🏥 Life on the ward
McIndoe let patients wear their uniforms and treated them as men getting better, not as invalids. Ward 3 was lively and relaxed.
Advances in Medicine, Surgery and Public Health, 1920-48: The NHS » Surgery, Blood and Women in the Second World War
What you'll learn this session
Study time: 30 minutes
Edexcel spec: Paper 2 Section B, Breadth study B2, Key topic 5
- How Archibald McIndoe and the Guinea Pig Club moved skin grafts forward
- How blood banks and the wartime transfusion service saved lives
- How the Second World War changed the role of women in medicine
- How to answer an 8-mark "Explain TWO causes" question
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Unlock This CourseThe Second World War and medicine
The Second World War (1939-45) brought huge numbers of wounded soldiers, sailors and airmen. For the first time in Britain it also brought large numbers of civilians injured by bombing from the air. As in the First World War, the pressure of war pushed doctors to try new methods and to organise medicine on a much bigger scale. This lesson looks at three areas: surgery, blood transfusion and women in medicine.
Surgery: McIndoe and the Guinea Pig Club
Many of the worst injuries came from the air war. When an aircraft caught fire, the crew could be burned badly on the face and hands. These men needed plastic surgery: operations to rebuild damaged skin and features.
Key terms:
- Guinea Pig Club: a club for the patients of Archibald McIndoe, named after the experimental surgery they had.
The key figure was Archibald McIndoe, a surgeon from New Zealand. He was a cousin of Harold Gillies, the pioneer of plastic surgery in the First World War. In the Second World War McIndoe led a specialist burns unit at the Queen Victoria Hospital in East Grinstead, Sussex. He treated badly burned airmen, many of them from the Battle of Britain in 1940. He used and improved skin graft methods, including the "walking stalk", where a tube of skin stays attached to the body while it grows into its new position. Because the operations were new and often experimental, patients had many of them, sometimes over months or years.
McIndoe also cared about the whole person, not just the wound:
🏠 The town
Local families were encouraged to welcome the airmen. East Grinstead became known as "the town that didn't stare", which helped patients to face the world again.
In 1941 the patients formed the Guinea Pig Club. It began informally with 39 members and had 649 by the end of the war. It gave the men support, friendship and a voice, and the name made a joke of the fact that they were the first to try new operations.
Change and continuity
Change: plastic surgery was now a recognised branch of surgery with its own specialist units, and rehabilitation became part of treatment. Continuity: the skin graft methods built on those developed by Gillies in the First World War, and war was again the spur.
Blood transfusion: banks and a national service
By 1939, transfusion was possible. Blood groups had been discovered in 1901, and sodium citrate stopped blood clotting so that it could be stored for a short time. What was missing was a system to collect, store and deliver blood to wherever it was needed. In the Second World War Britain built that system.
Key terms:
- Blood bank: a place where donated blood is collected, tested, stored and sent out for use.
- Plasma: the liquid part of blood. It can be stored for longer than whole blood and does not have to be matched to a blood group.
🏥 The army
The Army Blood Transfusion Service was set up in 1938. Its main depot opened at Bristol in 1939 under Lionel Whitby, supplying blood to the forces.
🏙 The civilians
Planners such as Dr Janet Vaughan helped create the Emergency Blood Transfusion Service in 1939, with depots around London (Slough, Luton, Maidstone and Sutton) run for the Medical Research Council.
💉 The donors
The service relied on volunteers who gave blood. Collecting teams went out to find donors, so the supply grew as the war went on.
The fear driving this was the bomber. Planners expected huge numbers of civilian casualties in the cities, and bombing did come in the Blitz of 1940-41. In the USA, Dr Charles Drew worked on separating plasma from the blood cells and storing it. In 1940 he led the "Blood for Britain" project, which sent plasma across the Atlantic. The Army service was in place before war began, so blood was ready for the forces from the start.
Change and continuity
Change: in the First World War, blood depots were small and near the front line. Now the whole country had a planned system of banks, depots and volunteer donors. Continuity: the science (blood groups and sodium citrate) was older, and war was once again the spur.
The role of women in medicine
Women had already proved themselves in the First World War, but afterwards many doors closed again. The Second World War opened them wider.
- Nursing and support: nurses were nearly all women, and many more were needed. From December 1941 unmarried women aged 20 to 30 could be called up for war work, and some went into nursing and medical services.
- Women doctors: there was a shortage of doctors, because so many men were serving in the forces. By 1940 women doctors in the forces received the same pay and allowances as men.
- Leaders: women also led. Janet Vaughan, a pathologist, helped plan the blood transfusion service.
- Training: in 1944 the Goodenough Committee on medical schools recommended wider admission of women, and all London medical schools had to admit women from 1947, because their funding depended on admitting a reasonable proportion of women.
Change and continuity
Change: women's work was now accepted as essential, and equal pay in the forces and the 1947 rule for London medical schools were real steps forward. Continuity: war once more created the chance, and after the war many women still found it hard to progress in medicine, so change was slow.
Common mistakes
- Saying McIndoe invented skin grafts. He improved them and ran a specialist unit; Gillies led the way in the First World War.
- Mixing up the two wars. Blood depots near the front line and citrate belong to the First World War, while the national blood banks belong to the Second.
- Writing "the war caused it" and nothing more. Always say how the war led to the change.
Exam-style question
Explain TWO causes of the development of the blood transfusion service in Britain during the Second World War. [8 marks]
Remember: one cause alone cannot score more than half marks. For each cause, give precise knowledge and explain how it led to the outcome.
Model answer
One cause was the fear of mass casualties from bombing. Planners expected that bombers would attack British cities, so in 1939 the Emergency Blood Transfusion Service set up four depots around London, at Slough, Luton, Maidstone and Sutton, supported by the Medical Research Council. This meant that blood would be ready when raids began, and that is why a national system, rather than a few hospital supplies, was created before the Blitz of 1940-41.
A second cause was earlier scientific progress that made large-scale transfusion possible. Blood groups had been discovered in 1901 and sodium citrate stopped blood clotting, so the problem was no longer science but organisation. This allowed doctors such as Lionel Whitby to set up the Army depot at Bristol in 1939 and collect donations from volunteers. Later, Charles Drew's work on storing plasma allowed supplies to be shipped to Britain in 1940.
What lifts it to the top level: each cause has dates and names, and each is linked to the outcome with "this meant" or "this is why".
Exam tip
Start each paragraph with the cause, add two facts, then finish with how it led to the service being built. Two causes with a clear link each beat four causes with no link.