In an earlier study1of the attenuated forms of suicide, I suggested that self-mutilation, appearing under the varying circumstances of psychosis, neurosis, religious ceremony and social convention, is in all cases the result of a compromise between the self-destructive and erotic tendencies, such that the death instinct is thwarted of its purpose through the sacrifice of a part for the whole.2I was able to demonstrate from representative examples of various types of mutilation that in all of them one could find evidence of a simultaneous indulgence in passive gratifications and punitive satisfaction, which at the same time atone for the guilt, repeat the crime (of passivity) and act as a peace-offering for the mitigation of the more severe punishment of death, i. e., a sacrifice to permit continued indulgence. I did not include in that study a form of self-mutilation with which clinical medicine has been familiar