Unpublished prior to the 1985 exhibition, this drawing is close in subject and composition to two prints by Ribera, which show men with similar growths on their necks. The etching of the Small Grotesque Head (Bartsch 8) is dated 1622 and the Large Grotesque Head (Bartsch 9), which represents a person very similar to that in the present drawing, must date from the same period. At this date Ribera was closely engaged in studying anatomy, as can be attested by a group of three etchings by the arist which show him focusing on precise features: ears, eyes, nose and mouth. These studies, also dating to around 1622, may have been executed as part of an instructional manual for artists, which Ribera never completed (J. Brown, Jusepe de Ribera: Prints and Drawings, exhib. cat., Princeton, Art Museum, and Harvard, Fogg Art Museum, 1973-4, p. 70).
The two prints of 'grotesque heads' have been related to a number of drawings, most frequently a red-chalk sheet in the Fitzwilliam Museum in Cambridge (inv. PD.26-1958). Two others, one in a Milanese private collection and the other in the Museo di Capodimonte, were published alongside the Fitzwilliam head and the present drawing in the 1985 catalogue (op. cit., nos. 2.5 and 2.6). They may be linked to a series of portrait prints, described by Giovanni Gori Gandinelli in 1771 as 'dodici fogliette con teste ideali, e di deforme aspetto' but presently unidentified. Although these portraits grow out of the tradition of 'grotesques' which began with Leonardo and his followers, Ribera's intention seems to be quite different. Rather than offering up the subject as an object of humor in a stereotyped caricature, this portrait is instead a straightforward representation of disfigurement, tempered with empathy and psychological insight. While elements such as the nose and the chin may have been slightly exaggerated, it nevertheless appears to be a portrait of a real individual.
In the 1973-4 Princeton catalogue Jonathan Brown suggests that the prints of the Small and Large Grotesque Heads (fig. 1) may show men with an identifiable condition: Von Recklinghausen's Disease. This condition of the nervous system leads to the growth of benign soft tumors beneath the skin, which can result in the goiter-like growths seen in the present drawing.