PROCEEDINGS OF SOCIETIES. 
41 
rendering the cure of 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 
linguae, 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 papillae ; for not only 
is there increase of cell structure towards the surface, but it even 
dips down and spreads laterally between the papillae themselves ; 
this especially appearing as it approaches the condition of epithe- 
lioma. Sooner or later an " ichthyotic " tongue became epithelio- 
matous ; 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 distin- 
guishing from tylosis linguae. Epithelioma 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 to which it is 
naturally foreign ; or, secondly, it may commence in the underlying 
structures, as the result of prolonged irritation from the ichthyotic 
patch. 
Palliative measures may relieve in the disease, but as yet we are 
ignorant of any cure, short of that by surgical interference. 
Mr. Henry Morris questioned the connection of cancer and 
ichthyosis linguae, 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 cancer, 
heterologous, but not so in ichthyosis. He had observed, at least 
once, epithelioma follow, as a direct 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 rapidly than if it had started quite independently, even 
though the ichthyosis may have been of long standing. He believed 
the disease to be like ichthyosis elsewhere ; he had seen it on the 
tongue, while the neck around was similarly afiected. 
Dr. Allchin 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 papillae, and of the 
cutis, which was infiltrated with large granular cells ; the vessels 
were also enlarged. He had traced the epitheliomatous growth to 
the original ichthyotic patch. 
Dr. Goodhart, in reply, preferred retaining the term icthyosis 
linguae, as one well understood now. Had but once seen the white 
