In the course of the First World War, many more soldiers died of disease than by the efforts of the enemy. Lice caused itching and transmitted infections such as typhus and trench fever. In summer it was impossible to keep food fresh and everyone got food poisoning. In winter men suffered from frostbite and exposure and from trench foot. There were no anitbiotics so death from gangrenous wounds and syphilis were common. Others suicided as a result of psychological stress.