Acromegaly, Mr Punch and caricature

Abstract

The origin of Mr Punch from the Italian Pulcinella of the Commedia dell'arte is well known but his features, large hooked nose, protruding chin, kyphosis and sternal protrusion all in an exaggerated form also suggest the caricature of an acromegalic. This paper looks at the physical characteristics of acromegaly, the origin of Mr Punch and the development of caricature linking them together into the acromegalic caricature that now has a life of its own.