Pâhkahk, often called by the diminutive Pâhkahkos, is a skeletal spirit of the Cree, a dried-up, bony being associated with starvation and disease. George Nelson's 1823 letter-journal from Lac la Ronge describes Pah-kack among the powerful beings of Cree cosmology, and among the Plains and western Woods Cree the being was honoured in feasts and the Give-Away Dance, in which goods were given away to win its favour; those who pleased it received striking good fortune, while those who offended it courted hunger and misfortune. Skeleton figures called pakakoos were among the tattoo designs David Mandelbaum recorded from Plains Cree men, a mark of the being's protective as well as fearsome character.