1hr 15mins. You need to answer 5 questions from this paper and there are a total of 50 marks



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John Snow and Cholera


In 1854, John Snow discovered the connection between contaminated water and cholera by plotting the course of a cholera outbreak in the Broad street area of London. He noticed that all the victims used the same water pump. When he removed the handle from the pump, the epidemic ended.

It was his scientific way of plotting the deaths on a map which helped him make this discovery.


Pasteur and germ theory


Pasteur was the first to suggest that germs cause disease.

Micro-organisms had been seen through 18th century microscopes, but scientists thought they were caused by disease and appeared because of illness. This was the theory of spontaneous generation. Instead of blaming the microbes, people looked for noxious gases called miasmas.

Louis Pasteur was employed in 1857 to find the explanation for the souring of sugar beet used in fermenting industrial alcohol. his answer was to blame germs in the air. Pasteur proved there were germs in the air by sterilising some water and keeping in a flask that didn’t allow airborne particles to enter. This stayed sterile – but sterilised water kept in an open flask bred micro-organisms again.


Robert Koch


A German scientist Robert Koch began the process of linking diseases to the microbe that caused them. Koch developed a solid medium to grow cultures and dying techniques to colour microbes, which he viewed through high-powered microscopes.

Hearing of Koch’s work, Pasteur came out of retirement in 1877 and started to compete in the race to find new microbes and combat them.

Pasteur looked for cures to anthrax and chicken cholera. Both he and Koch worked with large teams of scientist in the Franco-German competition for national prestige.

Pasteur’s theory was a huge turning point for medicine. His theory allowed others to build on his work and identify microbes and ways to combat them.


Florence Nightingale (1820-1910)


During the Industrial Revolution, the poorer classes often relied on informal midwives and ‘wise-women’.

The first signs of change came in nursing following the work of Florence Nightingale during the Crimean War. During her time there the death rate in Scutari fell from 43% to 2%. She believed disease was caused by miasma and emphasised cleanliness and fresh air. Her work was reported in British newspapers.



Mary Seacole also played an important part in improving nursing care during the war. However, probably because she was a black woman from Jamaica, she was not given much credit and was not allowed to work as a nurse in England after her return.

As a result of these developments nursing started to become a respectable medical profession. In 1859 Florence Nightingale’s book Notes on Nursing was published and a public fund was launched to raise money for a proper nursing school. The Nightingale School of Nursing was based at St.Thomas’ Hospital, London. Other training schools followed. By 1900 there were 64,000 trained nurses. Florence Nightingale also wrote over 200 books about hospital design and organisation.


Elizabeth Garrett Anderson (1836-1917)


Inspired by Elizabeth Blackwell, the first woman in the USA to qualify as a doctor. Repeatedly turned away by medical schools, she worked as a nurse while attending lectures for doctors, until she was forced to stop. Turned away by medical schools, which refused to accept a woman. Needed a certificate from one of the three medical organisations to become a doctor – in 1865 she was accepted by the Society of Apothecaries. Set up a medical practice in London. Still wanted a medical degree so she learned French and gained the qualification at Paris University. In 1876 an Act of Parliament allowed women to enter the medical profession. She was the first woman to qualify as a doctor in Britain.

Revision Task

Create an acrostic to help you remember the significance of the two women mentioned above.



  1. Read this example for Florence Nightingale:

Nightingale, first name Florence

Unimpressed by the way nurse were trained

Really wanted to do something about it

So she sent a report to the government

It got in the press, and people gave money for…

Nightingale’s School of Nursing –

Gave nursing a more professional and respectable feel

  1. Elizabeth Garrett Anderson, try using the word DOCTOR or maybe FEMALE DOCTOR if you come up with enough facts!

Practice Exam Question

12 Mark Question: How much did the role of women in medicine change between c1350 and c1900?

Model Answer for this question is in the Model answers document.

Home treatments and patent medicines


During the 19th century there was probably less use made of herbal remedies as people moved away from the countryside, but apothecaries sold many ‘preparations’, which they advertised as being a cure for practically everything. These took the form of potions, ointments and pills, made from things such as coloured liquids, alcohol, lard, wax, turpentine, ginger and arsenic. Pills were made by hand but this was revolutionised in 1844 when William Brockedon invented a machine to make standardised pills that were produced more quickly than being made by hand.

Thomas Beecham began selling his pills in 1847 and Jesse Boot, a herbalist, transformed his family shop into a chain of pharmacies in the late 19th century. By the end of the 19th century government regulations stopped many harmful ingredients being used in medicine. The growth of the chemical industry meant that companies such as Wellcome, Boots and Beecham could produce their brand off medicines on a national basis, advertising in newspapers and posters to increase sales. This type of business in called the pharmaceutical industry. There was still no cure for most diseases or illnesses.

Revision Task

Create a ‘hand of facts’ about the patent medicine industry. Draw around your hand and label the five fingers:



  • Who?

  • What?

  • When?

  • Where?

  • Why?

Use the information in this guide about patent medicines to help you write notes on each finger. For example under ‘When?’ you might write 19th C.

Practice Exam Question

6 Mark Question: Describe the key features of the patent medicine industry.

Exam Tip for this question: Use the information from your hand of facts to help you answer this question. Remember that you need to Describe the patent medicine industry: this is a chance for you to show off all your knowledge.

Model Answer for this question is in the Model answers document.

20th Century reasons for the increase in life expectancy


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