96 PROCEEDINGS OF SOCIETIES. 
20th November, 1874. 
Ichthyosis Lingue.—Dr. Goodhart has observed two cases, both 
men above middle age, both with a histury of syphilis, and in 
both the disease ended in epithelioma; in one the ichthyotie con- 
dition had lasted ten years. The naked-eye appearance of the 
disease is that of a thick, hard, white coating to the tongue, in 
patches on its dorsum, and sometimes on the cheeks. In one 
case the patches were of the character of local warty excrescences, 
a millimétre in height, consisting microscopically of a number of 
vertically set papillw, of fusiform shape and ragged surface; the 
surrounding epithelium was twice its normal thickness. In the 
plaque the epithelium was much thickened, as also the cutis vera 
and sublying fibrous tissue; at times the epithelial layer was of 
uniform thickness, at others it was seen dipping down to the 
interpapillary spaces and sublying fibrous coat, and was sur- 
rounded by a small cell growth ; to all these changes the warty ap- 
pearance was due. All this was explained by over-activity of the 
rete Malpighii, the supply of cells produced being greater than 
the demand created by wear and tear required. 
He had not observed the colossal papille described by Mr. 
Hulke, nor the shrunken papille described by Mr. Fairlie Clarke, 
which latter might be explained by the normal papille having 
been cut obliquely ; still, if the interpapillary depressions are for 
long clogged with excess of epithelium, then the papille would 
seem to be less prominent. The thickening of the subcutaneous 
fibrous tissue was especially noticed in the condensed fibrous 
band that normally may be seen running along immediately below 
the base of the papillee. 
The muscular fibre of the tongue had not been found diseased. 
In order of sequence it was difficult to state which ought to be 
placed first, the epithelial growth or the excess of subcutaneous 
fibrous tissue, but probably the former. 
The incurability of the disease might be owing to its being 
generally seen when almost in the condition of epithelioma. 
With regard to this latter affection it was hard to trace micro- 
scopically its exact relation to ichthyosis, the general infiltra- 
tion of the subjacent fibrous tissue of an ichthyotic patch with 
indifferent cells indicating its presence; in fact, this condition 
was generally characteristic of epithelioma in this situation, it being 
comparatively rare to see the so-called bird’s nests ot epithehum. 
Even before the onset of epithelioma the greatest difficulty in 
treating an ichthyotic patch with the idea of curing it would be 
from the altered habit that the cells must have acquired after a 
long time, which would have to be counteracted before the normal 
state of things could be resumed. In ichthyosis the normal 
tissues were only in excess, but in epithelioma this was not only 
the case, but the epithelial cells infiltrated parts foreign to them, 
and from their very rapidity of growth acquired the characters of 
“indifferent”’ cells. A second condition rendering the cure of 
