108 UNIVERSITY OF WISCONSIN STUDIES 



The next report from America was that of Duque" in 

 Cuba in 1908. 7 Duque reported three cases that clinically 

 were disseminated, yummatous sporotrichosis. They were 

 treated surgically and in two the amputation of an extremity 

 was resorted to without result. Under treatment of iodide 

 of potassium they all responded promptly and made complete 

 recoveries in periods of from one to two months. Details 

 concerning- the diagnosis are not given. Duque states that 

 the diagnosis was made by a careful examination of the pus 

 but does not say whether or not cultures were made. From 

 the clinical and therapeutic data we should judge that these 

 cases were sporotrichosis, but the lack of more complete 

 pathological data prevents further analysis. 



Burlew s in 1909 observed a case of sporotrichosis of the 

 disseminated gummatous type in a farm laborer in Santa 

 Anna, California. Both legs and the face were involved. The 

 organism was cultured and identified as the Sporothrix schen- 

 ckii. 



From this year (1909) to the present time the number 

 of cases recognized and reported ha>s increased rapidly so that 



* American Jour. Dermat. and Gen. Urin. Dis., 12, p. 240, 1908. 



7 The period of eight years lapsing between the reports of Hektoen and 

 Perkins and those of Duque, Burlew, Hyde and Davis, etc., in which no 

 cases appeared has been commented upon by de Beurmann and Gougerot. 

 Bull, et Mem. de la Soc. Med. des Hospit. de Paris, 35, p. 798, 1910. They 

 infer that sporotrichosis in North America had practically been forgotten 

 and that only after attention had been called to this disease through the 

 later work of the French did Americans begin again to recognize this dis- 

 ease. There is little truth in this statement. Naturally the large amount 

 of work that was being done by the French between 1906 and 1908 did at- 

 tract attention in America. However, it is surely not correct to state that 

 the disease had been forgotten here when men like Hektoen, Welch, Smith 

 and others, who had recognized or seen the disease and the fungus, con- 

 tinued to engage in active work in pathology. The real reason no doubt 

 was the fact that the disease in the human is restricted as we shall pres- 

 ently see, almost entirely to the valley of the Missouri River. This lo- 

 cality in the central and western portion of the country, especially at that 

 time, was not developed medically and naturally only the cases which 

 drifted out of the region to medical centers would be apt to be detected. 

 Such apparently was true of the cases of Schenck and of Hektoen and 

 Perkins. In later years when men like Sutton and others worked in that 

 locality cases were recognized in much larg-er numbers. 



8 South. Calif. Pract., 24, p. 1, 1909. 



