Medicine Paper – questions, mark schemes, advice
Study Sources A and B.
Source A: From a letter sent out by Ralph of Shrewsbury, Bishop of Bath and Wells, to local priests in
1348.
The plague has arrived in France and unless we pray constantly, it will reach this country. You should
arrange for processions and prayers to be performed at least every Friday, so that God will turn this
pestilence away from his people.
Source B: A photograph showing a vaccination being given at the end of the twentieth century to
prevent someone catching measles.
Question
Use the sources and your own knowledge
What can you learn about changes in the way people have tried to prevent the spread of infectious
disease?
January 2011
Study Sources A and B
A: A home remedy which was used during the Middle Ages to cure headaches and pains: ‘Take equal
amounts of the following plants – radish, bishopwort, garlic and hollowleek. Crush them and mix them
up, and boil them in butter. Keep the mixture in a brass pot until it is a dark red colour. Strain it through
a cloth and smear on the forehead or aching joints.’
B: A packet of paracetamol painkilling tablets. Such packets were widely sold in shops in the 20th
century.
Question – Use the sources and your own knowledge
What can you learn from Sources A and B about changes in the treatments people used for minor
illnesses such as headaches?
June 2011
Study sources A and B
A: From a description of how people tried to prevent the spread of Black Death in the fourteenth
century.
‘They entered the church and closed the doors and then marched in procession whipping themselves so
that the blood ran down over their ankles. Then they knelt down and stretched out in the form of a cross.
When they were all standing they sang: Your hands above your head uplift That God the plague may
from us shift.’
B: A photography of a pamphlet published in 2011 offering advice to students about vaccinations.
Picture unavailable due to copyright refusal
Question - Use the Sources and your own knowledge
What can you learn about changes in the way people have tried to prevent the spread of infectious
diseases?
June 2013
General Mark scheme for question 1
Target: knowledge recall and selection, analysis of change in a historical context, inference from sources
Level
Mark
Descriptor
1
1-2
Simple statements about changes without providing support from sources or
own knowledge
OR
Statements do not address change and are based on detail from the source
2
3-6
3
7-8
1 mark for each relevant point up to a maximum of 2
Developed statements
Change occurred based on an explanation of each source and or own
knowledge
Max of 4 marks if only sources OR own knowledge
Analysis
Inference about nature or extent of change based on explicit use of both
sources and supported with own knowledge of the historical context
Need to show:
Inference from each source
Knowledge about what has change and why/how between source A and Source B
Size of change?
Nature of change, e.g. natural to supernatural, simple to hi-tech, religion to science
Question 2 - 6 marks
QUESTION HAS FEWEST MARKS ON THE PAPER
Description of key features
Two boxes – choose one and describe…..
Question
Choose one and describe the key features of belief about the causes of disease (6)
In Roman Britain
During the plague of 1665
Question
Choose one and describe the key features of public health at this time(6)
Public Health in Roman Britain
Public health in the Middle Ages
Question
Choose one and describe its key features. (6)
The role of religion in health care in
the Middle Ages
The role of science in the discoveries
of William Harvey
Question
Choose one and describe the key features of this discovery (6)
Vesalius showing Galen was wrong
Structure of DNA
General Markscheme
Target: knowledge recall and selection, key features and characteristics of periods studied
Level
Level 1
Level 2
Mark
1-3
4-6
Descriptor
Generalised answer is offered with little specific detail.
Relevant details are offered with links to key features.
Question 3
How useful is this source to tell us about..? 10 marks
Target: knowledge recall and selection, key features and characteristics of periods
studied, evaluation of source utility
Level
1
Marks
1-2
2
3-6
3
7-8
Descriptor
Judgement based on simple valid criteria.
Comments are based on assumptions about usefulness because it is
reliable or because of the content relevance or amount of detail.
Allow 1 mark for each valid point based on source or on own knowledge,
up to a maximum of 2 marks.
Judgement is based on the usefulness of the source because of its
content or reliability.
EITHER
Answer focuses on the usefulness of content.
OR
Answer sees usefulness as dependent on reliability and analyses the
details and treatment of content or nature/origin/purpose in order to
assess how reliable/representative/authoritative the source is.
Maximum 4 marks if answer is based entirely on source or on own
knowledge.
Judgement is based on an evaluation of the usefulness of the
source’s content in the light of its provenance/ reliability.
Answer considers the value of information, taking into account its
reliability or how representative/authoritative it is, making explicit
what difference this makes to what the source can contribute.
Annotate source – content, nature, origin, purpose
Then think:
1. Is it accurate? Use your own knowledge here.
2. Is the person who drew/wrote it in a position to know?
Is the intention to be positive or negative?
So…is it reliable – can it be trusted? Remember that unreliable sources can be
useful, often because they tell us about attitudes
3. Is it complete? Has it left out some vital information – own knowledge again. Is it
representative of the whole situation
Nature: type of source
A photograph can be better than a written account for showing how many people were
involved in an event and might show how strongly they felt, but a written account
would give you a clearer idea of why they were there. A cartoon might be unreliable,
and possibly inaccurate, but useful for opinions
Origin: who produced it and when
Is it particularly useful because of who made it?
Can help with accuracy. Primary useful because there and might be in a position to
know, but may lack the bigger picture that a secondary source can show. It is wrong
to say that a source from an historian cannot be useful because the historian wasn’t
there at the time. The historian would have researched a wide range of sources and
evaluated them for reliability before putting the evidence together and reaching a
conclusion.
Purpose: why the source was made
To advertise, criticise, praise, inform, ridicule?
Do not make generalised statements such as newspaper lie/exaggerate, or primary is
better than secondary.
Source
Utility
Source
Utility
Nature
Origin
Purpose
Content
Nature
Origin
Purpose
Content
Question
How useful is this source to tell us about opposition to vaccination in the early nineteenth
century?
Use Source C and your own knowledge to explain your answer. (8)
A cartoon from 1802 by James Gillray
Caption says: The Cow-Pox – or – the
wonderful Effects of the New Inoculation
[…] Publications of the Anti-Vaccine
Society
Question
Use the source and your own knowledge
How useful is this source to tell us about the training of doctors in the Middle Ages?
Zodiacal man from a medieval woodcut
(Wherever the moon and stars are aligned with a certain astrological sign they correlated
with a body part, bodily system, or the four humors.)
Question 4 or 5 - 12 marks
• Choice between two questions
• Two bullet points PLUS own knowledge for top of Level 2 and Level 3
• Requires EXPLANATION
The mark scheme goes with this question:
Why did the discoveries of the Renaissance make little practical difference to medical
treatment in England in the period c1500–c1750? (12)
You may use the following in your answer.
• medical treatment
• William Harvey
You must also include information of your own.
Level
1
Marks
1-4
Descriptor
Simple or generalised comment is offered, supported by
some knowledge.
Candidate offers generalised comment with little supporting
detail or offers details about a very limited aspect of the
question.
2
5-8
3
9-12
Statements are developed with support from material which is
mostly relevant and accurate.
Candidate may provide details of Renaissance discoveries or of
medical treatments.
Maximum 7 marks for answers that do not describe an aspect in
addition to those prompted by the stimulus material
The response shows understanding of the focus of the
question and deploys sufficient accurate and relevant material
to support the points made.
Candidate shows that the nature of Renaissance discoveries had
little direct impact on medical treatment in England or shows
that training in England continued to be based on the works of
Galen and was largely unaffected by new discoveries.
Maximum 10 marks for answers that do not explore aspects in
addition to those prompted by the stimulus material, eg the
influence of the Church in England, the prevalence of Galen’s
ideas.
Sample Answer
William Harvey published his book about the importance of the heart and the circulation
of the blood in 1628. He included an explanation of his experiments and illustrations so
that other doctors and scientists could check his ideas for themselves. This was very
important because he was challenging the ideas of the ancient Roman doctor, Galen, who
had said that blood was mixed with air and was used up as it ebbed and flowed in the body
so that new blood was constantly being made in the liver. Harvey proved that blood was not
used up but circulated in one direction around the body, being pumped by the heart and it
could not flow backwards through the veins. Harvey also suggested that tiny blood vessels
must exist to carry blood throughout the body; he was right but the microscopes were not
powerful enough to prove this.
Other discoveries in the Renaissance were also important. In the century before Harvey,
Vesalius had dissected bodies and proved that Galen’s descriptions of anatomy were wrong.
The invention of the printing press meant that these ideas could be spread rapidly among
educated people and illustrations could be included in the books to spread an accurate
understanding of anatomy. Renaissance discoveries also included new plants which were
brought back when explorers reached the Americas.
However, all this had little impact on medical treatment. First of all, discoveries about
anatomy and physiology did not mean improved understanding of disease or of treatment.
People continued to believe that disease was caused by an imbalance in the Four Humours
or miasma and therefore treatment continued to be aimed at balancing the humours or
getting rid of miasma.
For most of this period, medical training was controlled by the Church and continued to be
based on the ideas of Galen, so treatment was usually based on bleeding, purging and his
Theory of Opposites. By the seventeenth century, the Church’s importance was declining
but even then, there was no change in people’s understanding of illness and therefore no
change in the treatments they used.
Examiner’s comments
The answer explains the importance of Harvey’s work and includes some additional detail
about Galen and other Renaissance discoveries in the first two paragraphs. However, at
that point it is only Level 2 because it says nothing about medical treatment and the
limited impact of these discoveries, so it is description and is not focused on answering
the question.
In the third paragraph the answer focuses on continuity in medical treatment; by itself
this paragraph is only Level 2 because it does not explain about the Renaissance
discoveries. However, the answer as a whole shows the nature of Renaissance discoveries
and the context of medical training to explain why the discoveries made little practical
difference to treatment. It clearly reaches Level 3 and the details about other
Renaissance discoveries, medical training, Galen’s importance and the role of the Church
bring in an additional area to those prompted by the stimulus material. The range of detail
offered is enough for full marks.
Explanation questions
These questions can ask for an analysis of cause, consequence, change, continuity,
importance, the role of an individual or a factor etc.
An explanation of why something happened should identify several causes. It could also
show which cause was the most important or explain that these causes were linked and had
an effect on each other.
An explanation of importance should show that there was a range of effects and add
comments about how important each one was – Were a lot of people affected? Did the
effects last for a long time? Was there a big change in people’s lives?
The stimulus material
The bullet points in the question offer two points students may include in their answer,
although they are not required to make use of them. The bullet points will be very simple
headings, relating to two key points that are relevant to this question. For example:
 A question which asks about change within a period might have bullet points about
two different aspects to encourage range within an answer. For example, the bullet
points for a question asking about changes in punishment during the nineteenth and
twentieth centuries might be: changes in prisons; changes in capital punishment.
 A question which asks about the causes or effects of something might have bullet
points highlighting two different reasons or effects. For example, the bullet points
for a question about the reasons why the nature of warfare changed in the
twentieth century might be: changes in technology; the development of the Home
Front.
 A question about what changed and what stayed the same during a period might have
one bullet point about change and one about continuity. For example, the bullet
points for a question about ideas about the cause of disease in the years 1350–1900
might be: belief in the supernatural; germ theory.
The sentence ‘You must also include information of your own.’ is a very important part of
the question and students should plan to include a third key point.
Process
 Key words in question – what will you be focussing on?
 Bullet points – what are they supposed to help you think about?
 What can you bring from your own knowledge
Explanation
PEER/SEED in every paragraph
Conclusion
 could be most important factor/issue
 without this…..
 might refer to short term it was this, but long term it was…
Questions
Why did it take so long for penicillin to be produced in Britain on a large scale? (12)
You may use the following in your answer.
• Alexander Fleming
• Florey and Chain
You must also include information of your own.
Sample material
Why did the standard of medical treatment improve so rapidly during the 20th century?
You may use the following in your answer
• 1909: Salvarsan 606 was discovered.
• 1948-49: In its first year, £373 million was spent on the NHS.
You must use information of your own
January 2011
Why have science and technology been so important in improving the treatment of illness
since 1900?
You may use the following in your answer
• 1909: Salvarsan 606 discovered.
• 1958: Kidney dialysis became available at three hospitals in Britain.
You must use information of your own
June 2014
How important was the work of Edwin Chadwick in improving public health in towns in the
19th century.
You may use the following in your answer
• Louis Pasteur published his germ theory in 1861.
• Public Health Acts were passed in 1848 and 1875.
You must use information of your own
June 2010
Why was the role of government so important in improving public health in the period from
1900 to the present day?
You may use the following in your answer
• 1907: School Medical Service established.
• 1971: The govt. required a health warning to be placed on cigarette packets.
You must use information of your own
Jan 2012
Question 6 and 7 16 marks PLUS 3 marks SPG
Question with the most marks, plus SPG = 19 marks, so really important to answer this one
Choice between two questions
Two bullet points PLUS own knowledge required to get top of Level 2, 3, or 4
This question can be similar in type to Q4 and Q5, but require a longer answer.
They may be of the ‘iceberg’ variety!
How far was the progress made in medicine by the Romans continued in the Middle Ages in
England? Explain your answer. (16)
You may use the following in your answer.
• public health
• medical training
You must also include information of your own. Sample Material
Level
1
Marks
1-4
2
5-8
Descriptor
Simple or generalised comment is offered, supported by some
knowledge.
Candidate makes generalised statement about change/continuity or
offers limited detail about punishment in one period.
Statements are developed with support from material which is
mostly relevant and accurate.
Maximum 7 marks for answers that do not describe an aspect in
addition to those prompted by the stimulus material, for example
work of Galen
3
9-12
4
13-16
The response shows understanding of the focus of the question
and deploys sufficient accurate and relevant material to support
the points made.
Candidate provides examples of continuity and/or change.
Maximum 10 marks for answers that do not explore aspects beyond
those prompted by the stimulus material, e.g. Galen or role of Church
A sustained analysis is supported by precisely-selected and
accurate material and with sharply focused development of points
made. The answer as a whole will focus well on the question.
Candidate provides an analysis examining the extent or nature of
change and continuity in order to reach a judgement.
No access to Level 4 for answers which do not explore aspects
beyond those prompted by the stimulus material, such as Galen, role
of Church
A mark out of 3 for SPG will then be added
0
Errors hinder meaning, or candidates do not spell, punctuate or use the rules of
grammar.
1
Candidates spell, punctuate and use grammar with reasonable accuracy.
Use a limited range of specialist terms appropriately.
2
Candidates spell, punctuate and use grammar with considerable accuracy and
general control of meaning.
Use a good range of specialist terms with facility.
3
Candidates spell, punctuate and use grammar with consistent accuracy and
effective control of meaning.
Use a wide range of specialist terms adeptly and with precision.
How much did the role of women in medicine change between c1350 and c1900?
You may use the following in your answer
• Wise women
• Elizabeth Garrett
You must use information of your own
January 2012
How important for the prevention of disease in Britain was the discovery of a smallpox
vaccination in 1796? Explain your answer
You may use the following in your answer
• Edward Jenner
• The role of government
You must use information of your own
Sample material
How important was the work of Edwin Chadwick in improving public health in towns in the
19th century.
You may use the following in your answer
• Louis Pasteur published his germ theory in 1861.
• Public Health Acts were passed in 1848 and 1875.
You must use information of your own
June 2010
How much did the understanding of the causes of disease change between c1350 and
c1900?
You may use the following in your answer
• Role of the church
• Germ Theory 1861
You must use information of your own
January 2012
How much have hospitals changed since 1800?
You may use the following in your answer
• Florence Nightingale
• NHS established 1948
You must use information of your own
June 2012
See Question 4/5 for ideas on explanation questions
Iceberg Questions
 What are the key parts of the question?
 What is ‘above the waterline’ - what must you write about?
 Bullet points – what are they there to make you think about?
 What else could you mention?
 Make a judgement – the question often says ‘x was the most important – do you agree?’
‘After the Romans left Britain the progress they had made in public health did not
continue.’ Do you agree?
You may use the following in your answer
• Roman sewers and drains
• wells for drinking water were often close to cesspits in the middle ages.
You must use information of your own
June 2011
‘Science and technology have had the greatest impact on health since 1900’
Do you agree?
You may use the following in your answer
• Penicillin
• Banning of smoking in public places July 2007
• You must use information of your own
Sample material