June 2021 MS - Paper 1 History GCSE

Mark Scheme (Results)
November 2021
Pearson Edexcel GCSE

In History (1HIA)
Paper 1: Thematic study and historic

environment (1HIA/11)
Option 11: Medicine in Britain, c1250–

present and
The British sector of the Western Front,
1914–18: injuries, treatment and the
trenches
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November 2021
Question Paper Log Number P67597
Publications Code 1HIA_11_2111_MS
All the material in this publication is copyright
© Pearson Education Ltd 2020
General Marking Guidance
• All candidates must receive the same treatment. Examiners must

mark the first candidate in exactly the same way as they mark the
last.
• Mark schemes should be applied positively. Candidates must be
rewarded for what they have shown they can do rather than
penalised for omissions.
• Examiners should mark according to the mark scheme not
according to their perception of where the grade boundaries may
lie.
• There is no ceiling on achievement. All marks on the mark scheme
should be used appropriately.
• All the marks on the mark scheme are designed to be awarded.
Examiners should always award full marks if deserved, i.e. if the
answer matches the mark scheme. Examiners should also be
prepared to award zero marks if the candidate’s response is not
worthy of credit according to the mark scheme.
• Where some judgement is required, mark schemes will provide
the principles by which marks will be awarded and exemplification
may be limited.
• When examiners are in doubt regarding the application of the
mark scheme to a candidate’s response, the team leader must be
consulted.
• Crossed out work should be marked UNLESS the candidate has
replaced it with an alternative response.
How to award marks when level descriptions are used
1. Finding the right level
The first stage is to decide which level the answer should be placed in. To do this, use a ‘best-fit’
approach, deciding which level most closely describes the quality of the answer. Answers can display
characteristics from more than one level, and where this happens markers must use the guidance
below and their professional judgement to decide which level is most appropriate.
For example, one stronger passage at L4 would not by itself merit a L4 mark, but it might be evidence
to support a high L3 mark, unless there are substantial weaknesses in other areas. Similarly, an answer
that fits best in L3 but which has some characteristics of L2 might be placed at the bottom of L3. An
answer displaying some characteristics of L3 and some of L1 might be placed in L2.
2. Finding a mark within a level

After a level has been decided on, the next stage is to decide on the mark within the level. The
instructions below tell you how to reward responses within a level. However, where a level has specific
guidance about how to place an answer within a level, always follow that guidance.
Levels containing two marks only

Start with the presumption that the work will be at the top of the level. Move down to the
lower mark if the work only just meets the requirements of the level.
Levels containing three or more marks

Markers should be prepared to use the full range of marks available in a level and not restrict
marks to the middle. Markers should start at the middle of the level (or the upper-middle mark if
there is an even number of marks) and then move the mark up or down to find the best mark. To
do this, they should take into account how far the answer meets the requirements of the level:
• If it meets the requirements fully, markers should be prepared to award full marks within the
level. The top mark in the level is used for answers that are as good as can realistically be
expected within that level
• If it only barely meets the requirements of the level, markers should consider awarding marks
at the bottom of the level. The bottom mark in the level is used for answers that are the
weakest that can be expected within that level
• The middle marks of the level are used for answers that have a reasonable match to the
descriptor. This might represent a balance between some characteristics of the level that are
fully met and others that are only barely met.
Indicative content
Examiners are reminded that indicative content is provided as an illustration to markers of some of the
material that may be offered by students. It does not show required content and alternatives should be
credited where valid.
The British sector of the Western Front, 1914–18: injuries, treatment and the trenches
Question
1 Describe two features of the dressing stations where injured soldiers might be taken to receive
treatment.
Target: knowledge of key features and characteristics of the period.

AO1: 4 marks.
Marking instructions
Award 1 mark for each valid feature identified up to a maximum of two features. The second mark should be
awarded for supporting information.
e.g.
• Dressing Stations were usually a short distance behind the trenches (1). They were often based in abandoned buildings
but sometimes they were just in tents (1).
• Staff at the Dressing Stations would treat minor injuries so that the soldier could return to the fighting as soon as
possible (1). Those with more severe injuries would be passed further down the evacuation chain where there were
better facilities. (1).
• They would be staffed by medical officers, together with male medical orderlies and stretcher bearers (1). After 1915,
some Dressing Stations also included nurses (1).
Accept other appropriate features and supporting information.

Question
2 (a) How useful are Sources A and B for an enquiry into the use of blood transfusions on the
Western Front?
Explain your answer, using Sources A and B and your knowledge of the historical context.
Target: Analysis and evaluation of source utility.

AO3: 8 marks.
Level Mark Descriptor
0 No rewardable material.
1 1–2 • A simple judgement on utility is given, and supported by undeveloped comment on the
content of the sources and/or their provenance1. Simple comprehension of the source
material is shown by the extraction or paraphrase of some content. Limited contextual
knowledge is deployed with links to the sources.
2 3–5 • Judgements on source utility for the specified enquiry are given, using valid criteria.
Judgements are supported by developed comment related to the content of the sources
and/or their provenance1. Comprehension and some analysis of the sources is shown by
the selection and use of material to support comments on
their utility. Contextual knowledge is used directly to support comments on the
usefulness of the content of the sources and/or their provenance.
3 6–8 • Judgements on source utility for the specified enquiry are given, applying valid criteria
with developed reasoning which takes into account how the provenance1 affects the
usefulness of the source content. The sources are analysed to support reasoning about
their utility. Contextual knowledge is used in the process of interpreting the sources and
applying criteria for judgements on their utility.
Notes
1. Provenance = nature, origin, purpose.
Markers must apply the descriptors above in line with the general marking guidance (page 3).
No credit may be given for contextual knowledge unless it is linked to evaluation of the sources.
No credit may be given for generic comments on provenance which are not used to evaluate source content.
Indicative content guidance

Answers must be credited according to candidates’ deployment of material in relation to the qualities outlined in
the mark scheme. While specific references are made in the indicative content below, this does not imply that these
must be included; other relevant material must also be credited. The grouping of points below does not imply that
this is how candidates are expected to structure their answers.
Source A
The usefulness could be identified in terms of the following points which could be drawn from the source:
• Source A is useful because it gives details about how blood transfusions were carried out.
• Source A is useful because the language in the source clearly suggests the importance of blood transfusions in
saving lives.
• Source A is useful because it demonstrates how quickly a blood transfusion could have an effect.
The following points could be made about the authorship, nature or purpose of the source and applied to ascribe
usefulness to material drawn from it:
• Charlie Shepherd was writing about his own experience and his first-hand account is useful evidence of the
successful use of blood transfusions.
• Charlie Shepherd seems to want to inform other people about the success of a blood transfusion.
• He was writing about his experience in 1915, which shows that blood transfusions were used early in the war.
Knowledge of the historical context should be deployed to support inferences and/or to assess the usefulness of
information. Relevant points may include:
• Many soldiers died from loss of blood rather than a fatal injury, so transfusions were an important development
in the treatment of the wounded.
• Blood clotted very quickly and therefore it was difficult to store blood, meaning that early transfusions were
carried out person-to-person.
Source B
The usefulness could be identified in terms of the following points which could be drawn from the source:
• The content of Source B is useful as it shows the urgency of dealing with the problem of blood loss.
• Source B is useful because it explains different ways that the procedure was carried out.
• The source stresses the positive aspects of the procedure, for example the fact that the surgeon is in control.
The following points could be made about the authorship, nature or purpose of the source and applied to ascribe
usefulness to material drawn from it:
• The source was written by a surgeon who had worked on the Western Front and was writing from his own
experience, which gives the article credibility.
• The article was published in The Lancet, with the intention of reporting the benefits of this procedure to other
surgeons.
• The article was written in 1918 and reflects the development of different methods of blood transfusion during
the war.
Knowledge of the historical context should be deployed to support inferences and/or to assess the usefulness of
information. Relevant points may include:
• Transfusions had been made possible after the discovery of blood groups by Landsteiner in 1901 but the
donor-to-patient process was not very practical in a war situation, meaning that new techniques were urgently
needed.
• The discoveries during the war of Lewisohn, Rous and Turner of ways to preserve blood made transfusions
more practical than the donor-to-patient method and allowed a blood depot to be created before the Battle of
Cambrai in 1917.
Question
2 (b) How could you follow up Source A to find out more about the use of blood transfusions on the
Western Front?
In your answer, you must give the question you would ask and the type of source you could
use.
Target: Source analysis and use (the ability to frame historical questions).
AO3: 4 marks.
Award 1 mark for selecting a detail in Source A that could form the basis of a follow-up enquiry and
1 mark for a question which is linked to it.
e.g.
• Detail in Source A that I would follow up: ‘they wanted a volunteer for ‘a blood transfusion.’ (1)
• Question I would ask: What would happen to the patient if a volunteer could not be found to give blood? (1)
(No mark for a question that is not linked to following up Source B, e.g. ‘because it would be an interesting question to
ask’.)
Award 1 mark for identification of an appropriate source and 1 mark for an answer that shows how it might help
answer the chosen follow-up question.
e.g.
• What type of source I would look for: RAMC records for hospitals carrying out blood transfusions. (1)
• How this might help answer my question: The records would show how many injured soldiers died from blood loss
or shock rather than from a fatal injury. (1)
Accept other appropriate alternatives.

Medicine in Britain, c1250–present
Question
3 Explain one way in which surgery in the years c1700-c1800 was different from surgery in the
years c1900-present.
Target: Analysis of second order concepts: difference [AO2];

Knowledge and understanding of features and characteristics of the period [AO1].
AO2: 2 marks.
AO1: 2 marks.
1 1–2 • Simple or generalised comment is offered about a difference. [AO2]
• Generalised information about the topic is included, showing limited knowledge and
understanding of the periods. [AO1]
2 3–4 • Features of the period are analysed to explain a difference. [AO2]

• Specific information about the topic is added to support the comparison, showing good
knowledge and understanding of the periods. [AO1]
Performance in AO1 and AO2 is interdependent. An answer displaying no qualities of AO2 cannot be awarded more
than the top of Level 1, no matter how strong performance is in AO1; markers should note that the expectation for
AO1 is that candidates demonstrate both knowledge and understanding.

must be included; other relevant material must also be credited.
Relevant points may include:
• Surgery is less painful in the modern period than it was before 1800. Before 1800, there was no form of pain
relief but in the modern period, anaesthetics are used to prevent the patient feeling pain.
• Before 1800, operations were basic, for example amputations or cutting for the stone. However, in the modern
period, complex operations can be carried out, using new technology, for example transplants, keyhole or
robotic surgery.
Question
4 Explain why there were changes in the prevention of illness in the years c1700-
c1900.
You may use the following in your answer:

• Edward Jenner
• Public Health Act 1875
You must also use information of your own.
Target: Analysis of second order concepts: causation/change [AO2];

Knowledge and understanding of features and characteristics [AO1].
AO2: 6 marks.
AO1: 6 marks.
1 1–3 • A simple or generalised answer is given, lacking development and organisation. [AO2]
• Limited knowledge and understanding of the topic is shown. [AO1]
2 4–6 • An explanation is given, showing limited analysis and with implicit or unsustained links to
the conceptual focus of the question. It shows some development and organisation of
material, but a line of reasoning is not sustained. [AO2]
• Accurate and relevant information is included, showing some knowledge and
understanding of the period. [AO1]
Maximum 5 marks for Level 2 answers that do not go beyond aspects prompted by the stimulus
points.
3 7–9 • An explanation is given, showing some analysis, which is mainly directed at the conceptual
focus of the question. It shows a line of reasoning that is generally sustained, although
some passages may lack coherence and organisation. [AO2]
• Accurate and relevant information is included, showing good knowledge and
understanding of the required features or characteristics of the period studied. [AO1]
points.
4 10–12 • An analytical explanation is given which is directed consistently at the conceptual focus of
the question, showing a line of reasoning that is coherent, sustained and logically
structured. [AO2]
• Accurate and relevant information is precisely selected to address the question directly,
showing wide-ranging knowledge and understanding of the required features or
characteristics of the period studied. [AO1]
No access to Level 4 for answers which do not go beyond aspects prompted by the stimulus
points.
The middle mark in each level may be achieved by stronger performance in either AO1 or AO2.

must be included; other relevant material must also be credited.
Relevant points may include:
• A method of vaccination was developed by Jenner, which made it possible to prevent people getting smallpox.
• The Royal Jennerian Society made smallpox vaccination freely available and the government later made
smallpox vaccination compulsory, so that prevention took place on a wide scale.
• The spread of disease was reduced when government legislation led to improved standards of hygiene, for
example the 1875 Public Health Act made it compulsory for local government to provide access to clean water
and to deal with sewage and rubbish.
• The involvement of central government meant that it was possible for nationwide policies to be implemented
and enforced.
• Snow’s work on cholera showed the link between polluted water and disease, with the result that new sewers
were built for London, which drastically reduced cholera epidemics.
• New vaccinations were developed, increasing the amount of illnesses that could be prevented.
Question
5 ‘The role of the Church was the main reason why there was little change in care and
treatment in the years c1250-c1500.’ How far do you agree? Explain your answer.
You may use the following in your answer.

• medical training
• herbal remedies
Target: Analysis and evaluation of second order concepts: causation; change and continuity
[AO2];
AO2: 10 marks.
AO1: 6 marks.
• The overall judgement is missing or asserted. [AO2]
2 5–8 • An explanation is given showing limited analysis and with implicit or unsustained links to
• The overall judgement is given but its justification is asserted or insecure. [AO2]
points.
3 9–12 • An explanation is given, showing some analysis, which is mainly directed at the
conceptual focus of the question. It shows a line of reasoning that is generally sustained,
although some passages may lack coherence and organisation. [AO2]
• The overall judgement is given with some justification, but some criteria selected for the
required judgement are left implicit or not validly applied. [AO2]
points.
structured. [AO2]
• Criteria for the required judgement are justified and applied in the process of reaching
the overall judgement. [AO2]
No access to Level 4 for answers that do not go beyond aspects prompted by the stimulus points.
The first two bullet points [AO1 and AO2] account for 3 of the 4 marks in the level and are equally weighted; the third
bullet point [AO2] accounts for the remaining mark. Once the level has been found, there are two steps to follow to
determine the mark within the level:
• Markers should consider bullet points 1 and 2 together. Strong performance (for the level) in both would be
awarded all 3 marks, while 2 marks may be achieved by stronger performance in either bullet point; weak
performance would be awarded 1 mark.
• The fourth mark in each level is allocated to the bullet point 3 and should be considered independently of the
award of the other marks.

must be included; other relevant material must also be credited. The grouping of points below does not imply that
this is how candidates are expected to structure their answers.
Relevant points that support the statement may include:
• The Church controlled medical training, which remained based on the ideas of Galen throughout the medieval
period.
• Since the physician’s treatment was based on his Church-controlled training, treatment remained based on
bleeding, purging, and the Theory of Opposites because those were Galen’s ideas.
• The Church encouraged people to think that illness was sent by God and so did not encourage people to
improve their understanding of the cause of illness.
• The Church offered care in hospitals but the focus was care, not cure; there was little change in the care being
offered.
Relevant points to counter the statement may include:

• For most people, illness continued to be treated by women in the family, based on herbal remedies or
traditional ideas; this was not linked to religion or the Church.
• Some herbal remedies were effective in the treatment of minor illnesses and therefore people continued to use
them.
• During the medieval period, technology was not developed enough to allow progress in understanding the
cause of illness and therefore there was little progress in treatment or surgery.
• Remedies offered by the apothecary were usually based on the ideas used by the physician and therefore did
not change until medical training changed.
Question
6 ‘The printing press led to significant progress in medical knowledge and treatment in the
years c1500-c1700.’ How far do you agree? Explain your answer.
You may use the following in your answer:

• Vesalius’ book, The Fabric of the Human Body
• herbal remedies
Target: Analysis and evaluation of second order concepts: consequence; change and
continuity [AO2];
AO2: 10 marks.
AO1: 6 marks.
Spelling, punctuation, grammar and the use of specialist terminology (SPaG): up to 4
additional marks.
• The overall judgement is missing or asserted. [AO2]
2 5–8 • An explanation is given showing limited analysis and with implicit or unsustained links to
• The overall judgement is given but its justification is asserted or insecure. [AO2]
points.
3 9–12 • An explanation is given, showing some analysis, which is mainly directed at the
conceptual focus of the question. It shows a line of reasoning that is generally sustained,
although some passages may lack coherence and organisation. [AO2]
• The overall judgement is given with some justification, but some criteria selected for the
required judgement are left implicit or not validly applied. [AO2]
points.
structured. [AO2]
• Criteria for the required judgement are justified and applied in the process of reaching
the overall judgement. [AO2]
No access to Level 4 for answers that do not go beyond aspects prompted by the stimulus points.
Performance in AO1 and AO2 is interdependent. An answer displaying no qualities of AO2 cannot be
awarded more than the top of Level 1, no matter how strong performance is in AO1; markers should note
that the expectation for AO1 is that candidates demonstrate both knowledge and understanding.
The first two bullet points [AO1 and AO2] account for 3 of the 4 marks in the level and are equally
weighted; the third bullet point [AO2] accounts for the remaining mark. Once the level has been found,
there are two steps to follow to determine the mark within the level:
• Markers should consider bullet points 1 and 2 together. Strong performance (for the level) in both
would be awarded all 3 marks, while 2 marks may be achieved by stronger performance in either
bullet point; weak performance would be awarded 1 mark.
• The fourth mark in each level is allocated to the bullet point 3 and should be considered
independently of the award of the other marks.

Answers must be credited according to candidates’ deployment of material in relation to the qualities
outlined in the mark scheme. While specific references are made in the indicative content below, this does
not imply that these must be included; other relevant material must also be credited. The grouping of
points below does not imply that this is how candidates are expected to structure their answers.
Relevant points that support the statement may include:
• The printing of Vesalius’ The Fabric of the Human Body included accurate drawings, which meant that
more people began to question Galen’s works, leading to progress in medical knowledge.
• Harvey’s book included diagrams of his experiments; this meant others could repeat his experiments
and led to improved medical knowledge.
• Sydenham’s book Observationes Medicae became the basis of medical training and provided a new
understanding of the difference between measles and scarlet fever, and of the condition of gout.
• Books of herbal remedies were printed, for example Culpeper’s Complete Herbal, and medical books
were translated so that medical knowledge began to spread beyond trained physicians.
Relevant points to counter the statement may include:
• Most treatment continued to be carried out in the home by the women of the family; this treatment
remained based on herbal remedies and folk remedies, so there was little improvement.
• Since medical training continued to be based on Galen’s ideas, treatment did not improve, as can be
seen in the treatments given to Charles II.
• New ideas were slow to be accepted, therefore there was limited progress in knowledge and
treatment.
• Much of the progress that did occur was the result of other factors, such as the use of scientific
methods, encouraged by the Royal Society; new technology, such as the microscope; or individuals,
such as Harvey.
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Mark Scheme (Results)

Pearson Edexcel GCSE

Paper 1: Thematic study and historic

Option 11: Medicine in Britain, c1250–

Pearson: helping people progress, everywhere

• All candidates must receive the same treatment. Examiners must

2. Finding a mark within a level

Levels containing two marks only

Levels containing three or more marks

Target: knowledge of key features and characteristics of the period.

Accept other appropriate features and supporting information.

Target: Analysis and evaluation of source utility.

Indicative content guidance

Accept other appropriate alternatives.

Target: Analysis of second order concepts: difference [AO2];

2 3–4 • Features of the period are analysed to explain a difference. [AO2]

Indicative content guidance

Relevant points may include:

You may use the following in your answer:

Target: Analysis of second order concepts: causation/change [AO2];

Indicative content guidance

Relevant points may include:

You may use the following in your answer.

Indicative content guidance

Relevant points that support the statement may include:

Relevant points to counter the statement may include:

You may use the following in your answer:

Indicative content guidance

Relevant points that support the statement may include:

Relevant points to counter the statement may include:

Pearson Education Limited. Registered company number 872828

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