The two diseases which are of most vital importance to the people of Porto Rico at present are undoubtedly tuberculosis and anemia. The ravages of tuberculosis are more noticeable in the cities, and it has been stated that in 1912, on one street in San Juan, 12 out of every 100 residents died of this disease. Anemia is prevalent throughout the Island, but is more noticeable in the country districts than in the cities, and while the death rate for anemia is not so high as the death rate of some other diseases, yet by reason of weakening the vitality of the sufferers it tends to offer a fertile spot for the incubation of germs of other diseases, and the working and producing power of the individual is lessened with the acuteness of the disease. It has been claimed that anemia was introduced into Porto Rico by the negroes who were brought here as slaves in the sixteenth and seventeenth centuries, and the identity of the disease with the anemia existing in about 20 per cent of all the negroes of the Gold Coast has been determined. The disease was for a long time limited to the coast land and was propagated on the sugar plantations, but after the introduction of coffee, which has come to be the chief product of the mountain regions, the disease was propagated throughout the entire Island. This disease has left its trace among the country people and they have been accused of laziness and idleness when it is probable that the cause of the apparent disinclination for work is due to the weakened physical condition which is a result of the anemia. In this connection, Drs. Gutierrez and Ashford in their work on _Uncinariasis in Porto Rico_ quote Col. George D. Flinter, an Englishman in the service of Spain, who published in 1834 "An account of Porto Rico," as follows: "The common white people, or lowest class (called _jíbaros_), swing in their hammocks all day long, smoking cigars and scraping their native guitars.... Most of these colonists are inconceivably lazy and indifferent. Lying back in their hammocks, the entire day is passed praying or smoking. Their children, isolated from the cities, without education, live in social equality with the young negroes of both sexes, acquiring perverted customs, only to later become cruel with their slaves." Commenting on this statement, Drs. Gutierrez and Ashford speak as follows: "What if these people were merely innocent victims of a disease, modern only in name? What if the brand placed by the Spaniard, the Englishman, and the Frenchman in olden times upon the _jíbaro_ of Porto Rico were a bitter injustice? The early reports savor strongly of those touristic impressions of the Island which from time to time crop out in the press of modern America, in which 'laziness and worthlessness' of the 'natives' are to be inferred, if, indeed, these very words are not employed to describe a sick workingman, with only half of the blood he should have in his body."