Tuberculosis of the spleen may be primary or secondary. By primary it is not meant that the spleen is the portal of entry of the organism, or even the first tissue of the body in which the disease manifests itself, but that the diseased process may localize itself in the spleen and not only bring about various lesions, but act as a focus for dissemination of the bacilli, while the original focus may be healed entirely. It is this type of the disease which we may speak of tentatively as primary tuberculosis of the spleen. It occurs most frequently in adults; may manifest itself as several distinct clinical types, and is characterized by rather typical symptoms and signs. In many instances the individual may be cured by splenectomy. A brief review of the occurrence and pathological anatomy of secondary tuberculosis of the spleen will make certain phases of our subject