Answer ALL questions. Write in full sentences for Questions 15, 16 and 17. You are advised to spend about 70 minutes on this pack.
1
Name the ancient Greek physician who is credited with first developing the idea that a person's health depended on a balance of four humours in the body.
(Total for Question 1 is 1 mark)
2
Name the physician of the Roman Empire whose medical writings, based on the Theory of the Four Humours, were still the basis of university medical training in England in the later Middle Ages.
(Total for Question 2 is 1 mark)
3
State the names of the four humours in Galen's theory of the causes of disease.
(Total for Question 3 is 4 marks)
4
Give the year in which the first and most severe outbreak of the Black Death reached England.
(Total for Question 4 is 1 mark)
5
Name the medieval theory that bad air, given off by rotting matter or dirty conditions, could cause disease.
(Total for Question 5 is 1 mark)
6
State one method used by medieval physicians to try to identify which humour was out of balance in a patient.
(Total for Question 6 is 2 marks)
7
Name two groups of people, other than university-trained physicians, who provided medical treatment in medieval Britain.
(Total for Question 7 is 2 marks)
8
Give one reason why the medieval Church was able to control medical education at English universities.
(Total for Question 8 is 2 marks)
9
State what a regimen sanitatis was, and give one example of the advice it might contain.
(Total for Question 9 is 2 marks)
10
Name the treatment that involved cutting a vein, or applying leeches, to remove blood from a patient believed to have too much of that humour.
(Total for Question 10 is 1 mark)
11
Give one supernatural or religious explanation that people in medieval Britain gave for the cause of the Black Death.
(Total for Question 11 is 2 marks)
12
Name the three planets whose alignment in 1345 physicians at the time blamed for causing the Black Death.
(Total for Question 12 is 2 marks)
13
Explain two ways in which the medical training of a university-educated physician and the practice of an unlicensed healer, such as a village wise woman, were similar in medieval Britain.
(Total for Question 13 is 4 marks)
14
Describe two treatments, other than bloodletting, that were used to try to cure illness in medieval Britain.
(Total for Question 14 is 4 marks)
15
Explain why the Catholic Church had such a significant influence over medicine in medieval Britain.
(Total for Question 15 is 8 marks)
16
Explain why the Black Death (1348-49) was so difficult for people in medieval Britain to treat effectively.
(Total for Question 16 is 8 marks)
17
'Religious belief was the main reason why people in medieval Britain struggled to explain the causes of disease.' How far do you agree with this statement? Explain your answer.
(Total for Question 17 is 16 marks)
Mark scheme · EDX.MED.1 Medicine in Britain, c1250-c1500: Ideas About the Cause and Treatment of Disease
Question 1
B1 Hippocrates
Answer: Hippocrates
Question 2
B1 Galen
Answer: Galen
Question 3
B1 blood
B1 phlegm
B1 black bile
B1 yellow bile
Answer: Blood, phlegm, black bile and yellow bile.
Question 4
B1 1348 (accept 1348-49)
Answer: 1348
Question 5
B1 miasma (theory)
Answer: Miasma theory
Question 6
B1 examining a sample of the patient's urine (uroscopy)
B1 checking its colour, smell and sometimes taste, often comparing it against a printed urine chart
Answer: Uroscopy: examining the colour, smell and taste of a patient's urine, often using a printed urine chart.
Question 7
B1 apothecaries, who prepared and sold herbal remedies
B1 any other valid group, e.g. wise women/folk healers (unlicensed, using traditional herbal remedies), or barber-surgeons (who carried out bloodletting and minor surgery)
Answer: Any two of: apothecaries, wise women/folk healers, barber-surgeons.
Question 8
B1 the Church founded and ran the universities, such as Oxford
B1 so it controlled which texts could be studied and taught, approving only those consistent with Christian teaching
Answer: The Church founded and ran the universities, so it controlled the curriculum and approved texts.
Question 9
B1 a set of guidelines on diet and daily lifestyle, believed to help keep the humours balanced and prevent illness
B1 an example of advice, e.g. what to eat and drink, how much exercise or sleep to take, or when to bathe
Answer: Guidance on diet and lifestyle to keep the humours balanced, e.g. advice on food, exercise and sleep.
Question 10
B1 bloodletting (venesection)
Answer: Bloodletting
Question 11
B1 the belief that it was sent by God as a punishment for humanity's sins
B1 supporting detail, e.g. this belief led some people to join flagellant processions or go on pilgrimage seeking forgiveness
Answer: God's punishment for sin, leading some to seek forgiveness through prayer, pilgrimage or flagellant processions.
Question 12
B1 Saturn
B1 Jupiter or Mars (accept either)
Answer: Saturn, Jupiter and Mars.
Question 13
B2 both aimed to restore a healthy balance of the four humours in the patient, e.g. through remedies intended to add or remove heat, moisture, blood or bile
B2 both drew on a shared stock of herbal remedies, sometimes based on the Doctrine of Signatures (the idea that a plant's appearance showed which ailment it could treat), to prepare medicines
Answer: Both aimed to rebalance the humours, and both used herbal remedies, some based on the Doctrine of Signatures.
Question 14
B2 purging: using herbal laxatives or emetics to remove 'excess' bile or phlegm from the body and restore humoural balance
B2 prayer and pilgrimage: visiting the shrine of a saint associated with a particular illness, or praying for God's forgiveness and healing, sometimes alongside physical remedies
Answer: Purging (herbal laxatives/emetics) and prayer or pilgrimage to a saint's shrine (any two valid treatments).
Question 15
Level 1 (1-2): Identifies one or two general reasons for the Church's influence over medicine, with little or no supporting detail or explanation.
Level 2 (3-4): Identifies and begins to explain one reason for the Church's influence, supported by accurate detail.
Level 3 (5-6): Explains two reasons for the Church's influence over medicine, each supported by accurate and relevant detail.
Level 4 (7-8): Explains two or more reasons for the Church's influence over medicine in a well-developed, logically structured way, supported throughout by precise and accurate detail, showing how the reasons connect.
Indicative content:
The Church ran the universities where physicians trained and controlled the medical curriculum, which was based on the ancient texts of Hippocrates and Galen.
Dissection of human bodies was rare and restricted, partly for religious reasons, which limited physicians' opportunities to challenge or correct Galen's ideas.
The Church taught that illness could be sent by God as a punishment for sin, so prayer, confession and pilgrimage were widely accepted as valid treatments alongside physical remedies.
Monasteries and the Church ran most hospitals, which focused on care, rest and prayer for the sick rather than on medical cure.
Because the Church controlled education and was the main source of authority in society, its approval was needed for new ideas to be accepted, which discouraged physicians from questioning ancient authorities such as Galen.
Question 16
Level 1 (1-2): Identifies one or two general reasons why the Black Death was difficult to treat, with little or no supporting detail or explanation.
Level 2 (3-4): Identifies and begins to explain one reason, supported by accurate detail.
Level 3 (5-6): Explains two reasons why the Black Death was difficult to treat, each supported by accurate and relevant detail.
Level 4 (7-8): Explains two or more reasons in a well-developed, logically structured way, supported throughout by precise and accurate detail, showing how the reasons connect.
Indicative content:
Contemporaries did not understand the true cause of the Black Death (bubonic and pneumonic plague, spread mainly by fleas carried by black rats, and person-to-person in its pneumonic form), so treatments were based on incorrect theories such as miasma and the imbalance of the humours.
Some people believed the Black Death was a punishment sent by God for humanity's sins, so treatments such as prayer, penance and the actions of flagellant groups were used instead of, or alongside, medical remedies.
Physicians also blamed a harmful alignment of the planets Saturn, Jupiter and Mars said to have occurred in 1345, and astrological treatments could not affect the real cause of the disease.
There was no effective national system of prevention or quarantine in medieval England, and the movement of trade and travellers along roads and rivers allowed the disease to spread rapidly between towns.
Because medical knowledge was based on ancient authorities such as Galen rather than on new observation, physicians had no accurate understanding of contagion and so could not develop treatments that addressed the real cause of the disease.
Question 17
Level 1 (1-4): Shows limited relevant knowledge of ideas about the causes of disease in medieval Britain, and offers only a simple, unsupported opinion on the statement.
Level 2 (5-8): Shows some relevant knowledge and identifies relevant factors, but the argument is only partly supported and lacks a developed judgement on how far the statement is accurate.
Level 3 (9-12): Shows good relevant knowledge and explains a range of factors, reaching a supported judgement on how far the statement is accurate, with some links made between factors.
Level 4 (13-16): Shows precise, well-selected knowledge and explains a range of factors in a balanced way, reaching a fully supported and sustained judgement on how far the statement is accurate, with clear analytical links between factors and consistently accurate use of specialist historical terminology.
Indicative content:
Supporting the statement: religious belief was deeply embedded in medieval society and shaped how disease was understood, e.g. the idea that God sent illness as a punishment for sin, or that the Black Death was God's wrath, led people to prioritise spiritual explanations and remedies such as prayer and pilgrimage.
Supporting the statement: because the Church controlled education and approved what could be taught, religious explanations for disease were rarely challenged, reinforcing their dominance.
Against the statement: the Theory of the Four Humours, based on the ancient writers Hippocrates and Galen, was the main scientific/medical explanation taught to physicians and shaped most professional treatment, largely independent of religion.
Against the statement: miasma theory (the belief that bad air caused disease) was also a widely held and largely separate explanation that influenced everyday behaviour, such as carrying sweet-smelling herbs.
Against the statement: astrology was taken seriously by trained physicians, who used charts linking the causes and treatment of disease to the positions of the stars and planets, showing that non-religious ideas also shaped explanations.
A balanced answer might argue that these explanations overlapped and reinforced each other rather than competing (astrology and the humours were both taught within a Christian intellectual framework), so isolating religion as 'the main reason' oversimplifies a combination of interlinked medieval beliefs.