best named medical discoveries.

Alice: Now that scientists knew microbes caused disease, they wanted to find a chemical that could wipe out the bad bacteria, without hurting the person it was meant to cure.

Anouska: In 1907 Paul Ehrlich was looking for a cure for syphilis, which is a sexually transmitted disease. He started experimenting with an arsenic based drug.

Alice: But it wasn’t quite working. It could attack the disease, but it also damaged the body since arsenic is poisonous.

Anouska: It wasn’t until 1909 when Ehrlich and another scientist called Sahachiro Hata discovered the first magic bullet.

Alice: It was called Salvarsan 606, because it was the 606th compound they tested, and it successfully killed the bacteria that caused syphilis.

Actor: Case study - Antibiotics

Alice: The first antibiotic was discovered in 1928. At that time, death from infection was common, but antibiotics killed bacteria or at least prevented them from spreading.

Anouska: You may have been prescribed antibiotics yourself - they’re very common today. But they were actually discovered by accident.

Alice: In 1928, Dr Alexander Fleming was conducting experiments with a common type of bacteria called staphylococcus.

Anouska: While away on holiday, he left a Petri dish in his lab that contained the bacteria.

Alice: When Fleming came back, he saw there was mould growing in his Petri dish, and the mould was killing the bacteria. He worked out that the mould produced a chemical substance that could kill bacteria. And he called it penicillin.

Anouska: In 1929, Fleming wrote about his findings in a medical journal but went no further with the study. Alexander Fleming has started off strong but, ooh who's this? Coming up behind to take the baton it’s Howard Florey and Ernst Chain. The crowd goes wild!

Alice: It wasn’t until around ten years later, in 1937, that another group of scientists took up Fleming’s work. They experimented first with giving penicillin to animals, and then human patients.

Anouska: During World War II, the allied forces, Britain and America, realised that penicillin could be used to treat injuries. They began mass producing the drug and it was used to treat infections in wounded soldiers.

Alice: Let’s put our knowledge to the test now. Don’t worry if you don’t know the answers, that was a lot of information.

Anouska: Just have a go at writing down your answers and if you need to, rewind this episode. First up - what do we call the structure that carries information about our genetic makeup? It’s DNA! In 1953, a team of scientists discovered its double helix structure.

Alice: Next question - what is the Magic Bullet? It’s a chemical cure that kills bacteria in the body. It was discovered in the early 20th century, and it’s great because it kills the bacteria while leaving the body unharmed.

Anouska: Thanks for listening to this episode of the Bitesize GCSE History podcast.

Alice: If you enjoyed it, there’s plenty more content on BBC Sounds, with podcasts on English, science, and more!

Anouska: Join us for the next episode where we’ll look at the role of government in public health. See you then.

Alice: Bye!

Alice: Hello! You’re listening to the Bitesize GCSE History podcast.

Anouska: We’ll be helping you with your GCSE exam on the History of Medicine. My name’s Anouska Lewis, and I’m a history podcaster.

Alice: And I’m Alice Loxton, historian and author. We know there's lots to learn for your exams so we’re here to highlight some of the key facts, people and events.

Anouska: In this episode, we’re looking at the government’s role in improving people’s health.

Alice: We’ll look at how it’s changed or stayed the same over time. Remember the concept of change and continuity is really important for this topic.

Anouska: You’ll be hearing actors reading real historical accounts and there will be a quiz at the end so stay tuned.

Alice: So, from our previous episodes, we know that governments didn’t really get involved in people’s everyday lives before the 19th century.

Anouska: The government mostly took a laissez-faire approach to medicine - laissez-faire being a French term that means ‘let it be’. The government didn’t think it was their job to interfere in people’s lives.

Alice: However, as we moved through the 19th century, things were changing, and the British government took on more responsibility for people’s health. But why did this come about and what did the change look like?

Anouska: Well, firstly let’s hear a report published in 1844. It’s part of a government investigation into the living conditions of people in Birmingham.

Actor: Many of these places stand greatly in need of regulations for cleansing. The atmosphere, which is necessarily close and confined, is often further deteriorated by the presence of open privies, close to which there is often one or more pigsties, tubs full of hogs’ wash, and heaps of offensive manure.

Alice: Sounds smelly. Well after significant pressure, the government passed its first Public Health Act in 1844, and a second one was passed almost 30 years later in 1875.

Anouska: The 1844 measures were optional, but the 1875 Act meant local authorities had to follow a set of rules to improve public health. Grab a notebook and make some notes here. Councils were now required to:

Alice: provide clean water,

Anouska: improve sewage systems,

Alice: regulate housing,

Anouska: regulate food safety,

Alice: collect waste and clean the streets.

Anouska: But why was the government making these changes now?

Alice: Firstly, the germ theory had proven the link between dirt and disease, so they knew cleaner towns and cities would help prevent illness.

Anouska: And in 1867, working-class men were given the right to vote. If political parties could deal with problems that affected this particular group, then they’d be much more likely to win their vote.

Alice: So, after the 1875 Act, public health became a serious topic in Britain. The government had put measures in place to improve the health of the nation.

Anouska: But it soon became clear that more needed to be done. In 1889, a social researcher named Charles Booth carried out an investigation. He created a social map of London and claimed that about 30% of the city’s population lived in poverty.

Alice: Then in 1900, another social reformer called Seebohm Rowntree conducted a similar study in the city of York. He found that almost 30% were living in poverty there too.

Anouska: Another driver for change was the Second Boer War which began in 1899. It was a conflict between the British Empire and the Boer republics in Southern Africa. But recruitment was poor. A large number of men who volunteered were too unfit to fight for medical reasons.

Alice: It was clear that more needed to be done to reduce poverty and improve public health. When the Liberal Party won the 1906 election, they began introducing their Liberal reforms. From 1906-1914 these reforms included:

Anouska: free school meals and medical treatment for children,

Alice: pensions for older people on low incomes,

Anouska: health insurance for low-paid workers,

Alice: and unemployment insurance for those out of work. These are just some examples. For more, head to the GCSE History section of the Bitesize website.

Alice: Anouska, in our episode on patient care developments, we talked about the first vaccine didn’t we?

Anouska: Yes, we did. It was discovered by Edward Jenner.

Alice: Well almost 150 years later, in the early 1940s, the first national vaccination campaign began. The vaccine was for diphtheria, which killed around 3000 children every year.

Anouska: Implementing the vaccine wasn’t quick, but as the Second World War progressed, keeping the population healthy and free from disease was a top priority.

Alice: Once the government did roll out the vaccine, infection rates from diphtheria dropped massively, and today it’s rare.

Anouska: The government has launched various vaccination programmes since then. In the 1950s there was one for polio. In the 1960s one for tetanus and one for measles. And in 1970 there was one for rubella. A recent example of a mass vaccination programme was to protect the population from Covid-19. This began in the year 2020.

Actor: Case study - The NHS.

Anouska: You’ve probably heard of the NHS - it’s Britain's National Health Service. But it hasn’t always existed, so how did it come about?

Alice: Commissioned by the war-time government, a civil servant named William Beveridge published a report in 1942. In it, he highlighted the big issues he felt threatened society. These included disease and squalor.

Anouska: To tackle disease, Beveridge proposed a new health system. It would be free at the point of service, open to everyone, and funded through people paying taxes. This was the beginning of the Welfare State.

Alice: The NHS was introduced in 1948 and marked a huge change in how involved the government was in medicine and healthcare.

Anouska: There was now free medical treatment for everyone, and services were under one organisation, including hospitals, pharmacists, opticians and dentists.

Alice: But not everyone agreed with it, did they?

Anouska: No. For example, doctors who had previously worked privately, thought that the NHS would take away some of their independence and their income.

Alice: To overcome this, Aneurin Bevan, who was the Minister of Health at the time, agreed that doctors could continue to treat private patients as well as NHS patients.

Anouska: The NHS case study demonstrates a change. The government was becoming more involved in public health.

Alice: Yes. Remember we started this episode talking about laissez-faire. During the 18th and 19th centuries the government wouldn’t really get involved in public health and had a hands-off approach. So that’s a big change.

Anouska: Throughout the 20th and 21st centuries, this government involvement continued. As well as providing free healthcare, today the government has a role in funding medical research, passing laws to help prevent disease, and educating people about their health.

Alice: NHS campaigns have encouraged people to lead healthier lives. For example, you may have seen adverts and posters about the importance of exercising and eating healthily. Let's look at an example.

Anouska: In 1952, the city of London was covered in a lethal smog for five days which killed thousands of people. But this wasn’t the first time.

Alice: No, this followed a long history of London fog where the city would be covered in a thick smoke-like pollution. It was caused by people burning coal to heat their homes.

Anouska: Here’s a statement from the Ministry of Health, dated 19th December 1952.

Actor: During the five days 5th to 9th December the greater part of Metropolitan London was continually enveloped by smoke-laden fog. There was for this period a spectacular rise in deaths registered in Greater London, to a total of 4,703 - a figure more than double that for the preceding two weeks.

Alice: A few years later, the Government introduced the Clean Air Acts of 1956 and 1968, banning the emissions of black smoke. They wanted to avoid something like this happening again.

Anouska: Smog isn’t a big problem in the UK anymore, but air pollution still is. It can cause conditions like asthma and lung cancer. The government continues to pass laws today, like limiting car emissions, as a way to protect the population.

Alice: Let’s have a quick quiz to make sure we’ve caught the key information.

Anouska: Let’s do it! Number one - what term is used to describe the British government’s approach to public health before the 19th century? Hint, it’s a French term! It’s laissez-faire, meaning a ‘hands-off approach’. The government didn’t really get involved in public health at the time.

Alice: Next question - in what year was the National Health Service, or NHS, founded? The answer is in 1948, and it was inspired by the Beveridge Report published a few years earlier in 1942.

Anouska: And finally, in which decade was the first national vaccination programme launched? It was in the 1940s and it was for diphtheria.

Alice: Thank you for listening to this episode, and a reminder that there are lots of other brilliant Bitesize podcasts.

Anouska: There are series for English, science, and other history topics too! Just search BBC Bitesize on BBC Sounds.

Alice: Join us next time where we’ll be meeting the pioneering female scientists that have shaped the modern world of medicine.

Anouska: I can’t wait for that one. Bye!

Anouska: Hello and welcome to the Bitesize GCSE History podcast. I’m Anouska Lewis, history podcaster.

Alice: And I’m Alice Loxton, historian and author. This is the series where we help you remember the key facts for your exam on the History of Medicine.

Anouska: Sometimes you'll hear actors reading real historical accounts or imagined conversations based on historical evidence.

Alice: And we’ll end each episode with a quiz to test your learning.

Anouska: Remember, you can listen to these episodes as many times as you need, and there are Bitesize podcasts on other subjects like English and science. Just head over to the BBC Sounds app.

Alice: In this episode, we’re looking at the pioneering women who have shaped medicine.

Anouska: Women’s roles have changed a lot over the last 800 years, so let’s start in the medieval period.

Anouska: During the medieval period, unlike today, women weren’t allowed to go to university. So, physicians, who we’d now call doctors, were always men.

Alice: But women still played a key part in treating disease. They had roles as herbalists making herbal remedies for patients, and as apothecaries, preparing and selling medicines.

Anouska: Women also had positions as female healers, known as ‘wise women’ and sometimes as surgeons too.

Alice: Midwives had a really important role as well, delivering babies in the community.

Anouska: But as we’ve said, there were restrictions on what women could do within the medical field. Some people didn’t think women should have roles as physicians.

Alice: But there were women that worked to get more recognition. Joan du Lee was treating patients in the medieval period, and in 1403 she wrote a petition to King Henry IV.

Anouska: In it, she asked the King for permission to practise medicine freely. It’s one of the earliest documented examples of a woman seeking formal recognition in England’s medical field.

Alice: Go Joan!

Anouska: Woo! Another amazing woman in medicine was Agnes Sampson, a respected Scottish healer and midwife. People called her the ‘Wise Wife of Keith’ because she was from a town called Keith.

Alice: However, Sampson’s immense knowledge and role within her community would eventually lead to her death.

Anouska: In this period of history, fear about witchcraft was at its height. Midwives were a prime target of accusations because birth was seen as a bit of a mystery.

Alice: Agnes Sampson was accused of being a witch. Of course that wasn’t true, but in 1590 she was killed.

Anouska: Throughout the 17th and 18th centuries, women continued to work as nurses, midwives and herbalists. But they couldn’t officially study medicine yet.

Alice: As we move into the 19th and 20th centuries, women gain more recognition and responsibility in the world of medicine.

Nightingale: Remember me?

Anouska: Oh hiya! That’s Florence Nightingale, who we heard lots about in our episode on patient care. I’d recommend listening to that one if you haven’t already. Florence, tell us what you did for medicine?

Nightingale: During the Crimean War in the 1850s, I revolutionised nursing. I introduced hygiene reforms which saved many lives. Before that, something as simple as washing your hands regularly wasn’t standard practice in hospitals. Later, I founded the Nightingale Training School for Nurses and wrote two books; Notes on Nursing in 1859, and Notes on Hospitals in 1863.

Anouska: Nightingale used data and statistics to prove that hospital care needed to improve. This was crucial in changing the way the British military collected data.

Alice: With her experience during the Crimean War, she published a diagram that demonstrated the main cause of death amongst soldiers was infectious disease, not injury from battle. This work helped push through reforms for patient care.

Anouska: That’s amazing. Nightingale had a huge impact on the nursing profession. Let’s hear an extract from her book Notes on Nursing.

Nightingale: Health is not only to be well but to be able to use well every power we have. Nursing proper is therefore to help the patient suffering from disease to live.

Alice: Thanks to Nightingale, nursing was now a respected and recognised profession, and she became a hero amongst British people.

Anouska: Another prominent woman around this time was Mary Seacole. Growing up in Jamaica, Mary’s mother was a healer who passed down her skills and traditional Jamaican medicines.

Alice: Seacole went on to treat diseases such as cholera and yellow fever, throughout the Caribbean and Central America.

Anouska: Seacole later arrived in England. Wanting to help with the Crimean War effort, she offered to go and treat wounded soldiers in Crimea.

Alice: But the British War Office refused her. Seacole had experienced racism in England previously, and this reluctance to accept her help left Seacole wondering:

Seacole: Did these ladies shrink from accepting my aid because my blood flowed beneath a somewhat duskier skin than theirs?

Alice: That was from Mary Seacole’s autobiography. Well, she refused to take no for an answer, travelling to Crimea herself. She tended to wounded soldiers on the battlefield and in The British Hotel, which she set up.

Anouska: Mary Seacole had a proactive approach to medicine and was incredibly brave taking her skills straight to the battlefield. She’s had a lasting influence and paved the way for diversity in British medicine.

Alice: Despite these developments in nursing, women were still unable to train as doctors. There was a ban on female medical students.

Anderson: I’m trying to change that!

Anouska: That’s Elizabeth Garrett Anderson. She was the first woman to qualify as a doctor in Britain. But it wasn’t easy.

Alice: After meeting an English woman called Elizabeth Blackwell who had managed to study medicine in the United States, Elizabeth Garret Anderson felt determined to pursue medicine in Britain.

Anouska: Anderson applied to teaching hospitals and universities but was rejected by all of them. So, what could she do?

Alice: Well, Anderson avoided the rules about women studying medicine at university by studying privately. And after taking the Society of Apothecaries examination, she qualified in 1865.

Anderson: As the first woman to qualify as a doctor in Britain, I worked hard for more women to have the same opportunity. Thanks in part to my campaigning, an act was passed in 1876 which allowed women to enter the medical profession!

Alice: Let's meet another pioneer. Annie Wardlaw Jagannadham was the first Indian woman qualified to practise as a doctor in Britain.

Anouska: She was born in 1864, in a city on the east coast of India. At this time, India was controlled by Britain, under colonial rule.

Alice: In 1888, Jagannadham registered as a medical student at the Edinburgh Medical School for Women, and she completed her training in 1890.

Anouska: After that, she went back to India and became a House Surgeon in Mumbai, treating patients every day.

Alice: Sadly, when she was just 30, she caught tuberculosis and died. Although Annie Wardlaw Jagannadham’s life was short, she opened doors for other female doctors to follow in her footsteps.

Anouska: Now, one of the most famous scientists of all time is Marie Curie. Born in Poland, she was the first woman to win a Nobel Prize, and the first person to have won a Nobel Prize in two scientific fields.

Curie: I discovered radium and polonium, two radioactive elements that would go on to be used in cancer treatments. I actually coined the term ‘radioactivity’. I also helped to develop mobile X-ray units during the First World War, called ‘petites Curies’. It meant X-rays could be used nearer the front line, so we could diagnose and treat injured soldiers quicker and easier.

Alice: After Marie Curie’s discoveries, scientists began using radiation to treat cancer and the first radiation therapies were developed in the 1920s.

Anouska: Since then, technology has come a long way. Modern radiotherapy uses much more precise equipment to target cancer cells while protecting healthy tissue.

Alice: What an incredible legacy. Fast forward to the mid-1900s, and we meet this episode’s final pioneering figure.

Saunders: I’m Dame Cicely Saunders and I founded the first modern hospice. Hospitals used to focus only on curing people, not helping them whilst they died. And patients weren’t always given adequate pain relief. I decided to do something about it.

Alice: Saunders had studied at the Nightingale Training School for Nurses, and after enrolling at St Thomas’s Medical School, she qualified as a doctor in 1957.

Anouska: Saunders turned her attention towards palliative care, also known as end-of-life care. Her vision was to provide patients with comfort, medical care, and compassionate treatment when they were nearing the end of their life.

Alice: In 1967, she opened St Christopher’s Hospice in London, the first modern hospice. It’s a place that gives specialist care to people who are seriously ill, helping them live comfortably and with dignity at the end of their lives. So, from medieval healers, to trailblazing nurses and doctors, to groundbreaking scientists, women have long been crucial to the development of medicine.

Anouska: Very inspiring! I think we should test our knowledge with a mini quiz. First up - what was the name of the woman who set up The British Hotel during the Crimean war? It’s Mary Seacole. She set up the British Hotel to help wounded soldiers.

Alice: Next question - which area of patient care did Dame Cicely Saunders transform? The answer is palliative care, or end-of-life care. She founded the modern hospice movement.

Anouska: And finally, how many Nobel prizes did Marie Curie win? She won two - one for chemistry and one for physics. She was the first woman ever to receive a Nobel prize.

Alice: And that’s another episode of the Bitesize GCSE History podcast! We hope you enjoyed it.

Anouska: There’s plenty more content for you to listen to, just search Bitesize History on BBC Sounds, and we’ll see you next time.

Alice: Thanks for listening. Bye!

Alice: Hello and welcome to the Bitesize GCSE History podcast, bringing you the key events for the History of Medicine. I’m Alice Loxton, historian and author.

Anouska: And I’m Anouska Lewis, history podcaster. In this episode we’re looking at the First World War, and specifically the experience of medicine on the Western Front.

Alice: You’ll hear actors reading historical sources and stay tuned till the end because we’ll have a quick quiz to make sure we’ve caught the key details.

Anouska: If you want to hear other episodes in this Bitesize GCSE History series, make sure you download the BBC Sounds app. On the 4th of August 1914, Britain declared war on Germany. It was a global conflict, involving countries all over the world. But one of the main areas that fighting took place was on the Western Front, in Belgium and France.

Alice: The warfare of World War 1 caused new types of injuries and led to developments in medical treatment, ones that have impacted medicine to this day.

Anouska: Grab a pen and paper and make some notes as we go through them.

Alice: Heavy gun fire from the start of the war led both sides to dig trenches as a way to protect themselves.

Anouska: These were long, narrow ditches, and the area between each warring side was called no-man’s land.

Alice: Over the next four years, enemies would attack each other’s trenches. This led to high numbers of casualties and horrific injuries.

Anouska: For example, in July 1916 on the first day of The Battle of the Somme in France, more men died than in any previous battle.

Alice: From July to November, there had been 420,000 British casualties. This type of warfare meant medical services were under intense pressure.

Anouska: Trenches were overcrowded and hygiene was poor. Trench fever was spread by lice. Symptoms included headaches, fever, and joint pain.

Alice: Trench foot occurred when trenches became waterlogged and soldier’s feet stayed wet. Their feet became swollen, blistered and turned blue. Sometimes feet had to be amputated.

Anouska: So, these difficult conditions on the Western Front created lots of painful injuries. Let’s hear an extract from a letter sent by a British soldier fighting in the trenches.

Soldier: It was quite uncanny to watch the enemy trench which appeared somewhat like a black wave and only sixty yards in front. Then you would suddenly see the flash of their rifles and machine guns. I fired about five shots at their flashes, then another two shells which lodged in the parapet either side of my head leaving about 2 to 3 inches between me and certain death.

Anouska: That letter is an example of a local, individual source. A personal account like that can be useful. It tells us about the personal experiences of soldiers on the Western Front. Other examples would be diaries or photographs.

Alice: But not every place or experience was the same, so these sources give us limited information about one place, or one moment captured in time.

Anouska: You may need to discuss sources in your exam, so for more analysis on the strengths and limitations of different types of sources, head over to the BBC Bitesize website pages.

Alice: So how did soldiers, who were injured by trench warfare, receive treatment?

Anouska: Medical care during World War One was largely the responsibility of the RAMC, that’s the Royal Army Medical Corps.Alice: Injuries needed to be treated quickly and effectively. A system was developed, known as the chain of evacuation. Let’s run through its main stages.

Anouska: Firstly, stretcher bearers picked up the dead and wounded from no man’s land where they would be brought to Regimental Aid Posts. These were first aid stations generally located near the frontline and their aim was to get men back to fighting as soon as possible.

Alice: If this wasn’t possible, the next stage was for injured soldiers to be evacuated to Casualty Clearing Stations. Here, soldiers were treated by doctors, nurses, and surgeons, often in tented accommodation.

Anouska: The last point in the chain of evacuation was Base Hospitals which were much further away from the front line and provided longer term care.

Alice: Nurses played an important role in providing care for wounded soldiers on the Western Front.

Anouska: Nurses initially came from the Queen Alexandra’s Nursing Service, a group of highly trained nurses, and the numbers grew throughout the war. There’s lots more information on the BBC Bitesize website, and you can listen to the rest of this series on BBC Sounds. Now let’s look at some other medical developments on the western front.

Alice: Given the dirty and overcrowded conditions of trenches and battlefields, infection was another big problem when treating injuries.

Anouska: In 1867, Joseph Lister had introduced antiseptic surgery. It was a method of preventing infection during an operation by using chemicals, called antiseptics, to kill germs.

Alice: The conditions on the Western Front meant operating theatres couldn’t be kept free from bacteria, so a new method was developed called the Carrel-Dakin technique.

Anouska: It allowed heavily infected wounds to be continuously disinfected. Medics would remove bullets and shrapnel and then cut away dead or damaged tissue around the wound.

Alice: They would then clean the open wound with antiseptics so bacteria wouldn’t be trapped inside the body.

Anouska: If the infection continued to spread, sometimes the only way to deal with it was to amputate wounded limbs.

Anouska: Okay, so we understand how trenches affected injuries and treatments but what about weapons?

Alice: On the Western Front, weapons had become more mechanised and automatic, leading to more severe injuries. For example, rifles fired rapidly, forcing bullets deeper into the body. And machine guns were able to shoot constantly, leading to higher numbers of casualties.

Anouska: Shrapnel shells were hollow shells filled with tiny metal balls. They would explode mid-air and small fragments would dig into soldiers’ bodies.

Alice: So how did medicine develop to tackle these types of injuries?

Anouska: Well at the start of the war, 80% of soldiers who had their femur broken by gunfire died from the injury. The femur is a bone in the thigh.

Alice: This was often because they lost too much blood being moved from the front line to medical stations.

Anouska: So, to stop this, their legs needed to be kept straight. Hugh Thomas, a British surgeon, designed a splint to stop joints from moving, and it became known as the Thomas splint. Once it was introduced, the death rate reduced from 80% to just 20%.

Alice: And pioneered by Marie Curie, mobile X-ray machines allowed surgeons to locate bullets and shrapnel quickly, removing them accurately.

Anouska: This improved the chances of patients receiving the correct treatment. You can hear more about Curie in our episode on leading women in medicine.

Alice: Powerful guns weren’t the only new type of weapon. Gas attacks were another.

Anouska: They were first used by the Germans in 1915 at The Second Battle of Ypres in Belgium.

Alice: Gas attacks could cause blindness, suffocation, breathing difficulties, and sometimes death.

Anouska: Soldiers were given gas masks to protect themselves.

Alice: Although gas attacks accounted for a relatively small number of deaths during the war, they did cause a lot of fear and suffering.

Anouska: Tanks were also a new, powerful weapon during the First World War.

Alice: The first large-scale use of tanks came during the Battle of Cambrai in 1917.

Anouska: They made really severe injuries even more likely.

Alice: These kinds of weapons led to life threatening injuries. And sometimes, soldiers needed something drastic like a blood transfusion.

Anouska: Blood transfusions were an important lifesaving tool but there were issues with storing blood for long periods of time. It could clot, or congeal, and when it did, it couldn’t be given to patients.

Alice: But discoveries were made during the war that helped, for example adding sodium citrate to blood which could prevent clotting.

Anouska: So, by the time the Battle of Cambrai was taking place, blood banks were prepared, ready to treat soldiers on the battlefield.

Alice: Captain Geoffrey Keynes was a doctor who developed a portable device that meant transfusions could happen more easily. Let’s hear an extract from his autobiography published in 1981.

Anouska: Whilst you’re listening, have a think about a detail in the source that you could follow up on, and a question you might ask about it? This is something you may need to do in your exam.

Keynes: It was our duty to operate where there was reasonable hope of recovery, rather than to waste effort where there seemed to be none. The possibility of blood transfusion now raised hopes where formerly there had not been any. In this way I had the satisfaction of pulling many men back from the jaws of death.

Anouska: If we take that source then, what’s a detail you could follow up on Alice?

Alice: Well, Keynes says there that blood transfusions ‘raised hopes where formerly there had not been any.’ So, I might follow up on that and to do so, we need to ask a question.

Anouska: How about, ‘did blood transfusions raise hope for injured soldiers?’

Alice: Yes, that’s good. But now we need to suggest a type of source to use, in order to follow it up. I’m thinking the diary of an officer, but we need to say why.

Anouska: Yes, it would be a good choice because he might say whether blood transfusions had a positive impact. That way we can confirm Keynes' original statement.

Alice: It’s time for a quick quiz to test our knowledge.

Anouska: Okay, I’ll start. What was the condition that sometimes came about when trenches became waterlogged? It affected a part of the body. The answer is trench foot. It sometimes led to soldiers having feet amputated.

Alice: Next question - what’s the name of the apparatus designed to keep injured soldiers' legs straight? The answer is the Thomas splint. It increased the survival rate for gunshot or shrapnel leg injuries.

Anouska: Thanks for listening to this episode of the Bitesize GCSE History podcast.

Alice: The next one is a whole quiz episode, so come and see how much you’ve learnt.

Anouska: There are loads of podcasts to help you with your GCSEs, just search for Bitesize on BBC Sounds. See you next time!

Anouska: Welcome to the Bitesize GCSE History podcast and have we got a bumper quiz episode for you! I’m Anouska Lewis, history podcaster.

Alice: And I’m Alice Loxton, historian and author. Throughout this series on the History of Medicine, we’ve brought you the key facts, people, and concepts for your GCSE exam.

Anouska: And in this episode, we're bringing it all together to test what we’ve learnt. So, grab a notebook and a pen, or make some notes on your phone.

Alice: And listen out for some special friends helping us with the questions.

Alice: So, Anouska, over this series we’ve been looking at how medicine has changed over time, as well as the factors that stayed the same.

Anouska: We explored the role of the Church, government and important individuals. And we also looked at the impact of science and technology, and attitudes in society.

Alice: We began this story in the medieval period, where a common theory about the cause of disease was miasma. It’s now an abandoned theory, but what was miasma?

Anouska: Was it A. Bad colour, B. Bad air, or C. Bad diet?

Alice: The answer is B - bad air! Miasma was the theory that bad air caused disease. People would try to clean the air and remove bad smells as a way to prevent illness.

Anouska: There’s lots more information on the BBC Bitesize website and you can listen to the rest of this series on BBC Sounds. In the medieval period, it was believed that God sent disease as a way to punish people for sin.

Alice: Religion was a big influence on how people viewed the causes and treatments of new diseases, one of which arrived in England in 1348. But what was this disease called? Was it A. The Black Death, B. The Dreadful Disease, Or C. The Sinful Sickness?

Anouska: It was A, The Black Death, an outbreak of plague which affected everyone - rich and poor. Popular treatment methods included praying, herbal remedies, and cleaning the air.

Alice: It’s now time to introduce a dear friend of the podcast - ancient physician, Galen.

Galen: Hello! Thank you for having me. Working in Ancient Rome, I worked on the theory of the four humours. It stated that a number of different liquids, or humours, in our body needed to remain in balance to avoid disease. My question is, how many humours did I think there were? Was it A. two, B. three, or C. four? It was C. four! It was C - four. I was inspired by another ancient physician’s theory - Hippocrates. We believed that the body’s four liquids were blood, phlegm, black bile, and yellow bile.

Anouska: Cheers Galen! This idea, which was popular in the medieval era, said that if a patient had too much of any of the four humours, they would become unwell.

Alice: To treat illness, some of the excess humour should be removed. For example, bloodletting would take place to remove excess blood.

Anouska: During the Renaissance, which took place from about 1500-1700, scientific ideas were beginning to change.

Alice: Andreas Vesalius was a scientist who made breakthroughs about human anatomy, publishing his ideas in the 1540s.

Anouska: He used a particular method to do so. Was it A. Dissection of bodies, B. Close observation of symptoms, Or C. Taking blood samples from patients?

Alice: It was A. Dissection of bodies. Earlier scientists had conducted dissections on animals, but Vesalius was able to get a better look at what was happening inside the human body. He learnt a lot about human anatomy.

Anouska: So scientific ideas were starting to change. And in 1861, French scientist Louis Pasteur wrote about a big new discovery.

Alice: He believed he’d found the cause of disease. What was his theory called? Was it A. Pasteur’s Hypothesis, B. The Microscope Theory, Or C. The Germ Theory?

Anouska: It was C - germ theory. Pasteur discovered that bacteria caused food to go bad, and he believed it may also cause disease in humans. It wasn’t until much later that antibiotic treatments were introduced though.

Alice: Throughout the 1700s and 1800s, hospitals were overcrowded, unclean, and didn’t have proper sewage facilities.

Anouska: One important figure who advocated for proper patient care was Florence Nightingale, and she has a question just for you.

Nightingale: Hello! Honoured to be here. I’m not going to give you multiple choices with my question, but don’t worry, there are lots of possible answers to it. Inspired by my experiences during the Crimean War, what is one change I made to improve hospital conditions? There are quite a few answers. Let’s see if you got any of these. I made sure there was regular hand washing. My nurses regularly cleaned wards. Bedding was changed often. I improved ventilation and sewerage in hospitals. And I set up the Nightingale Training School for Nurses which improved nurse training.

Alice: These are just some examples. For more head to the GCSE History section of the Bitesize website. The changes Nightingale made helped to prevent infection and disease in her patients. The development of prevention techniques was a theme throughout the history of medicine.

Anouska: In 1796, doctor and scientist Edward Jenner created the first vaccine. What disease was the vaccine for? Was it A. cholera, B. smallpox, or C. chickenpox?

Alice: It was B - smallpox, and this vaccine saved thousands of lives.

Anouska: As we moved into the 20th century, technology was speeding up scientific advances. We started using X-rays, ultrasounds, and a group of scientists discovered DNA. That was a huge breakthrough!

Alice: These technological developments helped to diagnose patients more accurately, but there were also breakthroughs in treatment.

Anouska: This included a new chemical treatment which could kill dangerous bacteria and attack disease, whilst leaving the patient unharmed. What was this type of medicine called? Was it A. The Marvellous Circle, B. The Little Pellet, or C. The Magic Bullet?

Alice: It was C - The Magic Bullet! The first one, discovered in 1909 was called Salvarsan 606 and treated syphilis.

Anouska: Let’s meet another guest quiz master, pioneering scientist Marie Curie.

Curie: Hello there. I was the first woman to win a Nobel Prize, and the first person to win a Nobel prize in two different scientific fields. I discovered two radioactive elements, radium and polonium, which would go on to be used in treatment. But what have they been used to treat? Is it A. tuberculosis, B. cancer, or C. broken bones? It was B - cancer. Radiation has been used in cancer treatments since the 1920s.

Alice: So, throughout the period covered by this series, scientists have made huge discoveries. They have helped to answer questions about the causes of disease and how to treat them.

Anouska: We talked about other examples like the discovery of DNA and the development of penicillin in our episode on modern medical advances, so go back and listen to that if you haven’t already.

Alice: But throughout history, governments have also increased their role in public health. Notably, the British Government introduced the National Health Service in 1948, providing free health care for everyone.

Anouska: It was inspired by a report published in 1942. But what was the name of that report? Was it A. The Beveridge Report, B. The Bevan Report, or C. The Benjamin Report?

Alice: It was A - The Beveridge Report, written by William Beveridge. He believed there should be a system which looked after people’s health. It was free for everyone, at the point of service.

Anouska: Thank you for listening to the History of Medicine Podcast, quiz edition!

Alice: We hope you were happy with your quiz performance! If you want to brush up for next time, go back and listen to the other episodes in the series. There are more resources over on the BBC Bitesize website.

Anouska: And you can check out the other BBC Bitesize podcasts over on BBC Sounds - there are series on other History topics as well English, science, and exam skills.

Alice: Thanks for listening.

Anouska: Bye-bye!