For years preceding the occupation of Porto Rico by the United States, the anemia problem had been widely discussed here by writers of all professions, and public opinion concerning this deplorable condition is well expressed by a physician and literateur, who, writing in 1886, remarks:1
To malaria, to the debilitating influence of a diet, limited in quantity and poor in quality, and to diseases produced by detestable hygienic defects, we can attribute the majority of the anemia of the Porto Rican peasant.
The author of the treatise above quoted was one of the first to acknowledge the parasitic cause of this anemia shortly after its announcement. But the public simplified its opinion further in succeeding years, laying more and more stress on the factor of insufficient food.
DEATHS UNDER SPANISH AND AMERICAN RULE
The number of deaths for the last five years of Spanish rule in the island was 130,207
ASHFORD BK, IGARAVIDEZ PG. SUMMARY OF A TEN YEARS' CAMPAIGN AGAINST HOOKWORM DISEASE IN PORTO RICO. JAMA. 1910;LIV(22):1757–1761. doi:10.1001/jama.1910.92550480001001
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