A forty-eight-year-old housewife sought treatment for anxiety and depression; an 'incidental' symptom was severe pruritus ani of five years' duration. The symptom was the derivative of an unconscious fantasy of possessing a penis. Feces were equated in her unconscious with both babies and penises. Before treatment, her orgasm was achieved not by intercourse but by clitoral ('penile') masturbation. The pruritus ani, with scratching, apparently represented a similar 'penile' masturbation. By both acts she reassured herself that she possessed a penis. When, in treatment, she surrendered the desire for the penis, she achieved vaginal orgasm and the pruritus was cured.