Section 1 Medicine and treatment
Chapter 3: Extension study: Medicine and public health from
Roman Britain to c1350
3.1 The Romans and approaches to medicine
Exam practice question 1 (page 17)
The Romans believed that disease was caused by an imbalance in the Four Humours. They
believed that the body was made up of black bile, yellow bile, blood and phlegm, and that
too much or not enough of one of these would cause illness. A fever, for example, showed
that you had too much blood. This belief was developed by Galen from the work of
Hippocrates, an Ancient Greek doctor.
The Romans also believed that bad air could cause disease. They thought it was important
to build cities and settlements away from swamps and marshes. This would have helped
them avoid diseases like malarias which were caused by mosquitoes, but they didn’t
understand why.
The Romans also believed that dirt and sedentary lifestyles caused disease, because they
encouraged the population to bathe regularly and exercise in the bath house. However,
they would not have understood why this kept people healthy.
Exam practice question 2 (page 18)
In some ways the influence of Hippocrates on Roman medicine was extremely important.
Hippocrates’s teachings included the theory of the four humours, which taught that the
body was made up of four elements and too much of one of these would cause illness. He
also taught the importance of clinical observation: watching a patient very carefully and
keeping detailed notes of their symptoms and how their illness progressed. This was very
important in Roman medicine because both of these theories were used by Galen. Galen
had been a doctor at a gladiator school but he ended up in Rome treating the emperor’s
family. Therefore he had a huge influence on Roman medicine, and because Hippocrates
had a huge influence on him, that meant that Hippocrates also had a big impact.
However, Galen did change Hippocrates’s ideas in some ways. For example, he added to
the theory of the four humours to focus treatment on balance – the idea of not just
removing too much of one humour, but adding something when there wasn’t enough. For
example, if somebody was suffering from a lack of blood, they might be treated with hot
chilli. The Romans also had some of their own ideas about medicine and the causes of
disease; for example, they thought bad air caused disease and they had a particularly strong
focus on public health. This didn’t have anything to do with Hippocrates.
However, overall I would say that the influence of Hippocrates was particularly strong in
Roman medicine, because Galen used a lot of his theories in his own work.
Exam practice question 3 (page 18)
In some ways the Romans had a significant impact on medicine in Britain, because they
brought new methods with them to Britain from Rome. For example, they introduced the
Theory of Four Humours which was a new way of diagnosing and treating disease. Before
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this, there isn’t much evidence of any collective understanding of what caused disease and
the population had relied mainly on herbal remedies. More herbal remedies were used
under the Romans, who brought knowledge and new plants with them from other parts of
the Empire. Unfortunately this also meant that new diseases came to Britain.
The Romans built hospitals and brought over trained doctors, but these would really only
have been for the legionaries who were stationed there, so this would not have had a huge
impact on medicine in Britain.
Perhaps the biggest long-term impact the Romans had on medicine was to introduce
Christianity. This was because the Church had a massive influence on and role in medicine
for more than a millennium after the Romans left.
3.2 Approaches to public health before 1350
Exam practice question 1 (page 20)
The Romans improved public health in Britain to a great degree after they conquered the
country in AD43. They built aqueducts to ensure clean water was supplied to their troops
and forts, and this was shared by the local population who also benefited from the supply.
They also created a system of sewers to remove dirty water and waste from populated
areas, to keep people healthy.
Furthermore, they used the clean water in the bath houses they built. These were built to
a Roman design and to begin with they were mostly used just by the Romans. However,
they were made available for everybody to use for a very small sum of money and over time
more of the local population began to use them too.
These developments were very significant because before the Romans there wasn’t really
any focus on public health, but their new methods and buildings showed the native
population how it was done.
Exam practice question 2 (page 21)
When the Romans left Britain it was difficult for their progress in public health to continue.
This was because they took their knowledge and expertise with them. For example, there
were no longer any engineers left who knew how to build or maintain aqueducts. This
meant that when these structures broke they couldn’t be fixed, and so over time there was
less provision for clean water. The local population used the stone from the bath houses
and other structures to build their own homes as there was less emphasis on public health.
The new rulers of Britain did not think it was as important as the Romans had. By 1350 there
were some quite serious public health problems in towns, where the lack of fresh water and
drainage was a problem. The government were not willing to donate funds to fixing this
problem. Therefore, the Romans’ progress was not maintained.
However, some things that the Romans did, did have a long term impact. For example, in
the Middle Ages some towns still offered public toilets and baths, in the form of stewes
where the public could go and wash. The Romans had been careful not to build near
swamps and the idea that bad air could cause disease was still popular.
However, I wouldn’t call any of these things progress. The Romans made considerable
headway during their stay in Britain but after they left this was not continued. In a way it
was less important because there were less large settlements, but public health did not
really become a key focus for government again until the nineteenth century. Therefore, I
agree with the statement.
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3.3 The impact of religion
Exam practice question 1 (page 23)
The Church played an important role in care of the sick during the Middle Ages because they
believed that it was part of their Christian duties. Therefore many monasteries and convents
provided hospitals. They would look after people, give them a bed to sleep in, food to eat
and pray for them to recover. They filled a gap in provision because they looked after
people who didn’t have family members who could care for them.
However, the hospitals would not admit people who had infectious diseases, such as the
plague. They mainly looked after the elderly, the disabled, or people suffering from noncontagious diseases such as leprosy. There were very rarely doctors in attendance.
Therefore, hospitals provided by the Church were more like rehab units where people could
rest and build up their strength, or where they went to die. The sick would not go there for
treatment.
Overall, the Church played an important role in caring for people, but not in caring for
people who were really sick.
Exam practice question 2 (page 23)
On the one hand, ideas about the causes of disease did not change. This was because
people in the Middle Ages still followed the ideas of Galen. Galen was a Roman doctor who
had invented the theory of the four humours. The Church liked this theory because it fitted
in with what the Bible taught, and so it continued to be used even after the Romans left.
Because the Church controlled all the universities, all doctors were taught the theory.
Therefore, people in the Middle Ages still believed disease could be caused by an imbalance
in the humours.
Furthermore, people in the Middle Ages believed disease could be caused by bad air. This
is an extension of what the Romans believed: they would not build their settlements near
swamps where there was ‘bad air’ because they believed diseases would be caught more
easily. This belief was not quite the same by the Middle Ages, but the idea was still around.
However, some ideas about the cause of the disease did change. This was because the
Church became more powerful and taught that God sent disease as a punishment. People
believed this particularly during the Black Death, when they would whip themselves to try
and make up for their sins. Although the Romans believed the gods could send disease, they
thought this was a result of curses instead of sin. People in the Middle Ages often looked for
astrological causes of disease by checking the alignment of the planets. This was completely
different to Roman beliefs.
Overall, I would say that ideas about the cause of disease developed from the Romans:
they were mostly quite different by the Middle Ages, but often had their root in Roman
beliefs.
3.4 The impact of government and war
Exam practice question 1 (page 24)
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In some ways medicine and public health changed a lot between the Romans leaving Britain
and 1350. In particular, public health changed. The bath houses and aqueducts which the
Romans had built steadily decayed because there were no engineers to maintain them. The
stone was sometimes taken and used in other building projects and there was a lot less
emphasis from the government on cleanliness and hygiene. Public health problems
increased after the population of some major towns like London and York began to grow.
Therefore, after the Romans left Britain there was a real change in public health, and it
wasn’t a positive one.
However, in some ways it stayed the same – particularly in medicine. This is because the
Church liked the teachings of Galen and promoted them in their universities. Galen had
been a Roman doctor and his ideas about the human body being perfectly designed fitted in
with the teachings of the Bible. Therefore, doctors continued to use the theory of the four
humours and Galen’s teachings on anatomy, amongst other things, until well past 1350.
Some things did change. For example, the Church taught that God sent disease; but the
teachings of Galen still formed the largest part of the work of the doctor.
Therefore, I think that public health changed a lot between the Roman withdrawal from
Britain and 1350, but not a great deal changed in medicine.
Chapter 4: Medicine and treatment c1350–c1750
4.1 Medicine at the time of the Black Death
Exam practice question 1 (page 26)
The Black Death was a problem in Britain from 1350 onwards because nobody knew what
caused it. There was no understanding of the causes of disease or how it was spread, which
meant that it spread very quickly and there was no satisfactory cure. Large numbers of the
population died and in some places there weren’t enough people left alive to bury the
bodies of the plague victims.
The disease was spread by fleas carried by rats that arrived in Britain on trading ships.
However, nobody knew this and therefore people tried all sorts of things to avoid catching
the Black Death. The most common of these was prayer, to ask God for forgiveness so he
would spare you. Burning barrels of tar to drive off the bad air which was thought to spread
the disease was also common. Unfortunately these things didn’t work very well and so the
Black Death continued to be a problem in Britain.
4.2 Ideas about the causes of disease: the influence of the past
Exam practice question 1 (page 27)
The theory of the four humours was very important in medicine until around about the
Renaissance era, when new discoveries proved it was wrong. The reason it was so popular
was because it fitted in with the Church’s ideas about what caused disease; therefore it was
used by doctors to diagnose and treat illnesses in the Middle Ages, as well as in the Roman
era, when it was promoted by Galen. The Theory taught that the body was made up of four
elements and that an imbalance in these caused illness. There was no real understanding of
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what caused illness until Pasteur came up with his Germ theory of Disease. This meant that
the theory of the four humours was really important because, even though it was entirely
wrong, it filled in a gap in medical understanding.
Exam practice question 2 (page 27)
Galen’s work influenced medicine in the Middle Ages because the Church approved of what
he taught. For example, he taught that the different parts of the body fitted together into a
well-designed whole, which agreed with the Bible’s teachings that man was made in God’s
image. Additionally, the Church supported the theory of the four humours. Because of this,
bleeding was a common cure used by physicians to treat all kinds of ailments.
Furthermore, the Church controlled all medical training. This meant that they controlled
what was taught to trainee physicians, and they only taught Galen. Therefore, Galen’s work
had a heavy influence on medicine in the Middle Ages.
4.3 The impact of the Renaissance on medicine
Exam practice question 1 (page 28)
Art and printing were important in improving medical understanding during the Renaissance
because they helped doctors and medical professors to share their discoveries and research
more efficiently with each other. Printing made it easier and cheaper to mass produce
copies of medical research and send it further afield, therefore improving communication
among doctors from across Europe. For example, Vesalius’s book “One the Fabric of the
Human Body” contained information about the mistakes in the works of Galen and was sold
very widely among medical professionals.
Art also had an impact because it helped to create more realistic and lifelike images of the
human body. Vesalius’s book had over 200 illustrations in it which were drawn from
dissections he had carried out on the human body. This was different from the past, when
artists had drawn in a more two-dimensional style and rarely from life. This meant that
there were a lot more accurate portrayals of the human body available to doctors, who used
this to improve their understanding of anatomy.
4.4 Medical Megastars: Vesalius and Harvey
Exam practice question 1 (page 31)
The work of Vesalius was very important because it provided new information for doctors
and medical students. Before Vesalius, doctors worked with Galen’s teachings which were
based on animal dissections. However, Vesalius was able to dissect human corpses and
correct some of Galen’s mistakes. For example, Galen had taught that the human jawbone
was made up of two pieces, like a pig’s; however, Vesalius was able to demonstrate that it
was only one.
These discoveries were particularly important as Vesalius shared them. Because he lived
during the Renaissance, Vesalius was able to have his detailed drawings of the human body
printed into books which were sent across Europe. The drawings were so detailed that they
are sometimes still used in medical text books today.
However, Vesalius’s work did not have an impact straight away. It was very important in
helping doctors to understand the anatomy of the human body better, but this did not have
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an immediate impact on medicine and treatment because it did not help doctors to
diagnose or cure diseases.
Exam practice question 2 (page 31)
Vesalius was able to prove Galen wrong in the sixteenth century because there was a lot of
change going on, during the Renaissance. One of the biggest changes was in technology.
Printing had been invented and it was cheap and easy to publish books. This meant that
once Vesalius had carried out his research, he was able to share it with lots of other doctors
and medical students, which helped to convince a lot of people that Galen had been
mistaken.
Another factor that helped Vesalius was changes in art. It has become fashionable to draw
bodies from life, which meant that anatomical drawings became much more realistic and
backed up Vesalius’s discoveries about Galen’s mistakes, for example the idea that blood
moves through holes in the heart.
A third factor that helped Vesalius was a change in beliefs. The Church became less
powerful after the Reformation and this made it possible for Vesalius to acquire and dissect
dead human bodies. Galen had not been able to do this and so it was the most important
factor in helping Vesalius to prove him wrong. It would not have been possible before, when
the Church was more powerful.
Exam practice question 3 (page 31)
Harvey’s discovery of the circulation of the blood eventually proved to be very important.
However, it took a long time for his theory to be accepted and this meant that for a long
time the discovery had limited impact. This was because understanding that blood
circulated around the body didn’t give doctors any new ways to treat their patients and
therefore Harvey’s ideas weren’t widely used. Doctors continued to bleed their patients in
accordance with what they had been taught during their training and continued to follow
the teachings of Galen. It wasn’t until microscopes were developed and people could see
the smaller blood vessels that attitudes changed towards the teachings of Galen that his
work started to have more of an impact.
Chapter 5 Medicine and treatment c1750–1900
5.1 Medical Megastars: Jenner and vaccination
Exam practice question 1 (page 33)
Source A shows that vaccination was not popular at first and that people thought having the
vaccination would cause them to sprout cow heads or become deformed. This shows a very
negative attitude towards vaccination. However, Source B shows that attitudes have
changed significantly because now vaccination is so popular that GPs have run out of it. This
means that lots of people must have wanted the flu vaccine, showing a significant change in
attitude from source A.
5.2 Medical Megastars: Pasteur and Koch
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Exam practice question 1 (page 35)
There was a massive change in people’s understanding of the causes of disease between
1350 and 1900.
In 1350 most people believed that disease was sent as a punishment from God, for their
sins. Another belief was that the body was made up of four different elements, or Humours,
and an imbalance in these led to illness. A third belief was that disease could be caused by
bad air, which wasn’t too far from the truth, but people couldn’t explain why. This was
because there was a lack of technology and people were unable to see germs or bacteria.
People continued to believe this for many centuries and it wasn’t really until the nineteenth
century that there was a major change.
By 1900, the understanding of the causes of disease had moved on to a great degree.
Developments in science and technology led to the creation of microscopes. This allowed
Louis Pasteur to observe the impact of microbes and so developed the germ theory of
disease. This had become widely accepted by 1900 and represented a massive change in
people’s understanding. Microbes responsible for specific diseases were identified and
cures and vaccines started to be developed.
Therefore, there was a complete change in the understanding of the cause of disease
between 1350 and 1900.
5.3 Improvements in hospitals and medical training
Exam practice question 1 (page 36)
The training of doctors changed a lot during the period 1350-1900. This was mainly due to a
change in beliefs and attitudes. At the beginning of the period, the Church controlled
medical training and insisted that Galen be taught to all medical students. They banned
dissection of human bodies, which meant that doctors could only go on what they learned
from Galen’s books.
Over time, beliefs changed and science became more important. During the Renaissance,
doctors like Vesalius challenged the authority of the Church by carrying out human
dissections and sharing his work. As new technology such as the printing press and the
microscope became more available, medical students were able to access lots of new ideas
rather than relying on the old ones. Surgeons like John Hunter encouraged their students to
carry out their own experiments and observations. This led to a more scientific
understanding of illness.
By the nineteenth century, medical students were completing part of their training in
teaching hospitals which gave them hands-on experience before they qualified.
Therefore, the training of doctors changed between 1350–1900, because there was a
move from a religious to a scientific focus in training, and from a theoretical understanding
to a practical one.
Exam practice question 2 (page 37)
There were several factors responsible for the improvement of medical treatment in
hospitals 1750–1900.
One of these was the increased interest and action of the government. During the
nineteenth century their attitude changed from one of ‘laissez-faire’ to an increased interest
in medicine and willingness to get involved in improving the health of the population. They
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introduced a Poor Law which meant that local tax payers were responsible for funding new
hospitals and asylums. This made medical treatment more widely available, thus improving
it.
Individuals like Louis Pasteur and Florence Nightingale played a big part in improving
hospitals. Pasteur’s development of the germ theory gave hospitals a greater awareness of
the link between dirt and disease, which led to cleaner hospitals. Nightingale had worked
hard to improve training for nurses and the hospital buildings, which led to an improved
standard of medical treatment.
Finally, there had been a big change in people’s attitudes during this time period. There
were a lot of social reformers who put pressure on the government to improve standards of
living among the poor. This led to them getting more involved and passing laws to make
hospitals more available and of a higher standard.
5.4 Medical Megastars: Florence Nightingale and Elizabeth Garrett Anderson
Exam practice question 1 (page 39)
Elizabeth Garrett Anderson had a big impact on the role of women in medicine because she
was the first woman to train and qualify as a doctor. After she had done this, it became
easier for other women to follow in her footsteps.
When Garrett Anderson trained, women were not allowed to attend university and she
had to train privately. She could not register with any of the medical Colleges which meant
she could not practice medicine, until her father took one of them to court to force them to
allow it. In 1865 she finally set up her own medical practice, and nine years later she helped
to set up a School of Medicine for Women. This made it possible for women to train to
become doctors and in 1876 the government passed a law which said women must be
allowed to register as doctors.
Garrett Anderson not only showed that it was possible for women to become doctors,
inspiring others like Sophia Jex-Blake, but she also made it easier for women to train and
qualify by setting up her own training facility and lobbying the government. Therefore, she
had a hugely positive impact on the role of women in medicine.
Exam practice question 2 (page 39)
The role of women changed a lot between c1350 and c1900.
In 1350, women were quite heavily involved in medicine, but not in an official capacity.
They acted as midwives and attended births; local wise women would provide herbal
remedies and advice on curing illnesses; and nuns took a big part in care of the sick, because
hospitals were usually in convents or monasteries. However, the nuns didn’t have any
medical training and would have mostly acted as nurses and said prayers for the people in
the hospital. Women could not officially become doctors because they were not allowed to
attend university.
By 1900 this had changed quite a lot. There was a school for women who wanted to
practice medicine, set up by Elizabeth Garrett Anderson - the first qualified female doctor in
England. Nursing had become more professional after Florence Nightingale set up a school
to train nurses. Therefore, the role of women was much more professional by 1900. I don’t
think it is true to say that they had a much larger role in medicine, because in 135- most
people would have been cared for at home by women. However, the role of women in
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medicine was more official by 1900 as they were allowed to train and qualify as doctors or
nurses.
5.5 Improvements in medicine: informal medical treatment
Exam practice question 1 (page 40)
Many people were still cared for at home in the period 1750-1900 because going to hospital
was still difficult and could be dangerous. Until the discovery of Germ theory, there was a
high risk of catching an infection or disease in hospital that would kill the patient.
Therefore, many sick people opted to stay at home and be nursed by their families because
they were less likely to catch another illness there. At home they would be cared for by
family members rather than the unqualified nurses which hospitals employed for the first
hundred years or so of the period.
Another reason why people were still cared for at home was because there was more help
available for people at home. Local doctors and GPs became more common after 1750 and
would carry out home visits and prescribe medicines when necessary. Hospitals were still
quite scarce outside of the big cities, and so it was easier and more economical to call a local
doctor than to go to a hospital.
Exam practice question 2 (page 41)
The patent medicine industry mass produced herbal remedies for the population. They were
often made up of cheap ingredients and advertised as ‘cure-alls’. They were popular
because a lot more people lived in towns by the nineteenth century and the herbs and
plants they used for their own herbal remedies were not as readily available.
To begin with there wasn’t any regulation of the patent medicine industry. People could
make up recipes and sell anything. Sometimes they even contained poisonous ingredients
which could kill patients if they took too high a dose. Some patients became addicted to the
medicine. However, some patent medicines were very popular and sold all over the world,
for examples James Morrison’s Vegetable Universal Medicine.
By the 1880s the government had started to pass laws to regulate patent medicines and
make them safer for the population.
Exam practice question 3 (page 41)
The development of pharmacies had a big impact on medical treatment by 1900,
particularly in the ways people were treated at home. This was because they made
medications available to the population and prescriptions could be written by doctors and
collected at the pharmacies. This meant that there was no need for the sick to go to
hospital.
Pharmacies also made medication available to poorer people because they were often
subsidised by local charities, which meant that they could sell the medication quite cheaply.
This helped to improve medical treatment for the poor at home.
Finally, pharmacies made more medical treatments available to people at home. Aspirin was
developed in the 1880s and this was available to buy without seeing a doctor. This might
have led to the development of other medicines, because manufacturers now had
somewhere to sell their goods and were more likely to develop medicine that could be sold
over the counter.
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Therefore, the development of pharmacies had a positive impact on medical treatment by
1900.
Chapter 6 Medicine and treatment c1900 to present day
6.1 New drugs: from prevention to cure
Exam practice question 1 (page 43)
Jenner’s discovery of a smallpox vaccination was very important for the prevention of
smallpox. Before this, some people had tried the method of inoculation – exposing
themselves to mild cases of smallpox to avoid the disease, but nobody had made the link
between milder forms of pox and a resistance to smallpox. Jenner’s discovery was picked up
by the British government who offered the vaccination to everybody for free and eventually
made it compulsory. People like Napoleon promoted the use of the vaccine abroad. Many
lives were saved as a result. Jenner’s work also showed that vaccination could succeed,
which inspired other scientists. Therefore, Jenner’s work was important.
However, it was not especially important for preventing diseases other than smallpox. This
is because Jenner did not understand how the vaccine worked and therefore the theory
could not be applied to other diseases. Furthermore, the smallpox vaccine is a special case
and later vaccines worked in a different way, which meant other scientists could not use the
same method as Jenner. Therefore, his discovery was not very important for the prevention
of disease other than smallpox.
Exam practice question 2 (page 43)
The development of the first Magic Bullet in 1909 was really important because it was the
first successful chemical cure for a disease. Paul Ehrlich and his team had tested over 600
compounds before they found one that worked to kill microbes causing disease without
affecting the rest of the body. They were using a dye that only stained bacteria, combined
with other chemicals that would kill the microbes.
Once Ehrlich and his team had proved that chemical compounds could kill microbes, this
opened the way for other scientists who built on the research and developed other
chemical cures for disease.
Exam practice question 3 (page 43)
Research teams played a very important part in developing Salvarsan-606. Firstly, the team
was made up of scientists from a variety of backgrounds. Some were chemists and others
were doctors. This gave them a wide variety of skills to bring to the task.
Secondly, as a research team they attracted funding from the government which helped
them to focus solely on the development of the Magic Bullet, rather than having to do other
things as well to cover their costs.
Thirdly, research teams allowed young scientists to work closely with their older and more
experienced scientists. Paul Ehrlich, for example, had worked on Robert Koch’s research
team before he became part of the Salvarsan-606 team.
Finally, it was important to have more than one person checking the results. This was
particularly important in the case of Salvarsan-606 because the working compound was
actually identified by Dr Hata. The other scientists had discarded it and said it didn’t work,
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but he proved that it did. So, if it had only been Paul Ehrlich working on the development he
might not have discovered it.
Exam practice question 4 (page 44)
Alexander Fleming’s discovery of penicillin in 1928 had such a limited impact on medical
treatment at the time because he was not able to develop it into a medication, due to lack
of funding. Fleming discovered penicillin almost by accident, when an unwashed petri dish
developed a mould which killed the bacteria in it. He published his findings in 1929 but he
was unable to get any funding to develop his research into a cure. It was not until the
Second World War, when governments needed a cure for infection to treat their soldiers,
that funding was made available by the American government to develop the research into
a workable cure.
Therefore, the impact was limited because although he discovered penicillin, Fleming was
unable to mass produce it or study its impact on disease, due to a lack of funding.
Exam practice question 5 (page 44)
Before 1941, there was no funding available to mass produce penicillin. It had not been
developed as a drug by Alexander Fleming and the British government did not offer him
funding. In 1939, when the Second World War broke out, the British government offered
funding to a pair of scientists, Florey and Chain, to develop penicillin for use on humans but
they did not have enough to mass produce it. They were able to successfully treat infection
in humans with what they produced, but could not make it fast enough or in large enough
quantities to supply the mass market.
However, in 1941 the Japanese attacked Pearl Harbour and the USA entered the Second
World War. They were looking for a drug to treat infection among their troops and they
gave drugs companies 80 million dollars to fund the mass production of penicillin. This
meant that the drug could be used on the front lines.
Therefore, it was possible to mass produce penicillin after 1941, firstly because Florey and
Chain had developed a treatment from Fleming’s research, and secondly because the US
government offered a large amount of funding to the drugs companies.
6.2 The discovery of DNA and its impact
Exam practice question 1 (page 45)
Science and technology were absolutely key in the work of Watson and Crick, who identified
the structure of human DNA in 1953.
Watson and Crick made use of technology such as improved x-rays and electron
microscopes, which allowed human cells to be magnified to an extremely high rate. This
meant that very detailed photographs could be taken of the human cells and then studied
carefully. This scientific process was called crystallography and had been developed during
the twentieth century. Watson and Crick studied photographs taken by a scientist named
Rosalind Franklin and were able to identify DNA from them.
Therefore, without the scientific and technological developments of the twentieth
century, especially of x-rays and electron microscopes, Watson and Crick would not have
been able to identify human DNA.
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Exam practice question 2 (page 46)
The discovery of the structure of DNA has led to some important changes in medicine since
1953, because it has allowed scientists and doctors to develop treatments and sometimes
even cures for genetic disorders.
For example, the Human Genome Project was completed in 2001 and the purpose of every
gene in the human body had been mapped. This helps doctors to test people for particular
genes to identify diseases which might be hereditary. This sometimes makes it possible for
parents to avoid passing on genetic disorders to their children by using IVF. It is also possible
to test unborn babies for genetic disorders such as Down’s syndrome.
More recently, the discovery of DNA has led to developments in gene therapy, for
example using stem cells to treat disabilities like blindness. If DNA had not been discovered,
this sort of treatment would not be possible.
Therefore, the structure of DNA had a big impact on medicine. However, so far this impact
has mainly been limited to genetic disorders and not to other illnesses.
6.3 The development of the NHS
Exam practice question 1 (page 48)
The NHS was launched in 1948 due to government action, changes in people’s attitudes
towards healthcare, and the work of individuals such as Aneurin Bevan.
The government had begun to move towards national health care when it passed the
National Insurance Act in 1911. However, this was not helpful to unemployed people and
over time the government began to take more action to ensure everybody had the same
provision.
People’s attitudes towards healthcare had changed as a result of the Second World War.
Poor health among the evacuees had created more demand for nationalised provision, and
more people had been able to access free healthcare during the War, which meant they felt
entitled to continue getting it afterwards. This encouraged the government to launch a free
service.
Finally, Aneurin Bevan, who was Minister for Health at this time, was able to convince
doctors and local authorities that the NHS was a good idea and that they should support it.
Without their support, the government would have found it very difficult to offer all the
services it did.
Exam practice question 2 (page 48)
William Beveridge was very important in the creation of the NHS, because he wrote a report
which recommended it. He was commissioned to write a report on what government action
could be taken to improve people’s standard of living, and he recommended that a free-atpoint-of-service health system be introduced. Beveridge had been very important in the
creation of the National Insurance scheme in 1911 and so he was able to use his prior
knowledge to help come up with a plan for funding the NHS, and what provision should be
included within it.
Without Beveridge’s report, we might have had a very different system in place today.
Exam practice question 3 (page 48)
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The main reason why the standard of medical treatment improved so rapidly during the
twentieth century is due to the massive improvements in science and technology that were
made. For example, the development of new drugs such as Salavrsan-606 meant that it was
easier to treat patients for illnesses such as blood poisoning. The development of penicillin
in the 1940s led to better treatments for infections and disease like meningitis, which meant
that people were a lot more likely to survive these diseases than they had been in the past.
Later on in the century, new technology such as the dialysis machine meant that people
were able to receive treatment when their kidneys failed. Transplant surgery was also
developed which meant that kidney failure and other illnesses involving major organs could
now be treated. Watson and Crick’s discovery of human DNA eventually led to gene therapy
being developed which also improved medical treatment.
Science and technology played a huge part in improving medical treatment so rapidly, but
a lot of these things were funded and provided by the NHS, which was launched in 1948.
Therefore, you could also say that the government was a really important factor in
improving medical treatment during the twentieth century.
6.4 The impact of new technologies
Exam practice question 1 (page 50)
Technology has had a massive effect on the treatment available to hospital patients since
1900. There have been a lot of new inventions which have led to improved treatment. For
example, x-rays allow doctors to set broken bones more precisely. Other types of scans help
doctors to diagnose and treat cancer, and are helpful during pregnancy in monitoring the
health of the baby and the mother. Treatments like radiotherapy and chemotherapy can
also be used to treat cancer. This has improved the survival rate for this disease.
Furthermore, the development of keyhole surgery, using fibre optic cameras to see inside
a patient and perform the operation without having to make a big incision, has rapidly
improved the recovery times because major operations can now be carried out more quickly
and with less trauma to the patient. It is also easier to monitor the health of patients in
hospital thanks to blood pressure machines and quicker blood tests.
Overall, technology has had a really positive effect on the treatment available to patients
in hospitals.
Exam practice question 2 (page 50)
Since x-rays were discovered in 1895 they have had an important and positive impact on
medicine. This is because doctors are now able to see inside a patient without having to cut
them open. This has helped them to diagnose tumours and other internal growths, and to
examine and set broken bones. They were particularly useful during the First World War,
when the government provided them for use in field hospitals to help with the diagnosis
and treatment of war wounds.
Although x-rays themselves have had a big impact on medicine, the development of the
science behind them by scientists such as Marie Curie has also had a massive impact. She
developed the science using radium, to develop radiotherapy to help with the treatment of
cancer. The technology is also used today in machines like CAT scanners and MRIs, which
help doctors to examine patients internally in even more detail.
© Hodder & Stoughton 2013
Chapter 7 Public health from c1350 to present day
7.1 Health problems in towns in the Middle Ages
Exam practice question 1 (page 53)
Between 1350 and 1750 fresh water became a problem because towns were getting bigger.
This placed a lot of pressure on the water supplies because there were lots more people
using the same amount of water as when towns were smaller. Also, the population were
using the rivers to dispose of their waste and this meant the water became even more
polluted, so made getting fresh, clean water was an even greater problem.
The situation was made worse because the authorities at the time weren’t willing to take
action to make fresh water more readily available. This was because they didn’t think it was
their job to provide for the masses. Instead, they left it up to private companies who usually
charged too much for most people to afford. This made the problem worse, as the private
water companies were using the same supplies as the rest of the townspeople and this put
even more strain on the supply.
Exam practice question 2 (page 54)
In some ways I do agree with the theory that the Industrial Revolution only made existing
public health problems worse. This is because the biggest public health problem in the
nineteenth century was the lack of clean water. There were no systems for removing waste
and there wasn’t enough clean water available for people to drink, bathe in and so on. The
Industrial Revolution led to massive growth in cities, as people moved there to work in the
factories. This made water even scarcer, whilst at the same time creating an even bigger
waste problem than there had been before.
However, the Industrial Revolution did make some public health problems worse. For
example, the quality of the air around many cities became a lot worse, due to pollution from
the factories. Respiratory illnesses became more common due to the dusty conditions in the
cloth factories. Alcoholism also became more of an issue among the population because a
lot of people turned to alcohol to deal with the misery of their everyday lives. Overcrowding
also led to an increase in dangerous slum housing, built without regulations, due to the
population increases.
Overall, I would say that the Industrial Revolution made existing public health problems
worse, such as the lack of clean water, but it also created some new ones. Therefore I do
not agree with the statement.
7.2 When and how did governments improve public health?
Exam practice question 1 (page 55)
Cholera spread so rapidly in industrial towns in the nineteenth century for two reasons.
Firstly, it was a water-borne disease. Secondly, people didn’t know how it spread.
Clean water was in short supply in nineteenth century industrial towns, because they were
overcrowded and there wasn’t enough clean water to go around. Cess pits were often dug
too close to wells which meant that there would be contamination. Open sewers ran
directly into the same rivers that supplied the water pumps, which made the contamination
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worse. People used the rivers to wash their clothes and themselves, and then took water
out of them to drink and to cook with. This meant that cholera spread extremely quickly,
because it was very contagious.
People didn’t know how it spread, either, which made it worse. They didn’t boil their
water before drinking it or know enough to avoid water from wells where lots of people had
died from drinking the water. The cities were extremely crowded and it was impossible to
quarantine people because the disease spread so rapidly and there wasn’t enough space.
Therefore, cholera spread very swiftly in industrial towns in the nineteenth century.
Exam practice question 2 (page 57)
In some ways I agree with this statement. This is because the biggest public health problem
pre-1900 was probably the lack of clean water and the problem of waste disposal. This was
particularly a problem after the Industrial Revolution, when cities grew much bigger and
more crowded. However, this problem had largely been solved by 1900. New technology
and funding from local and national governments had led to the provision of clean water
and a network of sewer systems to allow waste to be removed. The Germ Theory of Disease
had proved that illness is caused by microbes which encouraged governments to put
measures in place to prevent outbreaks of diseases such as cholera. They had also
introduced vaccination programs for diseases such as smallpox which helped to improve
public health.
However, there were other problems which continued into the twentieth century. For
example, standards of living among the poor were still very low. There was a lot of slum
housing and families living in cramped conditions. Their diets were usually very poor. The
government realised this was a problem when they tried to recruit soldiers for the Boer War
and found that a lot of the volunteers were medically unfit. There were other problems of
epidemics, such as measles and polio: these could not be tackled until vaccines were
developed later in the twentieth century. There was also the problem of expensive health
care, which was not fully solved until the introduction of the NHS in 1948.
Overall, I would say that the biggest problem of public health had been solved by 1900 but
there were more issues that needed tackling after 1900.
Exam practice question 3 (page 57)
In some ways I agree with this statement. This is because the biggest public health problem
pre-1900 was probably the lack of clean water and the issue of waste disposal. This was
particularly a problem after the Industrial Revolution, when cities grew much bigger and
more crowded. However, this problem had largely been solved by 1900. New technology
and funding from local and national governments had led to the provision of clean water
and a network of sewer systems to allow waste to be removed. The Germ Theory of Disease
had proved that illness is caused by microbes. It encouraged governments to put measures
in place to prevent outbreaks of diseases such as cholera. They had also introduced
vaccination programs for diseases such as smallpox which helped to improve public health.
However, there were other problems which continued into the twentieth century. For
example, standards of living among the poor were still very low. There was a lot of slum
housing and families living in cramped conditions. Their diets were usually very poor. The
government realised this was a problem when they tried to recruit soldiers for the Boer War
and found that a lot of the volunteers were medically unfit. There were other problems of
epidemics, such as measles and polio: these could not be tackled until vaccines were
© Hodder & Stoughton 2013
developed later in the twentieth century. There was also the problem of expensive health
care, which was not fully solved until the introduction of the NHS in 1948.
Overall, I would say that the biggest problem of public health had been solved by 1900 but
there were more issues that needed tackling after 1900.
Exam practice question 4 (page 57)
The government was very important in improving public health in both the nineteenth and
the twentieth centuries.
In the nineteenth century, they passed the Public health Acts of 1848 and 1875, which
made local councils responsible for the public health systems in their cities and make
provision for clean water and the removal of sewage. These Acts had a massive impact on
public health, particularly the second one which forced the changes through rather than just
recommending them. nineteenth century Britain was filled with overcrowded cities where
public health was a big problem, due to the lack of clean water and good drainage, so
solving these problems made an enormous difference to public health. Other measures like
the sewer system in London, new building regulations and compulsory vaccination against
smallpox also helped to improve public health.
In the twentieth century, the government had continued to offer vaccination programs
against diseases like diphtheria and whooping cough. It has introduced the NHS which
maintains lots of public health campaigns, for example family planning clinics and
vaccination against possible epidemic illnesses like swine flu. The government also has
propaganda campaigns to alert people to dangers to their health. For example, cigarette
packets carry health warnings and all alcohol advertising must include a message about
drinking responsibly. There are also campaigns encouraging people to exercise more. These
things will lead to better health among the population and better life expectancy.
Therefore, the government’s role in improving public health has been important in both
centuries. However, I think it was more important in the nineteenth century because the
conditions were much worse then, so they had a bigger improvementd to make. Also, in the
nineteenth century the government’s attitude changed completely from laissez-faire to
wanting to take responsibility for public health; this laid the foundations for the twentieth
century actions.
7.3 Why did government take action?
Exam practice question 1 (page 59)
John Snow was a doctor who developed a link between cholera and dirty water in 1854. He
was not able to prove that dirty water caused cholera because Germ theory hadn’t been
developed yet. Instead, he mapped out all the cases of cholera from the most recent
outbreak and investigated the water supplies of homes and businesses where cholera had
not caused any deaths. For example, he discovered that all the workers at the local brewery
drank beer or water from the brewery’s own well, and none of them were affected by the
cholera outbreak.
By doing this, he was able to prove that all the people who had died of cholera had been
drinking water from the same pump, on Broad Street, and he insisted that the handle be
removed from this pump to prevent anybody else from drinking from it. After the removal
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of the handle, the cholera outbreak subsided, thus proving Snow’s theory that it had been
caused by the water from that particular well.
Exam practice question 2 (page 59)
Edwin Chadwick was very important in improving public health in towns in the nineteenth
century. To begin with, he wrote the Report on the Sanitary Conditions of the Labouring
Population in 1842 which gave details of the public health problems of the time, and
showed how dirty conditions led to the rich paying higher taxes, because the poor were too
sick to work. He made recommendations about how public health could be improved, that
were later included in the first Public health Act which was passed in 1848. This Act created
a Board of Health, of which Chadwick was a member, to encourage local authorities to
improve conditions. Therefore, his work was extremely important because it led to the first
Public health Act.
However, the first Public health Act didn’t have a lot of impact, and it was only passed at
that time because there had been a cholera epidemic. The government didn’t really want to
force local authorities to make improvements because it cost a lot of money. It wasn’t until
1875, after the link had been made between dirt and disease, that a second Public health
Act was passed which forced local authorities to improve conditions. This was passed partly
because working class men had the vote. This convinced MPs they had to do something to
improve their conditions in order to gain the votes they needed to get elected.
Overall, although Chadwick’s work took a very long time to improve public health, it did
form the basis of the reforms that the government pushed through. I don’t think these
would have become enforcable by law if attitudes hadn’t changed thanks to more people
having the vote and the discovery of germ theory. Chadwick could not have done it on his
own; but I think the work he did was very important.
Exam practice question 3 (page 59)
The work of Aneurin Bevan was really important in launching the NHS in 1948, because he
was Minister for Health and so it was his responsibility. Bevan was very supportive of the
NHS and made lots of speeches to encourage other people to be supportive too. He inspired
people to register for the NHS which increased the demand for doctors, encouraging them
to sign up as well. He was able to make a compromise with the doctors to ensure that they
would work for the NHS, as they could continue to practice medicine privately as well to
maintain their wages. Without the work of Bevan, the NHS may have been a flop. If the
doctors had not signed up there wouldn’t have been enough medical provision for all the
patients.
However, other things were important in the launch of the NHS, too. William Beveridge, a
civil servant, had written a report on how to improve living conditions in Britain and he had
recommended the creation of a National Health Service in the first place, so without that
there wouldn’t have been a cause for Bevan to champion. The changing attitudes of the
population after the Second World War were also important: the middle classes particularly
were keen on the idea of health care for everybody which put pressure on the government
to provide it.
However, I think that without the vision and drive of Bevan the NHS might not have been
so successful so quickly. Therefore, I think Bevan’s work was very important.
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Section 2 Historical Source Enquiry: Surgery
Chapter 8 The transformation of surgery c1845–1918
8.1 Dealing with pain
Exam practice question (page 61)
These sources do not all suggest that chloroform was unpopular. For example, in source B
Queen Victoria calls chloroform ‘blessed’ and says it is ‘soothing and delightful’ which
suggests that she had a positive experience with it. In addition to this, in source C I can see
that a patient has accepted the use of chloroform for a minor operation which suggests that
it was not particularly unpopular.
On the other hand, the girl in the picture in source C died during the operation, and this
image may have been published to warn other people about its use. Likewise, the letters to
the Lancet in source A show strong objections towards chloroform on religious grounds,
saying that pain is sent by God and people should just put up with it. Both of these letters
suggest that chloroform was unpopular.
However, the first letter was published in 1848, as was the picture. Chloroform had only
been developed a year earlier and people were still very suspicious of it. The second letter,
published in 1853, was probably written before Queen Victoria used it in the birth of her
eighth child, because nobody would want to go against what the Queen said. So, I think that
these sources suggest that chloroform was unpopular until Queen Victoria gave it a positive
review, after which I know from my own knowledge it became more popular.
8.2 Dealing with infection
Exam practice question (page 63)
This source gives me the impression that other surgeons were very angry about Lister’s new
invention of carbolic acid spray to keep wounds free from infection. I can tell this because
the source says that ‘the wrath of many surgeons knew no bounds’. This was because his
invention proved that death from infection could be prevented by surgeons keeping their
hands and surgeries clean, and they were unwilling to accept that the answer was so simple.
The source also suggests that the surgeons were angry because they preferred to blame
some other source for the infections, and that taking the new measures would have taken
time, money and effort that they weren’t willing to give. This might be why it took quite a
long time for them to adopt his new techniques.
8.3 Dealing with blood loss
Exam practice question (page 65)
Source A is useful to an historian investigating the rapid development of blood transfusions
in the First World War because it shows nurses packing transfusion kits ready to be shipped
off to the trenches to treat the troops. The photograph was taken at the time and I can tell
from the stripes on the nurse’s uniforms that they work for the army, so I can infer that this
picture was taken during the war and it shows how important the transfusion was, because
a lot of them are working on it, and someone has made an effort to take a picture of them
doing it.
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Meanwhile, source B is useful because it gives me details on the development of the blood
transfusion, by explaining how they managed to stop the blood from clotting and the ways
that is was stored ready for transport. This is from a modern website so it is particularly
useful for helping an historian to find out some basic facts about the development of blood
transfusion.
Overall, I would say that source A is useful to an historian as a primary source, showing
how transfusions were prepared for the trenches, while source B is useful as a secondary
source, explaining some facts about how the transfusion was developed. They are both very
useful but in different ways.
8.4 Factors influencing developments in surgery
Exam practice question (page 67)
Source A shows how important the First World War was in the development of surgery,
particularly plastic surgery. Dr Howard Gillies developed this method of using pedicle tubes
to help to repair the facial injuries of soldiers who had been disfigured during the war. If the
war had not taken place, then this type of surgery might not have been developed.
However, in order to perform surgery like this it is important to have antiseptic conditions
so that no infection can take hold in the new skin being grown. Therefore, the development
of antiseptic surgery might be considered more important than the development of plastic
surgery, and the picture in source B shows how important new technology was in Lister’s
fight to keep surgeries scrupulously clean and remove the chance of infection. Lister had
tried wrapping wounds in carbolic acid-soaked bandages and also washing his hands and
instruments in it, but it was not until he started to use a new spraying mechanism to mist a
fine spray of the acid in the air that he really saw a drop in his mortality rates.
Finally, though, source C explains that Lister used the Lancet, a medical journal, to
publicise his findings and this shows how important improvements in communications were
in the development of surgery. If Lister had not been able to share his ideas, then others
would not have started to make use of them; aseptic surgery would not have been
developed and the risk of infection would not have been low enough to allow plastic surgery
to take place safely.
However, overall I think that improved technology has had the biggest impact on the
development of surgery between 1845 and 1918. Developments such as hypodermic
needles and steam sterilisers allowed surgeons to develop more invasive treatments,
because their patients were safe from infection and pain. This led to surgeons such as Gillies
being able to carry out his plastic surgery during the First World War.
Section 3: The American West c1840–1895
Chapter 9: Inhabitants and early settlers
9.1 The Plains Indians: their beliefs and way of life
Exam practice question 1 (page 69)
The buffalo were vitally important to the Plains Indians because they relied on them to
provide for every aspect of their lives.
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For example, the buffalo provided the Indians with most of their food. The buffalo hunt
would take place two or three times a year. Some of the meat would be eaten fresh, and the
rest would be dried or smoked so that it would keep for a long time. Although the Indians
also hunted other animals and ate plants and berries they gathered on the Plains, the
buffalo was their main food source.
Secondly, the buffalo provided the Indians with the materials they needed to clothe and
house themselves. Clothes would be made from the skin, which the Indian women tanned
using the buffalo brains. They would also use this tanned hide to make the tipi, which the
Indians lived in. This was a key part of their lifestyle as it could be packed up and moved
very quickly, and also it didn’t require a lot of wood, which was scarce on the Plains.
Overall, the buffalo was important to the Plains Indians for a lot of reasons, but I think it
was most important because it provided food, shelter and clothing.
Exam practice question 2 (page 70)
The Plains Indians did not fight wars for the same reasons as the white Americans. White
Americans fought wars over land, but because the Plains Indians did not believe anybody
could own the land, they fought for different reasons. For example, they would fight to win
horses, or to gain honour and win a wife. This meant that battles were usually very short,
and the emphasis was not on killing. Warrior bands would defend their village from attack
for long enough to allow the women and children to pack up and escape.
Because the object of the battle was not to kill, the bravest act an Indian could perform in a
battle was counting coup. This involved touching your opponent with a stick or with your
hand. This showed that you were braver than he was.
Exam practice question 3 (page 71)
The social structure of the tribes was very important in helping the Plains Indians to live
successfully. They were very well-organised and made sure everybody was taken care of.
For example, polygamy was allowed because there were more women than men: this made
sure all the women were provided for. Also, the tipi was owned by the woman which meant
she would always have a place to live, even if her husband was killed during a buffalo hunt.
Indian tribes were split into smaller bands. Each band was led by a chief, who took advice
from a council of elders and medicine men. This meant that major decisions were discussed
carefully and every man’s voice was heard.
Everybody had their job within Indian society. The men would form a warrior society who
would be responsible for organising the hunt, while the women looked after the tipi and
made clothing and other necessities. The elderly played an important role in looking after
children, but they would stay behind to die when they became too weak to keep up. This
helped the Indians to live successfully on the Plains, because everybody was clear about
what their role was and everybody worked together to make it a success.
9.2 Migrants and settlers in the west: early settlers
Exam practice question 1 (page 73)
Early settlers moved to Oregon in the 1840s due to various push and pull factors.
Firstly, they were tempted West by the pull factors. Fur trappers, who had travelled in
Oregon a lot from the 1820s onwards, reported that there was perfect farmland and a never
ending supply of furs and fish for people that went to Oregon. Also, the government passed
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a law which said that a farmer who squatted on a piece of land, built and house and cleared
the trees was entitled to buy it for a low price, which encouraged more people to move
there. This meant that farmers were more willing to take a chance.
Secondly, settlers were forced West by the push factors. In the 1830s the United States
was in an economic depression. There weren’t enough jobs in the East and wages fell. This
meant that food prices also fell so farmers in the East were not able to break even. They
also felt quite crowded in the East as populations had risen dramatically. This meant that
they started to look towards the unsettled land in the West to ‘get away from it all’ and
make a new start.
Exam practice question 2 (page 73)
There were many problems of law and order in California mining towns after gold was
discovered in 1849. The main reason for this was because there wasn’t enough law
enforcement. The population of the towns grew quickly and because it took so long for law
enforcers to travel from the eastern states, there were not enough people to keep law and
order among the miners.
There was a lot of racism in the mining camps. There were groups of black, Mexican, Asian
and Indian miners who were very unpopular among the white miners. Claim jumping was a
common problem and led to law and order problems, because to begin with claims to
certain areas were not properly recorded and it was easy to start mining on somebody else’s
land. This caused big law and order problems. However, both of these problems could have
been tackled if there had been more law enforcement officials in the mining towns.
Exam practice question 3 (page 73)
The discovery of gold in 1849 had both positive and negative effects on the growth of the
American West.
One good thing was that it encouraged more people to move to California. This meant that
the area became settled quickly, and the increased migration opened up the routes west
and encouraged the American government to fund the development of the transcontinental
railroad. This was really key in helping the Americans to achieve their ‘Manifest Destiny’ and
settle the whole of the continent.
The increase in people caused problems of its own because California wasn’t properly set
up for the new communities. Life was hard and there wasn’t much law enforcement, which
created law and order problems. Mining towns sprang up out of nowhere, often without
proper housing or sanitation, which caused health problems. Also, many of the new miners
were not trained and did not find any gold, which meant that there was a lot of poverty.
9.3 Migrants and settlers in the west: the journey west
Exam practice question 1 (page 74)
From this source, I can learn that the journey across the Plains would have taken a long
time. This is because Marcy recommends allowing the animals almost as much time resting
and grazing as they spend pulling the wagons. I can also infer that sometimes it was difficult
to find good grazing land for the animals because Marcy says ‘the best grass than can be
found’.
© Hodder & Stoughton 2013
Exam practice question 2 (page 76)
From this source, I can learn that travellers across the Plains faced danger from Indian
attacks. In the source, Jane Gould explains that she has heard about an attack and then she
sees some dead people who have been mutilated by the Indians. I can infer that Jane Gould
became very anti-Indian because of what she saw. Living in constant fear of attack must
have taken its toll on the settlers.
Exam practice question 3 (page 76)
From this source, I can learn that wagon trains faced attacks from Indians. In the source you
can see Indians attacking with tomahawks, machetes and bows and arrows. They are on
horseback and they look very fierce. However, I can also see that the wagon trains did a
good job of defending themselves against Indian attacks because they had more
sophisticated weapons than the Indians, such as rifles.
Exam practice question 4 (page 76)
Travelling West in a wagon train was a very dangerous and difficult journey. The pioneers
faced many dangers, which included bad weather, stampedes, Indian attacks, lack of
supplies and water and getting lost.
Bad weather was particularly difficult to deal with because it was very unpredictable.
Settlers would try to leave for the journey in April to get across the mountains before the
first winter snows, but sometimes they were not successful. There were also high winds and
scorching heat, which was difficult to deal with when there wasn’t a lot of water.
Getting lost was also a problem. Many wagon trains were led by experienced guides but
even they tried short cuts or took wrong turns. This could lead settlers a long way out of
their way and result in them running out of supplies.
The Donner party is a good example of a group who were unlucky enough to experience all
these things. They tried to take a short cut but it took longer than expected, and they lost a
lot of their supplies. Then they got snowed in in the Sierra Nevadas and over half of them
died.
Exam practice question 5 (page 76)
Getting lost was certainly a big problem facing the first people migrating West. This was
because there weren’t many points of reference on the trails, which made it difficult to
navigate. Most wagon trains were led by experienced guides, like mountain man Jim
Bridger, who knew the route well and could find the best way through the Rockies and the
Sierras. However, some groups took their chances with less experienced guides, such as the
Donner party, who followed a short cut recommended by a trail guide called Lansford
Hastings. Tragically, this short cut took a lot longer than expected and the Donner party
ended up getting snowed in and resorting to cannibalism.
However, getting lost was less of a problem as more settlers made the journey West,
because the routes became more established. Even today you can still see ruts in the rock
on some parts of the trail, which have been left behind by wagons. A much bigger problem
that faced the people migrating West were the harsh weather conditions, which could not
be predicted or protected against; the settlers also faced trouble if they ran out of supplies
because there were very few places along the way to restock. Furthermore, disease and
injury were common and could prove to be deadly – cholera was not uncommon, due to
poor sanitation.
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Overall, I would say that getting lost might have been the biggest problem for some of the
first travellers West, but most settlers faced other, much bigger problems on the journey.
9.4 Case Study: The Mormons
Exam practice question 1 (page 78)
From this source, I can learn that the gentiles had a negative attitude towards Mormons
because they practised polygamy. For example, the cartoonist has depicted some of Brigham
Young’s supposed wives as small, suggesting that he married some very young women
before his death. The cartoon also suggests that Brigham Young was rich – he has a fancy
carpet on the floor and the window blinds are monogrammed with his initials. The
cartoonist might be suggesting that Young made a lot of money out of being the leader of
the Mormons.
Exam practice question 2 (page 80)
Brigham Young was so important in the Mormons’ successful settlement at Salt Lake City
because it was his idea in the first place. He chose to lead them there because at the time it
was not part of the United States and so they were able to practise polygamy there. He
planned the journey well and ensured that everyone was provided for.
Once they arrived at the Great Salt Lake, Brigham Young continued to be important
because he was an inspiring leader. The Mormons listened to him as they believed he was
inspired by God. He made sure the land was carefully shared out among the Mormon
families: the biggest families had the biggest pieces of land. He also ensured an irrigation
system was dug to make sure everybody had fair access to the water.
Finally, Young was important because he came up with a plan to make sure the whole area
was settled with Mormons: the Perpetual Emigrating Fund. This fund made loans to
Mormons who wanted to travel to live in the area. Young sent missionaries to Europe to
encourage people to convert and move to the new Mormon territory of Utah.
Exam practice question 3 (page 80)
The Mormons began their journey to the Great Salt Lake in 1845 due to persecution. They
had become very unpopular in the eastern states for many reasons. One of these was that
they practised polygamy, which many gentiles felt was immoral. The non-Mormons were
also worried that by practising polygamy, the Mormons would be able to increase their
population very quickly by having lots of children. There was a lot of fear among the nonMormons that the Mormons were trying to take over the world, and this was not helped by
a rumour that their leader, Joseph Smith, intended to run for president. For this reason,
Joseph Smith was shot during an attack by a mob of 200 people. Lots of Mormons began to
fear that their town, Nauvoo, would also be attacked and so they started to look for a new
place to live where they could follow their own rules. Therefore, the Mormons were pushed
West by persecution.
The Mormons were also pulled West to the Great Salt Lake because in 1845, this area was
still under the control of Mexico. That meant that the Mormons could legally practise
polygamy. The Great Salt Lake was also a very remote place which nobody else wanted at
the time. The new Mormon leader, Brigham Young, thought it was the perfect place to go
because they would be free from persecution and able to build their own society according
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to their own rules. Therefore, the Mormons were pulled West by the remoteness of the
location Brigham Young chose.
Exam practice question 4 (page 80)
The Mormons were able to make a success of their journey to the Great Salt Lake because
their leader, Brigham Young, planned it very carefully.
First of all, he organised the wagons into groups of 100, with a captain in charge. Each
group of 100 was split into 10 groups of 10, each looked after by a lieutenant. This was very
well-organised and made it clear who was in charge. It meant there was very little room for
argument.
Secondly, Young himself went with the first wagon train and stopped every so often to
build a rest camp for the people coming on afterwards. The biggest of these was on the
banks of the Missouri River and it was called Winter Quarters. There were 1000 cabins built
and this is where the Mormons spent the winter. This helped them to avoid the worst of the
weather and gave them a place to rest and refuel.
Finally, after winter had passed, Young led a smaller ‘Pioneer Band’ to the Great Salt Lake
to start the settlement for the other Mormons. He included a mixture of farmers and
craftsmen. This meant that when the Mormons reached the Great Salt Lake they were not
arriving in a barren wasteland.
Overall, the Mormon journey to the Great Salt Lake was a successful one, thanks to
Brigham Young.
9.5 Migrants and settlers in the west: settlers on the Plains
Exam practice question 1 (page 81)
From this source, I can learn that the artist felt very positive about the idea of Manifest
Destiny. The train and wagon train are both heading forwards towards a green and unspoilt
land. In the foreground you can see people working hard to build their town, and the train is
full of people which shows that lots of people were eager to settle on the Plains.
Exam practice question 2 (page 82)
The government encouraged a lot of people to move to the Plains after 1860. This was
because they offered people free land under the Homestead Act of 1862. Settlers could
claim 160 acres of land as long as they agreed to live on it and farm it for five years. This was
a good deal for people who didn't own anything in the East and so it encouraged a lot of
people to move onto the Plains. Later on, the Timber Culture Act offered settlers another
160 acres of land as long as they agreed to plant 40 acres of it with trees, and the Desert
Land Act offered 640 acres of land in states where rainfall was particularly low. Therefore,
the government was extremely important because they gave the land away to people,
encouraging them to move to the Plains.
However, the railroads were also very important. Once the railroad had been completed,
the railroad companies advertised heavily to let people in the East know about the
opportunities available to them on the Plains. They also sold their spare land off very
cheaply. It was easier to travel to the Plains and to get supplies once the railway had been
finished. Therefore, the railroad was also an extremely important factor in encouraging
people to move to the Plains.
Overall though, I think that the government were important first, because they passed the
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Homestead Act in 1862, whereas the railroad was not completed until 1869. So, although
both were important, the government had more impact on settlement during the 1860s.
9.6 Farming on the Plains
Exam practice question 1 (page 84)
There were two main difficulties faced by homesteaders trying to settle on the Plains in the
1860s – lack of wood, and lack of water. They faced lots of problems, but most of them
stemmed from these two big issues.
Lack of water was the main one. This made it difficult for the homesteaders to grow crops.
This problem was made worse by the fact that they were trying to grow the same sort of
crops that they grew in the East, for example soft wheat, which couldn’t stand up to the
harsh Plains conditions. Also, because there was so little rain, the ground was really hard
and dry, and the ploughs they brought with them couldn’t stand up to the soil and broke.
This made preparing the ground for crops very difficult. Furthermore, the lack of water
made it difficult to keep clean and to give animals enough to drink.
Secondly, they faced a lot of problems because there wasn’t much wood. For example,
they were unable to build fences around their crops. This meant that they were easily
trampled and/or eaten by wild animals and their own cattle. Also, there wasn’t enough
wood to build houses, which meant that they had to build them out of baked mud bricks, or
sods. These were difficult to keep clean, especially when there wasn’t much water around.
Although the main issues were lack of wood and water, homesteaders who tried to adapt
did the best, and so perhaps the biggest issue of all was lack of experience and an
unwillingness to try new things.
Exam practice question 2 (page 84)
Technology was very important in helping homesteaders solve the problems they faced in
the 1870s and 1880s. Most of their problems were caused by a lack of wood and a lack of
water. The invention of the self-governing windmill helped homesteaders to solve the
problem of water shortages because it enabled them to pump water up from deep
underground to water their crops. They were also able to use their new ploughs, such as the
sod buster, to plough their fields quickly shortly after it had rained, which trapped a layer of
water under the soil so it couldn’t evaporate. This was known as dry farming. When barbed
wire was invented in 1873, the homesteaders used this, rather than wood, to fence off their
crops. Using barbed wire helped them to get around the wood shortage problem.
However, things other than technology were also important. For example, the government
introduced the Timber Culture Act in 1873 which allowed homesteaders to double their land
claim if they planted 40 acres of trees. This eventually increased the amount of wood
available on the Plains. Also, the homesteaders started to grow different crops which coped
better with the dry conditions of the Plains, for example, Turkey Red Wheat which was
grown in Russia.
Overall, I think that the main reason for the homesteaders’ success was hard work and
adaptability. It was not easy to be a farmer on the Plains and some of the problems, such as
extreme weather conditions and plagues of locusts, couldn’t be solved. Homesteaders got
round this by growing a surplus in good years and adapting to their surroundings as much as
they could. For example, they burned buffalo chips instead of wood. Technology certainly
helped them to succeed on the Plains, but a number of the new inventions were created by
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homesteaders who were trying to adapt to their new surroundings, which shows that it was
hard work and determination that was really the secret of their success.
Exam practice question 3 (page 84)
Women were highly valued on the Plains because they kept house and made sure
everybody was fed and clothed. This was very important on the Plains, where life could be
exceedingly hard. They were responsible for keeping a kitchen garden and growing
vegetables and fruit. They would also fish and hunt small game to help feed the family. They
would make and mend clothes and gather buffalo chips to keep the house warm and
provide a fire for cooking.
However, it was not just in the home that women were important. They were also vital for
building the community of the Plains. A large number of single women were recruited to be
school teachers in Plains townships, for example. Also, women helped to build a network of
communication among homesteads and organised social events to celebrate births and
harvests, which helped to build the community spirit upon which Plains life was built.
Chapter 10: Development of the plains
10.1 The construction of the railroads
Exam practice question 1 (page 86)
From this source, I can learn that the railroad builders had to hire thousands of Chinese
labourers to work on the Transcontinental Railroad. I can infer that this was because there
were not enough workers in the West to complete the job. Twelve thousand is a lot of
workers, so the project must have been very difficult. I can infer that it was easier to hire
Chinese workers who travelled to the west coast across the Pacific, than it was to hire
railroad workers from the East.
Exam practice question 2 (page 86)
The transcontinental railroad builders faced a lot of problems whilst they were building their
railroad. The first of these was the different types of land they had to cover. The railroad
had to cross several mountain ranges as well as deep valleys and long deserts. New
techniques had to be used to blast through solid rock just to get the railroad out of
California. The blasters used nitro-glycerine which was very dangerous, and accidents
happened. Therefore the terrain made it very difficult for the railroad builders.
Another problem faced by railroad builders was a shortage of workers. This might have
been linked to the dangers of the job, which might have put people off. Also, conditions
were very poor, because railroad workers lived in shacks by the side of the rails or in railway
carriages on the rails they had just completed. Conditions were horrible and pay wasn’t
good. This meant that fewer Americans were willing to sign up to work on the railroad. In
the end, the railroad builders were only able to complete their railway by bringing in extra
labourers from China and Ireland.
Overall, the main difficulties facing the railroad builders were the terrain and the shortage
of workers.
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Exam practice question 3 (page 87)
The transcontinental railroad changed the lives of the homesteaders because it made it
easier for them to get supplies from the East. New farming equipment could more easily be
purchased and goods could be shipped to markets in the East where they might fetch a
higher price. This meant that it was easier for the homesteaders to make a success of their
farms after the transcontinental railroad had been completed.
The transcontinental railroad also increased the number of homesteaders living on the
Plains. This was because the railroad companies advertised heavily about how amazing life
on the Plains was, to encourage people to move West and use the railroad. Furthermore,
the railroad companies sold off the land they had been granted to build the railroad but
didn’t need. They sold this land very cheaply to homesteaders looking to start a new life on
the Plains. Therefore, the railroads changed the lives of homesteaders by increasing their
numbers and therefore building bigger communities on the Plains.
10.2 The rise and fall of the cattle industry
Exam practice question 1 (page 89)
There were several reasons why cattle ranching spread to the Plains. The main reason was
that there wasn’t enough space in Texas. This is because during the American Civil War, the
cattle in Texas bred uncontrollably and by the end of the war there were about five million
of them, and there wasn’t enough grass to go round. This meant that the cattle ranchers
had to look to the Plains to find enough grazing land for their herds.
Once they had started to graze their cattle on the Plains, the ranchers discovered that the
low winter temperatures killed the ticks which caused Texas Fever, and that encouraged
more ranchers to keep their herds on the Plains. Therefore, the weather was another factor
which led to the spread of cattle ranching to the Plains.
Finally, the transcontinental railroad encouraged more ranchers to move to the Plains. It
provided an easy way for the ranchers to transport their cattle to the markets in the East. It
was easier to raise the cattle on the Plains than it was to raise them in Texas and drive them
north to the railway. Therefore, this was another important factor in the spread of cattle
ranching to the Plains.
Exam practice question 2 (page 89)
The cattle industry declined after 1883 for two main reasons. Firstly, demand had declined.
Secondly, there had been a run of particularly bad weather. These two factors combined to
force a decline in the cattle industry.
By the 1880s, demand from the East for beef had started to fall. This meant that the price
paid for each cow fell too, so ranchers didn’t want to sell their cows. They kept their cows
alive on the open range, hoping that the price would increase. This meant there was even
less grass to go round.
Then there were the severe weather problems. There was a bad drought in 1883 which
meant that there was even less grass for the cows to eat. Then in 1885 the winter was
especially bad, with an estimated 15 per cent of herds dying in the blizzards. Lots of the big
cattle ranchers went bankrupt which made it possible for smaller ranchers to become more
successful.
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10.3 Cattlemen and cowboys
Exam practice question 1 (page 90)
Charles Goodnight was very important in helping the cattle industry grow on the Plains.
Firstly, he founded a new cattle trail with his partner, Oliver Loving. They came up with the
idea to drive their cattle to a US Army fort and sell them directly to the US government, to
feed the army and the Indians on the reservations. He was very successful in this, even
though lots of his cows died on the journey due to the lack of water. Eventually the trail he
founded led all the way to the transcontinental railroad.
Secondly, Charles Goodnight founded a huge ranch on the Plains at the start of the cattle
boom. In 1870 he opened a ranch in Colorado and moved his herd of Texas longhorns onto
it. He set a good example for other ranchers, who began moving their cattle onto ranches
on the Plains, too.
Therefore, Charles Goodnight contributed to the growth of the cattle industry on the Plains
by opening up new trails and showing Texan ranchers that it was possible to keep cattle on
the Plains.
Exam practice question 2 (page 90)
Joseph McCoy was undoubtedly key in the development of the cattle industry, but there
were lots of other factors that helped it to develop, such as the growth of the railroads and
the increasing demand for beef.
Beef became more popular in the East in the 1850s, and then the government started
buying a lot of it to feed the army and the Indians on the reservations. This meant that the
price of cattle increased and the ranchers needed new ways to get their cows to market.
Luckily, the transcontinental railroad was being built and this gave them an easy way to
move their cows. This became even easier with the invention of the refrigerated railcar,
because it meant that the cows could be slaughtered before they were sent east. This
increased demand and improved technology meant that more cows were being bred and
sold than ever.
However, the ranchers still had to drive their cattle a long way to reach the
slaughterhouses and stations on the main railroad. More railways were being built further
south, and Joseph McCoy was the first person to take advantage of this. He founded
Abilene, the first cow town, in 1867. He created stock pens to hold cattle waiting for
transport to the east. This was very successful as cows did not have to be driven so far.
Other people copied his example and more cow towns were built as the railroads pushed
west.
Although Joseph McCoy was a real trail blazer and made it easier for cattle to be shipped
East from the Plains, I think that the most important reason for the development of the
cattle industry was the demand for beef. If this demand had not existed, then endeavours
such as Abilene might not have worked and the cattle industry might not have grown so big.
Exam practice question 3 (page 91)
From this source, I can learn that cowboys camped together during cattle drives and were
very well-organised. I can see some of the cowboys doing dishes in the background while
another is cooking over the fire. It looks like a couple of them are playing a game on the
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right of the picture. I can infer that cowboys got along very well together during the cattle
drives. It looks like they are having a good time. It does not look like hard work.
Exam practice question 4 (page 91)
At the height of the cattle boom, cowboys were mainly responsible for rounding up cattle in
the spring, branding them, and driving them to the markets. They would live in the ranch
house and spent their days riding around the ranch, herding stray animals back within the
boundaries, looking after sick animals and protecting them from wild animals like wolves.
This would go on through autumn and winter until it was time for the annual round up
again.
However, this changed with the decline of open range ranching. To begin with, when
barbed wire was introduced, cowboys started to spend a good deal of time mending fences.
This job became a more frequent one as conflict with the homesteaders became more
common, because the homesteaders would often cut the barbed wire to gain access to
water for their own animals, particularly where there were boundary disputes.
As time went on, extremes of weather and a falling demand for beef led to a decline in the
number of open range ranches on the Plains. Smaller ranches became more popular and
demand for cowboys fell. It is likely that a lot of cowboys tried to set up their own small
ranches and homesteads because they could no longer find work on the big ranches.
Therefore, over time, the demand for cowboys first rose and then fell, tracking the demand
for beef.
10.4 Law and order: problems and solutions
Exam practice question 1 (page 92)
Cow towns on the Plains in the 1860s and 1870s had lots of law and order problems. These
were mainly caused by the huge number of cowboys who arrived in the towns at the end of
cattle drives. They would be paid their wages at this time and they would spend it in the
saloons, on alochol and gambling, and they would also visit brothels. A lot of gamblers and
prostitutes would come to the cow towns at this time too, because they were able to make
money from the cowboys. Having masses of extra people in the towns caused law and order
problems, mainly because they spent most of their time drunk and gambling, which often
led to fights breaking out.
In Abilene, the first cow town, they hired a marshal called Wild Bill Hicock to try and keep
the peace. He made a law banning people from carrying guns in the town and this helped to
reduce law and order problems. Shooting was quite common in the West because if you
shot someone carrying a weapon, you could claim self-defence and get away with it.
Therefore, this caused problems with law and order as well.
Exam practice question 2 (page 93)
It was so difficult to keep law and order in cow towns because the population grew
massively at the end of the cattle drives every year. The number of people present in the
town could rise from 500 to 7000, as the cowboys who had accompanied the cattle arrived
in town.
This might not have been a problem on its own, but it was made worse by the fact that
cowboys were paid their wages at the end of the cattle drive. Because they didn’t have
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much time or opportunity to spend their money during the rest of the year, most of their
wages would have been spent on alcohol, in brothels and gambling in the cow towns. This
caused law and order problems.
These problems might have been solved if there had been effective law enforcement, but
there wasn’t. Because the towns were quite small for most of the year, there weren’t
enough law enforcement officials around to keep order when the cowboys came to town.
Therefore, I think the biggest reason why it was so difficult to keep law and order in the cow
towns was because there weren’t enough law enforcement officials. I think the problems
caused by the cowboys could have been tackled if there had been more police.
Exam practice question 3 (page 93)
Vigilantes were very important in dealing with lawlessness in the American West. This was
partly because there were not enough law enforcement officials to cover the whole of the
area, so it was up to the people living in the West to make sure that justice was served.
Vigilante groups were responsible for hunting down outlaws and bringing them to justice:
often this meant lynching them to ensure they could not commit any more crimes.
Vigilante groups were often led by local rich people, which meant they could ensure their
interests were being protected. Sometimes this was a good thing because the sheriffs were
not always trustworthy. For example, in Bannack, Montana, there was a group of robbers
which was led by the sheriff. In this case, the vigilantes were a positive force for law and
order as they helped to get rid of the corrupt law enforcement in the town.
Vigilantes also had a fearsome reputation. Most of the time they lynched the people they
caught without bothering to take them to court first. This meant that a lot of criminals were
more scared of vigilante groups than they were of the sheriffs. Therefore, in some cases, law
and order would have been better in areas where vigilante groups operated.
10.5 Law and order: conflicts
Exam practice question 1 (page 94)
One reason why there was conflict between cattle ranchers and other settlers was because
they all wanted the same land. For example, there was a lot of conflict between cattle
ranchers and sheep farmers, because they were both competing for the same grazing land
and water. This wasn’t helped by the fact that a lot of the sheep farmers were Mexicans or
Indians - racism was common on the Plains and made the situation worse.
There was also a lot of conflict between the cattle ranchers and homesteaders. The
homesteaders did not like the ranchers because their cattle carried a disease, Texas Fever,
which spread to the homesteaders’ cattle during the cattle drives. The herds also trampled
crops, because there was not enough wood to fence them off.
Over time, the cause of the conflict became the homesteaders rather than the ranchers.
Homesteaders used the newly-invented barbed wire to fence off their crops but they often
fenced off access to water at the same time, which made the ranchers angry. Also, some
homesteaders would take unbranded baby calves to start their own herds, which the
ranchers saw as rustling. In Wyoming this tension eventually built up to cause the Johnson
County War.
Exam practice question 2 (page 95)
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The Johnson County War was fought in 1892 because the cattle barons, or big cattle
ranchers, were not willing to share their land with the smallholders and homesteaders that
lived in the area. They set up the Wyoming Stock Growers Association to target the rustlers
and the homesteaders who were fencing off land which the ranchers considered to be
theirs. Since it was the WSGA that hired 24 gunfighters who played a key role in the war, it is
clear that they ranchers played an extremely important part.
The cattle barons were also responsible for starting the war in 1889, when they lynched
Jim Averill and Ella Watson, who owned a saloon on land claimed by one of the cattle
barons and had been suspected of rustling. They continued to take the law into their own
hands over the next couple of years and several more small ranchers were killed. By 1892
the cattle barons had drawn up a death list of 70 people which they gave to their
gunfighters. They were responsible for paying the gunfighters a bonus for every rustler
killed.
Therefore, the cattle barons played a huge part in the Johnson County War: without them,
it probably wouldn’t have happened.
Exam practice question 3 (page 95)
The Johnson County War marked the end of open range ranching on the Plains. This was
because the cattle barons had gone too far and they lost a lot of their power after the war.
This happened because they had obviously behaved illegally by drawing up a deathlist and
taking the law into their own hands, and the local government, such as the governor, no
longer supported their plans to protect their massive open range ranches.
Because the cattle barons no longer had as much power, smaller ranchers and
homesteaders were able to flourish on the Plains. They fenced off their farms and ranches
to create smaller parcels of land. The cattle barons couldn’t do anything to stop this. Smaller
farms became more popular as more and more of the Plains became settled and there was
less land available for open range ranching.
There were lots of other factors in the end of open range ranching, such as bad weather
conditions and falling demand for beef, but the Johnson County War marked the end of this
way of farming in Wyoming.
Chapter 11: Conflict on the plains
11.1 Conflict between settlers and Plains Indians: the Indian Wars
Exam practice question 1 (page 97)
Exterminators wanted to see the end of the Plains Indians. They wanted them to be wiped
out and removed from the Plains. Exterminators didn’t think that a peaceful solution was
possible. A lot of Plain settlers and homesteaders were likely to think like this because they
had first-hand experience of the Plains Indians, and often that experience was very negative.
Lots of homesteaders had encountered Indians on their wagon journey to the Plains. For
example, Jane Gould was a homesteader who kept a diary of her journey West and she
wrote about how she saw some travellers who had been murdered by Indians and
afterwards she said she wished all the Indians could be exterminated.
The other opinion about the Indians were negotiators, who wanted to make a peace with
the Indians and thought Americans could share the Plains with them. People who thought
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like this generally lived in the East and hadn’t experienced the Indians first-hand.
Homesteaders might have had their farms attacked by Indians or their animals kidnapped.
They had more reason the be afraid of the Indians and therefore wanted them to be
removed.
Exam practice question 2 (page 98)
There were several things that led to increased tension between the Indians and the US
government in the 1860s, but the main problem was that gold was being discovered in more
and more areas. The government and the Indians were stuck in a cycle: the government
would sign a treaty guaranteeing the Indians some land. Then gold would be discovered,
and settlers would move onto Indian land or cross it to mine, and the army would go in to
protect them from the Indians. The Indians would fight back but usually lost and had to sign
new treaties which reduced the amount of land they had. Therefore tension increased
between the Indians and the government because they both wanted the same land.
Another cause of tension was the failure of crops on the reservations. This left Indian
families starving and so they would leave the reservation to look for food, which led to them
attacking wagon trains. This then brought them into conflict with the army, which caused
even more tension.
Exam practice question 3 (page 98)
In some ways, Little Crow’s War was successful, because he did lead a successful attack on
the Indian Agency and successfully got rid of a column of soldiers who had been sent in to
help the Agency. Little Crow and his people felt they had no choice but to attack because
their crops had failed. They were starving and had no money to buy food, and the
government store had stopped their credit so they couldn’t get anything to eat. Therefore
they attacked the Indian Agency - this part was successful.
However, overall it was a disaster for the Indians. Little Crow couldn’t control the Santee
Sioux, who were starving, and lots of settler towns and wagon trains were attacked. This
meant that the US army sent in thousands of reinforcements who captured over 2000
Indians. Lots of them were sentenced to death and the rest of the Santee Sioux were moved
to a new reservation where the land was too poor to grow crops and the water wasn’t good
for drinking. This meant that hundreds more died of starvation and disease.
Therefore, it is completely wrong to called Little Crow’s war a victory for the Indians,
because even though they successfully attacked the Indian Agency and repelled the first lot
of troops, in the end it led to even harsher treatment of the Indians by the army and the
government.
11.2 Conflict between settlers and Plains Indians: the Great Sioux War
Exam practice question 1 (page 100)
Crazy Horse played a key role in the Battle of the Little Big Horn. He led the Indian forces
which were made up of Indians from a number of tribes. He was a respected leader in battle
and was famous for being very brave.
Crazy Horse was also important in ensuring that the Indians won at the Battle of the Little
Big Horn. This is because he adjusted his tactics to fit the army he was fighting. Indians
normally fought short battles and escaped as quickly as possible, because they weren’t
aiming to win land. However, Crazy Horse came up with a plan to lead half of the Indian
forces around behind Custer and his men. They were surrounded and this was one of the
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reasons why they lost. This shows how important the leadership of Crazy Horse was,
because it was his battle plan that helped the Indians to win.
Exam practice question 2 (page 101)
In the short term, the Battle of the Little Big Horn was definitely a victory for the Indians.
This is because the forces of Crazy Horse and Sitting Bull were able to defeat Custer’s army
quite easily. They changed their tactics and half of the Indian forces surrounded Custer,
which was a new way of fighting for the Indians. They also had a lot more men – around
2000 against 600 US soldiers – and better weapons, which they had bought from traders.
Custer attacked while his men were still tired and he split his forces into three, which was a
mistake. There was only one survivor from Custer’s force and that was an Indian scout.
There is no doubt that the Indians won the Battle of the Little Big Horn.
However, although it was a victory in the short term, the long term impact on the Indians
was devastating. This was partly because news of the epic defeat reached the East on 4 th
July, which was very bad timing because that is Independence Day. This turned a lot of
people against the Indians and the government sent in even more troops. They built two
new forts and hunted bands of Indians through the winter. Eventually all the Indians had
either returned to their reservations or fled to Canada. This meant that the Indians were no
longer capable of fighting against the US army.
Overall, I would say that the Indians won the battle, but lost the war: they were victorious
at the Battle of the Little Big Horn, but partly because of this they lost the Great Sioux War
and, as a result, the Plains.
Exam practice question 3 (page 101)
The discovery of gold was a very important factor in the Sioux Wars. To begin with, it was
discovered in Montana and a lot of settlers crossed Indian hunting grounds to get to the
new claims, which broke the first Fort Laramie treaty and led to the Sioux attacking
travellers on the route to Montana. This caused Red Cloud’s War and led to a second Fort
Laramie Treaty being signed, which made the land the Great Sioux Reservation. However,
when gold was discovered in the Black Hills, which formed part of this reservation, the same
thing happened and this led to the Great Sioux War and the Battle of the Little Big Horn.
Therefore, the discovery of gold was a key reason for the Sioux Wars.
However, the discovery of gold on its own might not have led to conflict. The US
government allowed miners and the US army to break the Fort Laramie treaties to get to the
gold – actually, they used the army to protect people who were looking for gold in the Black
Hills. Therefore, if the US government had been willing to keep their promises, the wars
might not have broken out. However, because they believed in Manifest Destiny they
wanted to control the whole continent. They also had a very different attitude towards the
land and tried to buy it off the Indians, which didn’t help with the conflict either.
So, overall, I think gold was really important as a cause of the Sioux Wars but I think the
main reason was the attitude of the US government, who wanted to settle the whole
continent and didn’t want to share it with the Indians.
11.3 Change of policy from 1876: destruction of Native American way of life
Exam practice question 1 (page 102)
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The US army played a key role in destroying the Plains Indians’ traditional way of life after
1876. This was because they were responsible for ensuring that the Indians kept to their
reservations. They made sure that the Indians did not hunt the buffalo, which meant that
they remained dependent on government grants and what crops they could grow. They also
supplied buffalo hunters with ammunition to wipe out the buffalo herds. This was key in the
destruction of the Indian way of life.
The US army used new tactics to break the Plains Indians. For example, they fought winter
campaigns. The Plains Indians did not usually fight in winter, when food was scarce, and so
they were vulnerable. Another new tactic was total war, where the US army destroyed the
Indians’ food and shelter, so they had to return to their reservations or face starvation. The
US army built forts on the Plains, such as Fort Phil Kearney, which made it easier for them to
attack bands of Indians and patrol the routes west.
Overall, I think the US army was very significant in destroying the Plains Indians’ way of life.
The government may have made the policies but the army were responsible for enforcing
them, and if they hadn’t done such a good job the story might have been very different.
Exam practice question 2 (page 103)
The 1887 Dawes Act split up the Indian reservations into 160 acre parcels of land. These
were then given to Indians who were encouraged to farm their land. This was a bad deal for
the Indians because the leftover land was sold to white settlers. A lot of Indians did not
want to farm the land so they sold it to white settlers, often for a lot less than it was worth.
Because the land was split up into pieces, the Indians couldn’t live together in bands
anymore. They were spread across a large area. This had a very negative impact on the
Plains Indians because it destroyed what was left of their tribal structure.
Furthermore, because a lot of Indians sold their land they didn’t have anything to live on
when their money ran out. This meant that they had to rely on the US government for
welfare to feed themselves. This had a negative impact on the Plains Indians because they
become very demoralised and they couldn’t come together to make group decisions about
how to deal with the white Americans.
Therefore, the Dawes Act had a negative impact because it split the Indians up and meant
they couldn’t live in tribes anymore.
Exam practice question 3 (page 103)
The Battle of Wounded Knee happened in 1890. Chief Big Foot and his band had fled the
reservation after Sitting Bull had been killed. They were practising the Ghost Dance, which
was a new religious movement among the Sioux Indians. However, because this was a
religious dance it was banned on reservations. Therefore the army tried to arrest Big Foot
and his band. Some of the Indians resisted and began to dance, and the army opened fire on
them. One hundred and forty six Indians were killed, including some children and babies.
They were buried in a mass grave. The Battle of Wounded Knee marked the end of the
Plains Wars.
Some historians think that the massacre was the army’s revenge, because the unit involved
was the seventh cavalry. The seventh cavalry had been massacred by Crazy Horse and his
warriors and the Battle of the Little Big Horn.
11.4 Changes to Native American culture by 1890: life on reservations
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Exam practice question 1 (page 105)
Indian children were taken away from their parents and educated in white boarding schools,
which played a large part in destroying Indian culture. One reason for this was because the
Indian children were taught English and not allowed to speak their own language. Also, they
were given a white ‘Christian’ name and made to convert to Christianity. This made it
difficult for them to go back to their tribes at the end of their schooling because they might
not remember their own language which would have made communication difficult.
Another reason why it destroyed Plains Indian culture was because they were kept in
military conditions and taught not to respect their traditional way of life. This meant they
not only forgot their old customs and way of doing things, but also thought living like a
white American was better and they would be less likely to return to their tribes. Even if
they did, they wouldn’t have any respect for the tribal structure or ceremonies.
Exam practice question 2 (page 105)
Reservation life was very difficult for the Plains Indians. They had to live in one place and
they couldn’t follow the buffalo anymore. They had to learn to farm and start living in solid
houses instead of the tipis they were used to.
The Plains Indians found it very hard to maintain their customs on the reservations,
because they couldn’t fight battles against each other or go hunting. This made it difficult
for men to gain status in their bands and tribes. Therefore, reservation life had a bad effect
on the social structure of the Plains Indians.
Furthermore, the Plains Indians were demoralised by living on the reservations. This is
because they went from hunting to fulfil all their needs to relying on food and money from
the US government, especially when their crops failed, which they often did because the
Indians were not used to farming and the reservation land was often poor quality land
which white farmers didn’t want.
Therefore, reservation life had a very negative impact on the Plains Indians.
Exam practice question 3 (page 105)
The destruction of the buffalo herds played a huge part in end of the Plains Indians’
traditional way of life. This was because they were reliant on the buffalo for everything.
They hunted buffalo for food, clothing and shelter, and they used every part of the animal to
create the things they needed to live on the Plains. The buffalo was also an important part
of their rituals and ceremonies: young warriors would eat the heart raw to take on the
strength of the buffalo, and the dung would be smoked during special ceremonies.
Therefore, when the buffalo was destroyed, a large part of their lifestyle was destroyed with
it.
However, the Plains Indians were very adaptable and it seems likely they would have
survived without the buffalo. Unfortunately, they were in the way of the white Americans
fulfilling their Manifest Destiny and this was probably the main reason for the end of their
way of life. They were forced to live on increasingly smaller parcels of land and were kept
there by the US army. They lost the right to live on land that was sacred to them, like the
Black Hills, because they contained gold and silver which the US government wanted. The
Plains Indians could not understand the white Americans’ attitudes towards the land and
they did not recognise the threat to their culture.
This, therefore, is the main reason why the Plains Indians’ traditional way of life was
destroyed: they were in the way of what the white Americans thought was their Manifest
Destiny. As a result of this, the buffalo were hunted almost to extinction, Indians were
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forced onto reservations and Indian children were sent to white boarding schools. This
meant that the Indians were no longer a threat to the white Americans.
Section 4 Life in Germany c1919–c1945
Chapter 12: The rise of the Nazi Party
12.1 The early years of the Weimar Republic
Exam practice question 1 (page 108)
Source A suggests that German opinion about the Treaty of Versailles was very negative
towards the French as they thought they wanted to use it to take as much away from
Germany as possible. I think this because Clemenceau the French leader is shown as a
vampire sucking the life out of Germany who is represented as a sleeping woman. This also
suggests that Germany felt they were innocent and didn’t deserve it.
Exam practice question 2 (page 109)
One reason how the Treaty of Versailles had a negative effect on the German people was
the clause in which blame for starting the war had to be accepted by Germany alone. The
War Guilt Clause triggered widespread anger in the country as many felt Germany was not
the only country to blame for the outbreak of the First World War. With countries such as
France and Britain forcing them to accept the blame, the German people saw it as unfair
and resented the treaty and those who produced it.
Another reason why the Treaty of Versailles had a negative effect on the people of Germany
was that the country also lost a lot of land to other nations. Almost 15 per cent of
Germany’s land mass was carved up and given to other countries, along with all of their
colonies. Some of this was major industrial and agricultural land such as the region of
Alsace-Lorraine. This did more than just anger the Germans; it also meant that they had lost
areas that usually produced food and goods that would be sold in Germany and abroad.
Not only did the loss of land have a harmful effect on Germany, but they also had their
armed forces reduced. Again, the German people were made to look weak as their army
was cut down to 100,000 men and they were not allowed to have an air force. This harsh
move by the Big Three had a negative effect on the country as it damaged their pride and
made most Germans hate the Treaty of Versailles and the countries that enforced it.
12.2 Challenges and recovery: the impact of economic problems 1923–29
Exam practice question 1 (page 111)
I agree that Stresemann was a strong leader as he was able to successively negotiate with
countries around him. In 1923 he negotiated with the French to leave the Ruhr and also
signed the Locarno Treaties which confirmed Germany’s boundaries with Italy, France and
Belgium. A year later; Stresemann also oversaw Germany’s inclusion in the League of
Nations. All of this shows that he was a strong leader who was able to negotiate successfully
on the international stage which made him popular with many Germans.
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I also agree that Stresemann made Germany stable as the popularity of extremist parties
such as the Nazis was low during this time. The evidence for this is in the fact that the Nazis
received 32 seats in the 1924 election and only 12 seats in the 1928 election. This poor
performance could be down to the fact that Stresemann was a popular leader who ruled
well by making the country prosperous so there was no need for Germany to risk this and
vote in an extremist party like the Nazis.
Furthermore by negotiating the Dawes plan you could say it made Germany more
economically stable. This is because the Dawes Plan of 1924 allowed Germany to pay off the
reparations over a longer period of time, so the amount Germany paid off each year was
lower. This meant that more money could be spent on factories and infrastructure projects
like railways and roads. Many Germans shared in this prosperity which increased
Stresemann’s popularity as they believed he was responsible for this.
On the other hand you could say he was buying time and Germany’s economy was not
stable or prosperous. This is because Germany’s prosperity all depended on money that was
borrowed from the USA in the form of loans. Even Stresemann had said the countries
’wealth could be described as ‘dancing on a volcano’ which means it wasn’t safe as it could
explode and the loans could be recalled. This meant that the prosperity Germany was
experiencing could fall apart at any moment and so the country was not as stable as it
looked.
Overall I agree that Stresemann was strong and did make the country more stable. Even
though the money Germany had come mostly from US loans between 1924 and 1928, he
used the money well and on successful projects. This, coupled with his shrewd diplomatic
negotiations, resulted in many people believing that the stability of the country in this
period was down to Stresemann’s strong leadership and thus made him popular.
12.3 Increasing support for the Nazi Party
Exam practice question 1 (page 113)
One reason why the Nazis failed to get into power was that many Germans felt that the
country under Gustav Stresemann was doing well and there was no need to vote for an
extremist party. Between 1924 and 1928 Germany enjoyed low unemployment thanks
partly to loans negotiated in the Dawes Plan with the USA. The money from these loans was
spent on new factories and infrastructure in the country. Since lives for many Germans were
considerably better than they had been before, many people thought voting for a largely
unknown and extreme party was pointless.
Another reason why the Nazis failed to gain power in Germany by 1928 was that Hitler was
unable to speak in public before then. When he was released from prison after the failed
Munich Putsch, Hitler was banned from public speaking. His skill as an inspirational speaker
was often seen as a reason why more Germans had joined the party once he became leader
in 1920. By banning him from speaking in public, Hitler was unable to persuade more people
to join and get his views across to those who would listen.
Finally a further reason for the Nazi Party’s failure to secure power was down to their
inability to secure the working class vote. Many working class people in Germany preferred
to vote for other parties such as the Communists. Since the working class were the largest
group of voters, the Nazis could not get power in the country without a majority of that
class voting for them.
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Chapter 13: Government of the Third Reich
13.1 Creation of the Nazi State
Exam practice question 1 (page 117)
The Reichstag Fire helped Hitler increase his control over Germany as it showed how the
Communist Party was a threat to Germany and needed to be stopped. When Van Der Lubbe
was found at the scene, the Nazis used the fact he was communist to claim the whole event
had been part of a master plan by them to take over Germany. As a result Hitler was able to
ask Hindenburg for emergency powers to hunt down and arrest thousands of Communists.
This helped Hitler increase his control over Germany because these new powers enabled
him to eliminate one of the biggest political opponents to the Nazis.
Moreover, because the Reichstag fire showed the apparent communist threat to the
government, it also helped Hitler increase his control by persuading Hindenburg he needed
to pass emergency laws that affected security. Some these new powers allowed the police
to arrest and hold people without charge and even a trial. These new powers which Hitler
could use meant that he was able to take more control of the way the country was run.
The Reichstag Fire also helped Hitler increase his control over Germany because only a few
weeks later the Nazis achieved their best ever election result. The elections in March saw
the Nazis get 44% of the vote and this result was partly down to the way Hitler handled the
Reichstag Fire. Many Germans voted for the Nazis thinking they were tough on extremists
like the Communists and had Germany’s best interests at heart. As a result of the election,
Hindenburg had to take Hitler more seriously and in return he was given more control of the
affairs of the country.
13.2 Nazi methods of control
Exam practice question 1 (page 118)
One way in which the Nazis used terror to control the German people was through
concentration camps. These were set up in the early 1930s to hold people for questioning
and they slowly turned into forced labour camps where torture was often carried out. Any
opponents of the government knew that if they questioned Hitler’s policies they could end
up in one of these places. This was an effective method of control by terror used by the
Nazis as people would fear these places.
Similarly, the Gestapo was an effective terror method that was used to control the German
people. They could open letters, tap phones and collect information from informers who
lived among ordinary people and relayed anything suspicious to the Gestapo. Having the
power to arrest, torture and imprison without trial anyone they deemed anti-Nazi was a
useful method of control as people would be scared to say anything against the
government.
The SS was another tool of terror the Nazis employed to control the German people. By
1939 there were 240,000 members of the SS who were used by the government in a variety
of different roles. They were extremely loyal to Hitler and would be used to arrest people
without trial and search houses of suspected opponents of the government. The SS also ran
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the concentration camps. All of these made the SS feared by the German people and was
another example of the use of terror to control the population.
Exam practice question 2 (page 119)
I can learn from Source A that Nazis felt the radio was an important method of spreading
their ideas around Germany as it would reach a wide audience. You can see this by the fact
the radio is big and glowing in the middle of the poster and crowds of people are facing it.
This shows how significant the Nazis thought the radio was in spreading their propaganda.
13.3 Opposition and resistance to the Nazi Government
Exam practice question 2 (page 119)
I agree that opposition to the Nazis was weak because Hitler’s government was quite
popular with many Germans. One reason for this was that between 1933 and 1939 the Nazis
managed to cut unemployment which was nearly at 6 million when they gained power and
they had started to build up the armed forces again. This made many in Germany think the
Nazis were popular as they did not want to return to the weak Weimar Government that
had done little to tackle the problems in Germany during the depression. This resulted in
weak opposition as only a minority decided to question what the government was doing
while the majority of people supported them.
Another reason why opposition to the Nazis was weak was because they treated their
opponents very harshly. The White Rose group, led by Hans and Sophie Scholl, had been
caught spreading anti-Nazi messages about the government and, in particular, their
persecution of the Jews. When they were caught they were tortured, publically put on trial
and then executed. This meant that a severe penalty was an effective warning to others that
harsh punishments would await them if they tried and challenge the Nazis.
Similarly, opposition was also not a threat because it was difficult to resist Hitler’s
government in a police state. The Nazis had an effective network of informants, local
wardens, police and Gestapo that all worked together effectively to seek out and arrest any
opposition. Every town had these networks that collected information and spied on people
living there. It was difficult for opposition to remain secret or carry out any anti-Nazi activity
so it wasn’t seen as a threat.
On the other hand you could argue that opposition wasn’t weak because some groups
managed to operate inside Germany for many years without being stopped. One of these
groups, the Edelweiss Pirates, managed to conduct anti-Nazi operations between 1938 and
1944. The Edelweiss Pirates were groups of young people around Germany who met and
sang anti-Hitler songs, beat up Hitler Youth members and rejected anything to do with the
Nazis. Several members of one group were publically hanged in Cologne which showed that
the Nazis took them seriously and were seen by the government as a threat to their power.
Overall I do agree that opposition was weak and was not really seen as a threat to power.
Even though groups such as the Edelweiss Pirates did operate for many years, they did not
pose a demonstrable threat to the Nazi government. The Nazis had such an effective
network of control with the use of informants and police that they experienced no real
threat to their power. Many Germans actually liked the Nazi government as they felt the
country was much stronger and richer with them in charge and so there was no need to
oppose them.
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Chapter 14: Social impact of the Nazi state
14.1 Nazi Policies towards women and the young
Exam practice question 1 (page 124)
I can learn from source A that the Nazis saw the role of women as important to the future of
the nation. I think this because the mother is seen surrounded by her family and holding a
baby telling us that looking after them was important. The eagle behind them is wrapping its
wings around the family suggesting that the Nazis wanted to protect this role and shows
they must have felt they were central to the nation state.
Exam practice question 2 (page 125)
The lives of women changed during the period 1933-1939 significantly in terms of the role
that they were expected to undertake. Before 1933 women were relatively free to choose a
career path that they wanted. But this changed under the Nazis as more women were
encouraged to concentrate on being mothers and looking after their families. Their role was
seen as very important by the Nazis as they were expected and rewarded for having large
families for the good of the nation. Medals were given to women who bore large numbers
of children, gold for eight or more, silver for six and bronze for bearing five children. The
1933 Law for the Encouragement of marriage reinforced how important the Nazis felt this
role was by offering young couples loans and offered higher maternity benefits.
To cope with this new change in role, women’s lives also changed in terms of how they were
educated. Boys and girls were schooled separately and educated in different subjects in
order to fit the roles they would eventually undertake for the Nazis. Girls had lessons in
domestic duties such as making beds and cooking which were all about getting them ready
for motherhood. They were taught the three ‘K’s which translated as Children, Church and
Cooking. This role was also shown in Nazi propaganda of the time to illustrate the Nazi ideal
woman and the part they should play in the Third Reich.
Furthermore the lives of women changed during this period in terms of the work they were
employed in. Even though women had been discouraged from taking a job when the Nazis
came to power, after 1936 the shortage of workers meant that women were taken on to
help with re-armament. So while they had been discouraged in 1933 not to take a job and
concentrate on motherhood, the desire to be self-sufficient and have a powerful army
meant that by 1939 there were actually more women in employment than in 1933. So the
lives of women changed quite significantly during this period as at first they were
encouraged to concentrate on families and by the end of the period many were doing the
opposite and were in fact employed in factories to satisfy the needs of industry.
14.3 The Nazi views on minorities
Exam practice question 1 (page 128)
One reason why Kristallnacht was important was that it allowed Hitler and Joseph Goebbels
the excuse to escalate the persecution of the Jews. Before 1938 the Nazis had brought in
number of laws that had taken away the rights of Jews as citizens in Germany including a
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right to go to certain public areas such as swimming pools and restaurants and also the right
to be employed in certain jobs like civil servants. After Kristallnacht the persecution became
more severe, eventually leading to the Final Solution in 1942. So Kristallnacht was important
as it intensified the persecution of the Jews in German territories.
Another reason why Kristallnacht was important was that it signalled an increase in actual
violence towards the Jews by the Nazis. Before Kristallnacht, violence against Jews was not
as common since most of the persecution against them had been carried out discretely
using discriminatory laws. After this event, the Nazis seemed to use more violence against
the Jews including forcing them into Ghettos and allowing death squads to follow the
regular army into conquered countries and shooting dead Jews they found.
A further reason why Kristallnacht was an important event was the extent of the damage
caused. Even though the murder of von Rath by a Polish Jew (one of the reasons for the
riots) took place in Paris, the extent of violence and damage led to over 800 shops being
destroyed and around 90 Jews killed all over Germany. This level and scale of damage had
not been seen before against the Jews in Germany and showed how significant this one
event was in the history of persecution against the Jews by the Nazis.
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