What factors drove or held back change in medicine, and what were the turning points?
The factors that encouraged or inhibited change in medicine across the thematic study (individuals, institutions, science and technology, attitudes in government and society, war and chance) and the key turning points such as germ theory.
A focused answer to the factors of change at the heart of Edexcel's Medicine thematic study, explaining how individuals, institutions, science and technology, attitudes, war and chance each drove or held back medical progress, and identifying the major turning points such as germ theory.
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What this dot point is asking
This page is the analytical spine of the Medicine thematic study. Edexcel's 12 and 16-mark questions usually ask about the factors that drove or held back change (individuals, institutions, science and technology, attitudes, war and chance) and about turning points. You need to be able to argue how each factor worked across the whole period, both helping and hindering progress, and to reach a judgement. Master this and you can plan any thematic essay.
Individuals
Institutions
Institutions could preserve, support, spread or block progress. The Church preserved Galen's texts but held medicine back by forbidding challenges to him. Universities trained doctors. The Royal Society (1660) encouraged and published experiment. In the modern era, the NHS (1948) delivered treatment to all, and pharmaceutical companies and research bodies funded and produced new drugs.
Science and technology
Attitudes, war and chance
Attitudes in government and society had to change before progress could happen. While people accepted Galen as near sacred and government followed laissez faire, medicine stagnated; once people questioned authority and demanded government action, change accelerated. War spurred medicine, driving surgery and the chain of evacuation on the Western Front and the mass production of penicillin in the Second World War. Chance mattered too, most famously Fleming noticing mould had killed bacteria.
Turning points
Try this
Q1. Name the six factors of change Edexcel expects you to weigh. [Knowledge recall]
- Cue. Individuals; institutions; science and technology; attitudes in government and society; war; and chance.
Q2. Explain why germ theory is seen as the greatest turning point in medicine. [Short explanation]
- Cue. Before germ theory (1861) people only guessed at the cause of disease; after it they knew microbes caused disease, which made vaccination, antiseptics and public health rational and underpinned almost all later progress.
Exam-style practice questions
Practice questions written in the style of Pearson Edexcel exam questions on this dot point, with worked answer explainers. The year tag is the paper they imitate, not the source.
Edexcel 202216 marksHow far do you agree that science and technology was the main factor in the development of medicine in the period c1250 to present? Explain your answer.Show worked answer →
The Paper 1 thematic 16-mark essay (plus 4 SPaG), testing the factors across the whole period. Argue both sides and judge.
For (science and technology). Germ theory, the microscope, vaccination, antibiotics and scanning technology drove the biggest breakthroughs, especially from 1800, transforming understanding and treatment.
Against (other factors). Individuals (Pasteur, Lister, Fleming) made the discoveries, institutions (universities, the Royal Society, the NHS) supported and spread them, attitudes had to allow change, and war and chance often triggered progress.
Judgement. A strong answer argues science and technology was the leading factor since 1800, but worked through individuals, institutions and changing attitudes, and barely advanced when those held it back (the medieval period). Support with dates; write for the SPaG marks.
Edexcel 202112 marksExplain why the work of individuals was important in the development of medicine c1250 to present.Show worked answer →
The Paper 1 thematic "Explain why" question (12 marks). Reward at least three developed reasons across the period.
Reason one (breakthroughs). Individuals made the key discoveries, such as Pasteur's germ theory (1861) and Fleming's penicillin (1928), without which whole fields could not advance.
Reason two (challenging old ideas). Individuals like Vesalius and Harvey had the courage to test and disprove Galen, opening the way for others to question authority.
Reason three (limits). Individuals depended on the science, technology, institutions and attitudes of their time, so the same theme also shows that no individual worked alone, which a top answer notes.
Top band. Three developed reasons with named individuals and dates, ideally noting how individuals interacted with other factors.
Related dot points
- Medieval ideas about the cause of disease (the Four Humours, miasma, religion and astrology), approaches to prevention and treatment, who provided care, public health in towns and monasteries, and the response to the Black Death of 1348 to 1349.
A focused answer to the medieval period of Edexcel's Medicine in Britain thematic study, covering ideas about the cause of disease, the dominance of Galen and the Church, medieval prevention and treatment, who provided care, public health, and the response to the Black Death.
- Renaissance ideas about the cause of disease, the challenge to Galen by Vesalius and Harvey, the work of Sydenham, the impact of the printing press and the Royal Society, continuity in treatment, and the response to the Great Plague of 1665.
A focused answer to the Renaissance period of Edexcel's Medicine in Britain thematic study, covering how Vesalius and Harvey challenged Galen, the work of Sydenham, the role of the printing press and the Royal Society, the continuity in everyday treatment, and the response to the Great Plague of 1665.
- The breakthroughs of c1700 to 1900: Jenner and vaccination, Pasteur's germ theory and Koch's microbes, the development of anaesthetics by Simpson and antiseptics by Lister, Nightingale and nursing, and the move to government public health.
A focused answer to the c1700 to 1900 period of Edexcel's Medicine in Britain thematic study, covering Jenner's vaccination, Pasteur's germ theory, Koch's microbes, anaesthetics (Simpson) and antiseptics (Lister), Nightingale and nursing, and the shift from laissez faire to government public health.
- Modern advances in understanding the cause of disease (genetics and lifestyle), improvements in diagnosis, magic bullets and antibiotics including penicillin, the impact of science, technology and the NHS, and the case of lung cancer and smoking.
A focused answer to the modern period of Edexcel's Medicine in Britain thematic study, covering new understanding of the cause of disease (DNA and lifestyle), better diagnosis, magic bullets and the discovery and mass production of penicillin, the role of the NHS, science and technology, and the lung cancer case study.
- Planning and writing the 16-mark 'How far do you agree' essay across the Edexcel papers, building a balanced, well-supported argument and judgement, and earning the spelling, punctuation and grammar marks.
A focused answer to the Edexcel GCSE History 16-mark essay, explaining how to plan and write a balanced 'How far do you agree' answer with a clear argument and judgement, how to use evidence and stimulus points, and how to earn the SPaG marks.
Sources & how we know this
- Pearson Edexcel GCSE (9-1) History (1HI0) specification — Pearson Edexcel (2016)