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Monday 10 June 2013 Morning GCSE HISTORY A (SCHOOLS HISTORY PROJECT) A952/21 Historical Source Investigation Developments in British Medicine, 1200 1945 *A917770613* Candidates answer on the Answer Booklet. OCR supplied materials: 12 page Answer Booklet (OCR12) (sent with general stationery) Other materials required: None Duration: 1 hour 30 minutes * A 9 5 2 2 1 * INSTRUCTIONS TO CANDIDATES Write your name, centre number and candidate number in the spaces provided on the Answer Booklet. Please write clearly and in capital letters. Use black ink. Answer all the questions. Read each question carefully. Make sure you know what you have to do before starting your answer. Study the Background Information and the sources carefully. You should spend at least ten minutes doing this. Do not write in the bar codes. INFORMATION FOR CANDIDATES The number of marks is given in brackets [ ] at the end of each question or part question. The total number of marks for this paper is 53. This document consists of 10 pages. Any blank pages are indicated. You will be assessed on the quality of written communication in your answer to question 6. Questions marked with a pencil ( ) will carry 3 additional marks for spelling, punctuation and grammar. [T/501/5386] DC (SJF/SW) 66179/3 OCR is an exempt Charity Turn over

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3 Study the background information and the sources carefully. You should spend at least ten minutes doing this. In answering the questions, you will need to use your knowledge of the topic to interpret and evaluate the sources. When you are asked to evaluate specific sources you must do so, but you may also use any of the other sources if they are relevant. Answer ALL the questions. 1 Study Source A. What can you tell from this source about nineteenth century public health? Use the source to explain your answer. [6] 2 Study Source B. How useful is this source as evidence about public health in the nineteenth century? Use the source and your knowledge to explain your answer. [8] 3 Study Sources C and D. How similar are these two sources? Use the sources and your knowledge to explain your answer. [8] 4 Study Source E. Are you surprised by this source? Use the source and your knowledge to explain your answer. [9] 5 Study Source F. Why was this source published in 1858? Use the source and your knowledge to explain your answer. [9] 6 Study all the sources, A F. Conditions were so bad in English towns in the nineteenth century because people did not care about public health. How far do the sources in this paper support this view? Use the sources and your knowledge to explain your answer. Remember to identify the sources you use. [10] Spelling, punctuation and grammar [3]

4 Developments in British Medicine 1200 1945 Why was public health in towns so bad in the nineteenth century? Background Information During the nineteenth century many British towns grew rapidly in size. In 1800 there were only six towns in Britain with a population of more than 70 000. By 1900 there were 45 places with populations this size. By 1851, for the first time in British history, there were about as many people living in towns as in the countryside. This huge growth in population caused many new problems in the health and hygiene of the people who lived in the towns. The average age of death was very low and deaths among children were very high. In some cases, the health of the population was worse at this time than it had been in the Middle Ages. Reformers put forward many proposals to improve conditions, but their ideas were often resisted. Were conditions in towns in the nineteenth century so bad because people did not care about public health?

5 SOURCE A A drawing of barrels of tar being burnt in the streets of Exeter in 1832. Turn over

6 SOURCE B The east and north-east districts of Leeds are foul. Row upon row of little streets have been thrown up with no planning and little consideration for the health of the people who have to live there. There are no paving stones on the surface and not even an inch of sewer underneath. Deep trodden mud forms the only pavements. The toilets are falling to pieces and all are most horrible. Imagine streets and towns and yards which have not been cleaned for hundreds of years and you can imagine a town built in a slimy bog. These same streets and yards are drenched with the slops which each family flings out daily and nightly. In front of almost every door there is a little heap of domestic refuse. There is a Nuisance Committee in Leeds, so I inquired whether they were aware of these outrages. Yes, I was answered by a man much interested in the subject. Yes, I have reported these things over and over again, until I am sick and tired of reporting; but you see nothing has been done. A traveller s description of Leeds in 1848. SOURCE C After an examination of the evidence I conclude: First, that the various forms of epidemic disease amongst the labouring classes are caused by damp and filth, overcrowded dwellings and by impurities in the air which are produced by decaying animal and vegetable substances. It is also caused by the impurities given out by the bodies of the people who live there. The annual loss of life from filth and bad ventilation are greater than the loss from death or wounds in any war. Second, that the most important and practical measures are drainage, the removal of all refuse from the streets and the improvement of supplies of water. The expense of public drainage and supplies of water would save money by cutting the existing costs resulting from sickness and mortality. From Report on the Sanitary Conditions of the Labouring Population, by Edwin Chadwick, published in 1842. SOURCE D I found that nearly all the deaths had taken place within a short distance of the Broad Street water pump. There were only ten deaths in houses situated nearer to another pump. In five of these cases those who had died had always used the pump in Broad Street. There is a brewery in Broad Street. None of the brewer s men died. I called on Mr Huggins, the owner, and he informed me that there were about 70 workmen employed in the brewery. The men are allowed to drink beer, and Mr Huggins is quite certain that they do not drink water at all. People of every age and occupation, rich and poor, were being supplied with water containing the sewage of London. Some of this sewage was from cholera patients who died just before the great outbreak of 1854. From a report by John Snow called On the Mode of Communication of Cholera, published in 1854.

7 SOURCE E There is nothing a man hates so much as being cleaned against his will, or having his floors swept, his wall whitewashed, his pet dung heaps cleaned away. It is a fact that many have died from a good washing. We prefer to take our chance with cholera than to be bullied into action. The truth is, Mr Chadwick has very great powers, but it is not easy to see what they can be used for. From The Times newspaper, 1854. SOURCE F A cartoon about the River Thames called The Silent Highwayman. Your money or your life, published in 1858.

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10 Copyright Information OCR is committed to seeking permission to reproduce all third-party content that it uses in its assessment materials. OCR has attempted to identify and contact all copyright holders whose work is used in this paper. To avoid the issue of disclosure of answer-related information to candidates, all copyright acknowledgements are reproduced in the OCR Copyright Acknowledgements Booklet. This is produced for each series of examinations and is freely available to download from our public website (www.ocr.org.uk) after the live examination series. If OCR has unwittingly failed to correctly acknowledge or clear any third-party content in this assessment material, OCR will be happy to correct its mistake at the earliest possible opportunity. For queries or further information please contact the Copyright Team, First Floor, 9 Hills Road, Cambridge CB2 1GE. OCR is part of the Cambridge Assessment Group; Cambridge Assessment is the brand name of University of Cambridge Local Examinations Syndicate (UCLES), which is itself a department of the University of Cambridge.