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, gummatous 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* 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- 
ck. 
From this year (1909) to the present time the number 
of cases recognized and reported has increased rapidly so that 
“American Jour, Dermat. and Gen, Urin. Dis., 12, p. 240, 1908. 
™The period of eight years lapsing between the reports of Hektoen and 
Perkins and those of Duque, Burlew, Hyde and Davis, ete., 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 
Jater 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, coi- 
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 larger numbers. 
® South. Calif. Pract., 24, p. 1, 1909. 
