How did trench warfare affect injuries and treatment?
These teachers notes can be downloaded as part of our Teachers Pack PDF. (7.2 MB)
Both these collections of original sources Part 1 and Part 2 can be used to support GCSE thematic modules which cover ‘Medicine through Time to the present day’ and the ‘historical context of the British sector of the Western Front’. Teachers have the flexibility to download and create their own resources from these documents, to develop their pupils’ understanding of how to work with sources and prepare and practice for source based exam questions. Each collection includes a wide range of sources to encourage students to think broadly when exploring these topics.
With each collection we have suggested 5 tasks based on some of the documents. The tasks can be completed individually or in groups.There is a downloadable pdf of questions (0.02 MB) to help working with sources.All documents are provided with transcripts. We hope that exposure to original source material may also foster further document research. The following themes covered by the documents in Part 2 include:
- Treatments for ‘shell shock’, neurasthenia and gas attacks, government reports on ‘shell shock’ and ‘mustard gas’
- The trench system and its organisation and topography.
- Weapons, experience of being under fire, defensive mining, gas masks
- Daily life on the front: from mud to hair cuts
- The attack on Hill 60, south west of Ypres, April 1915
- The experience of ordinary men of their medical treatment and trench warfare gathered from some letters written by those who had worked for Great Western Railway before the war.
- The experience of some of the Women’s Army and Nursing Services on the Western Front
Working with these sources:
It is fundamental when using sources that students get to grips with what they are looking at! What type of source is this? What is being said? How is it being said? For example, if looking at an army medical card, a superficial view response might be that it contains, by its nature, only limited information or only provides answers to generic questions. Encourage students to “look behind the source”. The army records included here infer a huge amount of planning and record keeping and can suggest the scale of a particular problem. Some of information contained may be limited but this suggests that the purpose was to gather statistics for medical authorities/government. Other sources, such as medical case sheets, unit war diaries, reports and pension records can be highly detailed. It is possible to understand a huge amount about how patients were assessed, examined and treated, how their cases progressed and how their treatment continued after the war. Whilst the emphasis of the sources in Part 1 centres on injuries, treatment and medical services, these also provide invaluable information about the nature of trench warfare, its organisation and impact. Part 2 includes sources which focus more specifically on the nature of trench warfare, but also documents relating to the experience of women at the front and further sources covering injuries and treatments during wartime.
When working with the photographs in these collections, students should always consider why has the photograph been taken? Does it show some kind of development or system of organisation? Can you tell if the photograph is posed, or an official war photograph? Remember too, a photograph can be selective in choice of subject or could it have been cropped? Is there an original caption linked to the photograph? Captions can add meaning to a photograph and add a particular message. They are added after the photograph was taken, therefore we must not necessarily take them on face value. It is also useful to know that many soldiers used photography to record their experiences and some carried small Vest Pocket Kodak cameras which were banned after 1915, but many continued to carry them regardless and some such photographs have survived, although examples are not included here. Finally, other soldiers were employed as official photographers during the First World War as well as newspaper photographers.
The big question when working with sources is: how can the evidence provided within the source be considered useful for a particular enquiry question? Therefore, encourage students to consider both the witting and unwitting testimony a source may reveal. Part of this evaluation is to consider if there are any gaps in the evidence or issues of accuracy in authorship. Why would we trust/not trust this source? What other sources might be needed to provide additional information/context? Does the document support other knowledge that you have already for a certain line of enquiry?
Always pay attention to the origin of the source. Ask students to look at the document reference. Do they know what that means? The record series/government department can contribute a whole layer of meaning to the interpretation of a given source. What does the type of record tell you (see below) about the content of the source?
General source guidance questions:
The purpose of these questions is to help students to analyse, evaluate and understand documents in order to develop their own interpretations and conclusions. Teachers may wish to print these out from pdf download and discuss them with the students before they look at the sources.
- What is the date of the source?
- Who wrote/created it?
- Do you know anything about the author?
- What type of source is it? (Letter, report or newspaper, war diary, pension record, medical record, map, diagram, photograph.)
- What is the source saying/showing?
- Check the meaning of any words you are unsure about.
- How useful is this information, does it support what you know already?
- What can you infer (information which is not directly stated)
- What type of enquiry would be this record be useful for?
- Does the document show the writer’s opinions/values?
- Are there any clues about the intended audience for the document?
- Why was the document created?
- Does it have any limitations or gaps?
- Does it link to other sources in this group?
- Does it share the same ideas, attitudes and arguments?
- How would you explain any differences between these documents?
The records in this collection include other war diary extracts which evidence the nature of trench warfare. For example, some of the diaries here describe ‘defensive mining’ including the attack on Hill 60, south west of Ypres in April 1915, types of weapons used and equipment, including P.H. helmets and box respirators, and the first use of ‘liquid fire’ at Hooge. These sources give important context to the nature of the injuries and diseases experienced by those who fought on the Western Front. Again, some of the war diary extracts shown here give information about different types of trenches and their organisation and how trenches were supplied, wired, repaired and rebuilt. Two trench maps also help provide more information about trench system. Photographic evidence, including a ‘trench panorama’ available here, reveals the landscape and the conditions that soldiers were forced to experience as well as the environment that the medical services had to operate within when treating and caring for the sick and wounded.
There are also documents relating to other illnesses on the Western Front, including shellshock and a War Office report from a committee of ‘Enquiry into the Causation and Prevention of the condition’. Some medical case sheets in this collection refer to another condition, neurasthenia, which many ‘shell shock’ patients showed symptoms of as well. Probably over 250,000 men suffered from ‘shell shock’ as result of the First World War. The term was coined in 1915 by medical officer Charles Myers. At the time it was believed to result from a physical injury to the nervous system during a heavy bombardment or shell attack, later it became evident that men who had not been exposed directly to the front line were just as traumatised. This was a new illness that had never been seen before on this scale. In addition, there are sources relating to the nature of gas warfare including government reports on ‘mustard gas’ and sources on types of mask and how they worked. A chemical Warfare document described treatment of severe gas patient cases.
The experience of some of the Women’s Army and Nursing Services on the Western Front are included in this collection. These sources give an insight into their work and the difficult circumstances in which they worked. The Casualty Clearing Stations were managed by the Royal Army Medical Corps (RAMC) and staffed by the Queen Alexandra’s Imperial Military Nursing Service (QAIMNS), sometimes supported by nurses from the Territorial Forces Nursing Service (TFNS) and members of the Voluntary Aids Detachment (VAD) and the First Aid Nursing Yeomanry (FANY). This collection also includes a Foreign Office source statement on the execution of Edith Cavell.
Finally, a small selection, taken from a wider collection of digitised original letters (also available on the National Archives Education website) written by those who had worked for Great Western Railway before the war, provides a specific window into the experience of ordinary men of their injuries, medical treatment and trench warfare.
Web links related to nursing services
A useful website providing detail all nursing services and VADS https://www.scarletfinders.co.uk/
A nursing sister on the Western front: https://www.thehistorypress.co.uk/articles/a-nursing-sister-on-the-western-front/
A day in the life of a field nurse: https://www.thehistorypress.co.uk/articles/what-was-a-typical-day-like-for-first-world-war-field-nurses/
St John in the First World War – with a particularly good film telling the story of a fictional VAD nurse: https://museumstjohn.org.uk/research/projects/st-john-first-world-war/
Students could consider British Pathe film sources as interpretations of the First World War in relation to these documents on trenches, injuries and medical treatment: https://www.britishpathe.com/
Oral testimony online
Students can explore some of the oral testimonies and eyewitness accounts available from the Imperial War Museum Sound Collections alongside the written and photographic sources available in this collection: https://www.iwm.org.uk/collections/search?
First World War Digital Poetry Archive: https://www.oucs.ox.ac.uk/ww1lit/
Other useful links
The National Army Museum’s Birth of Plastic Surgery resource: https://www.nam.ac.uk/explore/birth-plastic-surgery/Back to top