SECTION A - Revision• Section A = Sources Section• It is compulsory – you have to do it and

you won’t get a choice• There will be 3 sources and 4 questions• You will have to use the sources to

answer the questions• For YOUR exam, the topic will be

‘Surgery and Anatomy’ – the sources and questions will all be about developments in surgery and anatomy through time

How much is this section worth?

• 26 marks in total (15% of your GCSE grade)

• You should spend 52 minutes on this section

Mark allocation = a) 4 marks (8mins) b) 6 marks (12mins) c) 8 marks (16mins) d) 8 marks (16mins)

What questions might they ask?

• The could ask you to – - describe and explain reasons why

understanding of anatomy changed over time (progress, regress or continuity)

- describe and explain reasons why surgical techniques changed over time

• Talk about surgery and anatomy in a specific time period

• Compare the work of 2 key individuals in terms of their contribution to the understanding of surgery and anatomy

• Explain the importance of factors in the development of surgery through time

Question a – What does source A suggest about understanding of anatomy during the Roman Period? Explain your answer using

Source A and your knowledge. (4 marks)

Level 1: Answers that select details from the source or show some knowledge of understanding of anatomy in Roman times

e.g. the Romans didn’t know much about the inside of the human body 1 mark

Level 2: Answers that draw an informed inference based on the source and/or own knowledge

e.g. the Romans had some understanding about human anatomy but it was limited 2-3 marks

Level 3: Answers that develop a complex, informed inference based on the source and/or own knowledge

e.g. the Romans had limited knowledge and understanding about human anatomy. They knew about some internal organs and where they were but they did not base understanding or knowledge on real life dissections 4 marks

Look at your answer. Have you made any of these clangers?!

- No reference to the source! Some people just discussed the bigger picture or talked about the time period. e.g. ‘Knowledge of anatomy was bad at the time as dissection was not allowed’. Where have you used the source?

- No bigger picture e.g. ‘the source shows that they knew where the main organs and bones were but made some basic mistakes.’

- You have said ‘I can infer that………..’ but not actually made an inference. You have said simple what the source shows you , not what it infers about knowledge of anatomy in this time period.

KEY INGREDIENTS FOR QUESTION a

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INFERENCEBIGGER PICTURE

A GRADE

Source A suggests that understanding of anatomy was limited. It suggests that the Romans knew a little bit about the inside of

the human body and internal organs, but their knowledge wasn’t very detailed. For example, it shows veins and arteries so they knew about them, but there are no capillaries. They would not have known about capillaries because they are too

small to see without microscopes and the Romans did not have this equipment. The source also has mistakes, for

example the liver is on there, but it is not the right shape or size. This shows that some of their knowledge was inaccurate and it is likely because Galen based his work on dissections of animals as human dissection was not allowed at this time and so some of his work was incorrect because animal anatomy is

not the same as humans

CAN YOU SEE THETHREE INGREDIENTS HERE?

1a) What does source A suggest about techniques in surgery during the Middle

Ages

A Medieval surgeon and his assistant operate to remove a boil from the skin on their patient

Have a go...• Target: You use knowledge and

understanding to make an inference about the source

• Level 1 = Select detail from the source or write about the time period (1 mark)

• Level 2 = Say what the source means using your own knowledge or the source (simple inference) (2-3 marks)

• Level 3 = Say what the source means and put it into context using own knowledge (complex inference) (4marks)

Model Answer Source A suggests that surgery in the Middle Ages

had many problems. The patient is awake and so the operation would have been painful. At this time there was only limited anaesthetics like alcohol which would reduce pain, but not take it away completely. Similarly, the operation is not sterile and so infection was probably a problem. Neither of the people doing the operation are wearing special clothing so there could be germs. The picture shows they had specialist equipment like knives for surgery, but from my own knowledge I know they didnt have protective clothes as they didn’t know about germs in the Middle Ages

(b) What different surgical techniques are suggested by Source B?

Explain your answer using Sources A and B and your knowledge (6 marks)

Level 1: Answers that select details from source Be.g. Source B shows detailed parts of the inside of the human body 1-2 marks

Level 2: Answers that provide a simple comparison based on the details of both sources

e.g. the understanding in Source A is very basic but in Source B it is more detailed.

ORAnswers that may use both sources but provide an informed inference

from onee.g. the understanding in Source B is very detailed and drawn from real life

dissections but in A they don’t really know about the human body 3-4 marks

Level 3: Answers that develop an understanding or draw informed inferences about attitudes based on the details of both sources

e.g. in Source A the understanding is very limited and based on guess work because at this time they were not really allowed to do human dissections and based their knowledge of anatomy on Galen but in Source B during the Renaissance they started to challenge the ideas of Galen and it was less risky to do dissections because the Church was less powerful 5-6 marks

• Only talked about source B? Many of you didn’t refer specifically to source A! - OUCH!

• Said ‘source A says…’ ‘where as source B says…’?? - NO BIGGER PICTURE.

• Said ‘ Source A tells us that knowledge of anatomy was poor but source B suggests that by the renaissance it had improved.’ NO DETAIL FROM THE SOURCE + A VERY BASIC INFERENCE

Look at your answer. Have you made any of these clangers?!

KEY INGREDIENTS FOR QUESTION b. COMPARE THESE

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INFERENCEBIGGER PICTURE

A GRADE

Source A was badly drawn and contained limited detail, mainly due to the banning of dissection in Roman times. It shows that the Roman’s

understanding of anatomy was fairly poor and inaccurate as the organs are incorrect and not detailed.

Source B however, which appeared in one of Vesalius’s books, ‘The fabric of the human body’ is a well drawn, detailed diagram. It shows that knowledge

of internal organs was far better in the Renaissance. Source B shows a better understanding because during the Renaissance anatomists like

Vesalius paid skilled artists to draw from life, not guess work as bodies were dissected. In source B the source clearly shows the organs in the correct place and drawn accurately, whereas in Source A the organs almost seem to be stuck on and not connected together in any real way so it suggests that they didn’t know about how the body worked as a whole, whereas in

Source B the body is a more complete system.

CAN YOU SEE THETHREE INGREDIENTS HERE?

What different surgical techniques are suggested by Source B?

Explain your answer using Sources A and B and your knowledge

Joesph Lister at work operating on his patient in 1877 using carbolic acid spray

Have a go...• Target: You use your own knowledge and

understanding to make an inference from two sources

• Level 1 = Answer that just refers to Source B (1-2 marks)

• Level 2 = Answer that shows simple understanding of both sources OR Answer refers to both sources but only makes an inference from one (3-4 marks)

• Level 3 = Answer that shows a developed understanding of both sources and puts them into context to explain the differences (5-6 marks)

Source B suggests that some of the problems in surgery that can be seen in Source A have been dealt with. For example, Source B shows Lister using carbolic acid as an antiseptic to kill germs. In source A, infection would still have been a problem. The carbolic acid spray also shows they had more developed equipment in the Industrial Revolution. The patient in source B is asleep, which shows that the problem of pain had been dealt with. From my own knowledge, I know that Simpson’s discovery of chloroform in 1847 provided an anaesthetic to over come pain, but in Source A there was no effective anaesthetic as it was just basic alcohol and the patient is clearly awake.

Level 1: Answers that select details from sourcesORAnswers that say how the sources are differente.g. they are different because A is not very accurate and Source B is a more

detailed.The answer demonstrates simple understanding of the rules of spelling,

punctuation and grammar. It is generally coherent but basic in development 1-2 marks

Level 2: Answers showing simple reasoning about different attitudes based on changes over time, place or author

e.g. Source A was made during the Roman times when there wasn’t much dissection because it wasn’t really allowed. Source A is made by Galen who based his work on animal dissection. Source B was written In the Renaissance when the Church was less powerful and so they did dissections of human bodies.

(c) Why was there different understanding of anatomy at these times?

Explain your answer using Sources A and B and your knowledge 8 marks

Level 3: Answers showing developed reasoning about different attitudes based on changes over time, place or author

e.g. Galen based his work on animal dissection and his work as a Gladiator doctor and then assumed that human anatomy was the

same. Vesalius however was also an anatomist but based his work on real life dissections of human bodies which he stole from the

gallows when criminals had been excuted. During the Renaissance after the Reformation the Church was less

powerful so people like Vesalius did dissections of humans without being quite so terrified that the Church would execute them. Ideas had changed in the Renaissance – people wanted answers about the world so were willing to challenge old ideas like Galens where

as before that, the Church said Galen was right and no one wanted to challenge him

Vesalius was probably even more arrogant than Galen and wanted his book to be the best ever so strictly checked the artists drawings to make sure they were really accurate, where as Galen did not place

as much importance on accuracy.The answer demonstrates developed understanding of the rules of

spelling, punctuation and grammar. It is well organised with an appropriate form and style of writing. Some specialist vocabulary is

used 6-8 marks

Did you talk about factors

rather than provenance?

Look at your answer. Have you made the biggest clanger of SECTION A?!

• Many answers had paragraphs on key factors explaining the difference in time period but this is not the only thing the examiner wants to know!!

• Some of you didn’t refer directly to the sources• Some of your comparisons were basic. Did you

say, ‘the sources are different as they are made by different people’ and then tell me a bit about the background of Galen and Vesalius? This isn’t enough- you need to explain how their learning led to them producing different images.

There are many different reasons why the understanding of anatomy was different in these two sources.

One of these reasons is due to the people who drew and published the two drawings. In the Roman times, Galen was an anatomist who discovered more about anatomy. The only

problem was that dissection wasn’t really allowed so he based his work on dissections of animals like apes and dogs instead of humans. This made his discoveries wrong because although similar in many ways, human anatomy is not the same as animals. This suggests that the picture by Galen in Source A is mainly guesswork and assumptions based on what

he knew about animals. Similarly, it might mean that he observed a living body and identified veins from there as clearly there are not enough in his diagram.

Vesalius on the other hand took dead bodies of criminals from the gallows in order to dissect them and learn more about actual human anatomy. By dissecting actual human bodies he could accurately describe and produce drawings of the human body. Source B is therefore

drawn from life, not guesswork like Galen.Another reason is the audience both sources were aiming their work at. In source B Vesalius

was writing a book specifically to inform other anatomists that Galen’s work was wrong. When Vesalius was doing this work many others were also challenging old ideas so he

wanted to be the best and make a name for himself. He encouraged others to also dissect human bodies, whereas Galen was very arrogant and believed he was right – he called

himself the greatest anatomist who ever lived and he worked alone.Finally, the date when the sources were written is really important. Source B was drawn during

the Renaissance when human dissection was more acceptable, (although not totally ok – Vesalius still worked in secret a lot of the time). This was a time of new ideas and new answers to old questions, where as Galen was working at a time when dissection really wasn’t allowed. The different attitudes to dissection at the different times of the sources

being written are really crucial in explaining why the levels of understanding had changed. Galen had never seen the inside of a human body, whereas Vesalius made a point of

drawing from real life.

KEY INGREDIENTS FOR QUESTION c. COMPARE THESE

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AUTHOR/MOTIVE

DIFFERENCE IN TIME PERIOD

(FACTORS)

OTHER ISSUES

-TYPE OF SOURCE

-WHERE ARE THEY TALKING ABOUT?

A GRADE

There are many different reasons why the understanding of anatomy was different in these two sources.

One of these reasons is due to the people who drew and published the two drawings. In the Roman times, Galen was an anatomist who discovered more about anatomy. The only problem was that

dissection wasn’t really allowed so he based his work on dissections of animals like apes and dogs instead of humans. This made his discoveries wrong because although similar in many ways, human anatomy is not the same as animals. This suggests that the picture by Galen in

Source A is mainly guesswork and assumptions based on what he knew about animals. Similarly, it might mean that he observed a living body and identified veins from there as clearly

there are not enough in his diagram.Vesalius on the other hand took dead bodies of criminals from the gallows in order to dissect them

and learn more about actual human anatomy. By dissecting actual human bodies he could accurately describe and produce drawings of the human body. Source B is therefore drawn from

life, not guesswork like Galen.Another reason is the audience both sources were aiming their work at. In source B Vesalius was

writing a book specifically to inform other anatomists that Galen’s work was wrong. When Vesalius was doing this work many others were also challenging old ideas so he wanted to be the best and make a name for himself. He encouraged others to also dissect human bodies, whereas Galen was very arrogant and believed he was right – he called himself the greatest

anatomist who ever lived and he worked alone.Finally, the date when the sources were written is really important. Source B was drawn during the

Renaissance when human dissection was more acceptable, (although not totally ok – Vesalius still worked in secret a lot of the time). This was a time of new ideas and new answers to old questions, where as Galen was working at a time when dissection really wasn’t allowed. The

different attitudes to dissection at the different times of the sources being written are really crucial in explaining why the levels of understanding had changed. Galen had never seen the inside of a

human body, whereas Vesalius made a point of drawing from real life.

CAN YOU SEE THETHREE INGREADIANTS HERE?

Why were there different surgical techniques at these times?

Explain your answer using Sources A and B and your knowledge 8 marks

• A Medieval surgeon and his assistant operate to remove a boil from the skin on their patient

• Joesph Lister at work operating on his patient in 1877 using carbolic acid spray

• Who has produced the source• Audience• Dates – What has happened between the sources?

What was happening when the sources were written?

Have a go...• Target: Explain and understand different ideas

and attitudes and how they change over time• Level 1 = Answer that selects detail from the

source OR Answer that says how the sources are different, but doesn’t explain why (1-2 marks)

• Level 2 = Answer shows simple reasons about different attitudes based on changes over time, place or author (3-5 marks)

• Level 3 = Answer shows developed reasoning about different attitudes based on changes over time, place or author (6-8 marks)

• One of the key reasons why there was different surgical techniques at these times is developments in science and technology. During the Middle Ages, pain was a problem as source A shows because anaesthetics were limited and simple like alcohol, but by the time of Source B, Simpson had developed chloroform, (in 1847) so patients could be put to sleep reducing pain. It also meant surgeons could take their time and do deeper operations. Also, infection had been overcome because Pasteur had discovered germ theory in 1865 and Simpson used this to create an antiseptic – carbolic acid, to kill germs.

• Another reason for the differences is that by the Industrial Revolution in Source B surgeons now had better knowledge of disease and so made antiseptics. In the Middle Ages they didn’t know about germs, so surgeons didn’t bother to be clean and hygienic

(d) Study Source C.Understanding of Anatomy has improved at different times for

different reasons.Why was this?

Explain your answer using Sources A, B and C and your knowledge 8 marks

Level 1: Answers that provide general statements, describe single factors or factual details about anatomye.g. the Church meant that people weren’t allowed to do dissection so they didn’t know much about what was inside but when the Church became less powerful they started doing dissections. 1-2

Level 2: Answers that comment briefly on several factors, to do with improvement in understanding of anatomye.g. the power of the Church declined so people challenged Church ideas and started doing dissections and challenging GalenSometimes key people like Vesalius or Harvey helped to improve knowledgeBetter technology means we can see inside the body without cutting it open. 3-4

Level 3: Answers that recognise and explain several factors to do with improvement in understanding of anatomy in specific detaile.g. there were many powerful reasons why understanding of anatomy improved. The decline of religion meant that it was safer to challenge old ideas and once people like Vesalius and Harvey proved Galen was wrong it became more acceptable to challenge the old ideas that were wrongKey people in the Renaissance worked exceptionally hard and at great personal risk to make vital discoveries that changed the way people thought about the human body and made them challenge old work. They paved the way for others to also investigateNew technology has made it easier to investigate the human body while they are alive – eg. CT scanners and ultrasound. This means we can find out more about how the body worksBetter communication means that ideas can be shared quickly and in detail. Eg. The printing press in 1485 meant that pages from detailed books on anatomy by Vesalius and Harvey could be reprinted very quickly and easily. 5 – 6 marks

Level 4: Answers that develop out of level 3 and evaluate the relative importance of individual factors or come to a summary assessment about the factors involved or provide details of the links between factorse.g. religion was a really important factor in lots of time periods because it had a really big impact on what people were allowed to do with a human body, in Egyptian times it helped develop understanding of anatomy, but in the Middle Ages it stopped new ideas and investigation as dissection was banned by the Pope in 1306 and they supported GalenKey individuals (Source B) were really important but wouldn’t have been able to do their work without the change in attitudes to religion and if they have had new technology they wouldn’t have been able to communicate their ideas eg. The printing press in 1485 or the very sophisticated technology that helps us now (Source C). 7-8

RECEIPE (PLAN) FOR SUCCESSSTEP ONE – LIST THE FACTORS THAT ARE

IMPORTANTSTEP TWO – CONSIDER WHICH ONES LINK TO

THE SOURCES – JOT THEM ON YOUR PLANSTEP THREE – SELECT THREE/FOUR OF THE

FACTORS THAT ARE MOST IMPORTANT AND LINK TO SOURCES

STEP FOUR – THINK ABOUT YOUR CONCLUSION – WHICH FACTOR IS MOST IMPORTANT? HOW DOES IT LINK TO OTHER FACTORS. CAN YOU MENTION THIS IN THE BODY OF YOUR ESSAY?

Following these steps will lead to this

NOT This!

Understanding of anatomy improved at different times, mainly due to the different factors.For example, during Roman times religion was a limiting factor. The Church banned dissection which

resulted in drawings like Source A, which showed limited detail because it was done based on guesswork. When this ban was lifted, understanding vastly improved.

Another factor which helped understanding to improve was individual brilliance. Source B shows not only huge detail, but also methodical hard work. People like Vesalius used their own skills and individual brilliance to increase the knowledge of others and write books like the Fabric of the Human Body in 1543 and the Tabulae sex in 1538. This meant that others could learn about

anatomy and corrected many of Galen’s mistakes. Similarly, other individuals such as Harvey worked very hard to prove the function of the heart and the circulation of the blood in 1616.

Communication helped to improve as methods of communication developed and meant ideas could be shared quicker and in more detail. For example, during the Renaissance the printing press was developed in 1485 which helped knowledge of anatomy progress because drawings like

Vesalius’s could be created and then reproduced much more quickly and easily and books made and shared. Vesalius checked every original page copied on the printing press so that he knew

the drawings in his book were really accurate – this can be seen in Source B which is an example of this.

A final example of the way that factors led to improvements in understanding of anatomy at different times is Science and Technology. Source C shows and ultrasound scan, which is now used to

view the inside of the human body whilst a person is alive and can show bone structure, tumours and unborn babies. It has meant that we now know about the different stages a foetus goes

through before birth and allows greater understanding of movement and muscle structure. This improved technology has led to huge developments in knowledge and understanding of anatomy.

In conclusion, understanding of anatomy has improved at different times for different reasons, mainly due to the different factors and their level of influence at the time. In my opinion, the most important factor was individual brilliance because Vesalius and Harvey pioneered the way

forward for others by dissecting the human body and proving Galen wrong. If they had not done this, then others may not have made further progress. However, technology and better

communication helped Vesalius and Harvey so are also important, and equally, if it had not been for the Reformation and decline of religion in the 1500s, then these men may have still been too

afraid to do human dissections.

CAN YOU SEE THETHE RECIPE HERE?

Study Source C• Have the developments in surgery always led to

progress?• Explain your answer using Sources A, B and C and your

knowledge 8 marks• Level 1 = Answer provides general statements, describes

single factors or gives factual details about improvement (1-2 marks)

• Level 2 = Answer comments briefly on several reasons for improvement (3-4 marks)

• Level 3 = Answer recognises and explains several factors for improvement in specific detail from sources and own knowledge(5-6 marks)

• Level 4 = Answer does the same as level 3 but has a conclusion and links factors for improvement (7-8 marks)

• FINALLY• ALTHOUGH THIS IS A SOURCE

SECTION YOU HAVE TO BE ABLE TO APPLY DETAIL (OTHERWISE ITS LIKE AN APPLE

CRUMBLE WITHOUT THE APPLE). • LEARN KEY FACTS/DATES/PEOPLE

AND HAVE THEM AT THE FRONT OF YOUR MIND SO THAT YOU CAN APPLY THEM TO THE SOURCES!