In hematogenous tuberculosis, whether acute or chronic, tubercles are scattered widely throughout the body. Unfortunately, from the viewpoint of early diagnosis, there are relatively few accessible sites which, when involved, furnish diagnostic signs. The most important of these is the presence of miliary lesions in the chest roentgenogram. However, this finding is not pathognomonic, as there are numerous other conditions which can give a similar picture.1The presence of choroidal tubercles, when seen ophthalmoscopically, is a valuable, but rare, finding. Occasionally, tubercle bacilli may be demonstrated by culture of the aspirated bone marrow. In protracted cases, when some lesions have progressed to caseation, smears or cultures of the gastric contents or urine also may reveal tubercle bacilli. Awaiting the results of cultural studies necessitates considerable delay in diagnosis and therapy. Any additional method which can aid in the early diagnosis of hematogenous tuberculosis is therefore welcome. Punch biopsy of