Handheld dexterity puzzles have enjoyed long popularity since their introduction in the late 19th century. In the 20th century, these puzzles shrank in size so that they could be held in one hand. Their subjects vary but they often tend to reflect fads and currents in popular culture. This example illustrates a pinhead cartoon character. Historically, "pinhead" refers to a person with microencephaly, a condition shared by several famous circus performers of the past. The term was also used for a cartoon character with a small pointed head, which likely influenced the design of this puzzle.