MEDICAL MICKOSCOPICAL SOCIETY, 97 
ichthyosis doubtful, and at the present time impossible, was the 
increase of fibrous tissue. At first excessive epithelial growth 
was found; this meant increased blood supply, and this in turn 
increased development of tissue supplied by the blood; hence the 
one condition reacted on the other. 
The President discussed the paper generally, criticising the 
use of the term Ichthyosis; he thought that of Tylosis better. 
He had not had the opportunity of observing a case pass on to 
epithelioma, and quoted one where there was no history of 
syphilis. 
Mr. Fairlie Clarke remarked he had, in adopting the term 
Tylosis lingue, only reproduced the original name, and _ that 
there were strong arguments clinically against that of Ichthyosis. 
He had found microscopically a thinning and wasting of the 
papillz, for not only is there increase of cell structure towards 
the surface, but it even dips down and spreads laterally, between 
the papille themselves ; this especially appearing as it approaches 
the condition of epithelioma, Sooner or later an “ichthyotic” 
tongue became epitheliomatous, but there is a condition where 
white patches (‘‘ white fibrous cicatrices ’’) are seen on the tongue, 
which, though incurable, does not lead to epithelioma, and hence 
requires carefully distinguishing from tylosis lingue. Epithe- 
lioma supervenes in two ways—either by extension of cell growth 
from the surface, which growth not only is in large quantity 
but penetrates into tissues into which it is naturally foreign ; or 
secondly, it may commence in the underlying structure as the 
result of prolonged irritation from the ichthyotie patch. Pallia- 
tive measures may relieve in the disease, but as yet we are 
ignorant of any cure short of that by surgical interference. 
Mr. Henry Morris discussed the connection of cancer and 
ichthyosis lingue, remarking that though, in his opinion, quite 
distinct diseases, yet that both depend upon modified nutrition, 
this being the production of excessive epithelium in the case of 
eancer, heterologous, but not so in ichthyosis. He had observed, 
at least once, epithelioma follow, as a distinct result of irritation 
to an ichthyotic patch that had shed its scale, the red raised spot 
becoming a cancerous ulcer. Where epithelioma has followed, it 
does not spread more rapidiy than if it had started quite inde- 
pendently, even though the ichthyosis may have been of long 
standing. He believed the disease to be like ichthyosis else- 
where; he had seen it on the tongue while the neck around was 
similarly affected. 
Dr. Allchen asked whether the secondary conditions described 
were not rather extensions of the ichthyotic growth, and not 
true epithelioma, in a histological sense, although clinically 
malignant. 
Mr. Needham, in two cases operated on where epithelioma was 
commencing, had observed hypertrophy of the papille and of the 
cutis, which was infiltrated with large granular cells. The vessels 
VOL. XV.—NEW SER, G 
