THE Island of Porto Rico is more free from disease than the average tropical or semi-tropical country, due to the active efforts of the medical profession and of the special commissions and departments created for the elimination of disease within the last few years. Nevertheless, a great deal of sickness which might be avoided, part of which is responsible for death, and part of which merely incapacitates the sufferers or renders them less useful citizens, is to be found. The elimination of such diseases as smallpox and yellow fever, which formerly were responsible for a great number of deaths and which descended upon the Island as epidemics with considerable regularity, has been accomplished, and if similar care were taken in the case of less dreaded diseases, there is reason to believe that they could also be wiped out of existence in the Island. For the year 1915-16 there was a total of 26,572 deaths in Porto Rico. Most of these deaths were from diseases classified as transmissible, and, consequently, from diseases which could be prevented by complete quarantine. Following is a list of the number of deaths from the diseases which took the heaviest toll in the Island: Rickets 1,271 Tuberculosis (lungs) 2,125 Malaria 1,290 Typhoid fever 94 Whooping cough 167 Tetanus 109 Cancer 365 Meningitis 344 Epilepsy 57 Acute bronchitis 1,015 Chronic bronchitis 309 Bronco-pneumonia 822 Pneumonia 569 Diarrhea and enteritis under two years 3,485 Diarrhea and enteritis two years and over 870 Infantile tetanus 729 Lack of care in infancy 117 Congenital debility in children 1,145 Uncinariasis 479 Smallpox 9 Diphtheria 26