By the end of May, Grant's plan to exert continuous pressure on
^^ Illness and Disease Take a Toll on Soldiers
Approximately 359,000 Union soldiers and 258,000 Confederate soldiers lost their lives during the war. Although many of these men died on the battlefield, almost twice as many died of disease as were killed in combat. Part of the problem was that the science of medicine was not very advanced in the 1860s. "The unfortunate Civil War soldier, whether he came from the North or from the South, not only got into the army just when the killing power of weapons was being brought to a brand-new peak of efficiency; he enlisted in the closing years of an era when the science of medicine was woefully, incredibly imperfect, so that he got the worst of it in two ways," historian Bruce Catton explained. "When he fought, he was likely to be hurt pretty badly; when he stayed in camp, he lived under conditions that were very likely to make him sick; and in either case he had almost no chance to get the kind of medical treatment which a generation or so later would be routine."
During the Civil War years, doctors did not know what caused disease or why wounds became infected. The war occurred just before scientists discovered the microscopic organisms, like bacteria and viruses, that can infect food and water or enter the human body through wounds. As a result, doctors did not sterilize surgical instruments, bandages, or wounds. Vaccinations and antibiotics did not exist. Soldiers in army camps did not practice basic hygiene in cooking or disposing of waste. They thought that water was safe to drink unless it smelled bad or had garbage floating in it.
Disease hit soldiers the hardest right after joining the army. When thousands of men from different areas and the Army of Northern Virginia was taking a heavy toll on the rebels. In mid-May, Lee lost legendary cavalryman Jeb Stuart (1833-1864) in a battle with Union cavalry led by Philip H. Sheridan (1831-1888). In addition, some of Lee's most important officers died from illnesses or had nervous breakdowns. Even Lee was not immune to Grant's relentless pressure. At one point the Confederate general contracted a severe case of flu that left him too weak to mount his horse. Fi nally, Grant's aggressive style was slowly eating away at Lee's army. Each battle and skirmish added to the Confederate death toll and deepened the mental and physical exhaustion of survivors.
But the fighting took a heavy toll on the Union Army, too. From May 5 to May 12 alone, the Army of the Potomac suffered thirty-two thousand casualties. Continual skirmishes pushed the casualty rate ever higher.
backgrounds crowded together in army camps, large numbers of them contracted common diseases like measles, mumps, tonsillitis, and smallpox. Although most men eventually recovered from these diseases, the outbreaks reduced the strength of military units. To make matters worse, the poor sanitation in army camps led to numerous cases of dysentery, typhoid, pneumonia, and other illnesses. Maintaining the health of the troops was a major problem for both the North and the South throughout the war. "Disease was a crippling factor in Civil War military operations," historian James M. McPherson wrote. "At any given time a substantial proportion of men in a regiment might be on the sicklist. Disease reduced the size of most regiments from their initial complement of 1,000 men to about half that number before the regiment ever went into battle."
Grant pushed forward, however, and at the end of May he prepared for another major clash with Lee at a place called Cold Harbor, located ten miles northeast of Richmond.
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