A twenty-seven-year-old Navy veteran with many tattoos was undergoing psychotherapy for a variety of emotional problems. In the course of this treatment, one of the tattoos—a picture of a dagger penetrating slits in the skin—developed a peculiar wheal which was definitely limited to the outline of the dagger. The authors believe that 'the sympton, functioning as a substitutive reaction, served to bind, resolve, and thus lessen the danger of eruption of a whole complex of hostile, erotic, exhibitionistic impulses combined with masochistic and self-punishing needs' which were mobilized by the psychotherapy. The tattooed dagger could serve as the symbolic repository of all these converging impulses. The precise psychophysiological mechanisms in the production of this symptom are not clearly understood; but they are believed to be under the direction of the autonomic nervous system and (like palmar bleeding in the stigmata of crucifixion) are not usually susceptible of direct symbolic translation of conflict into symptoms.