(US, dialect, Appalachia) Sickness, weakness.

(archaic) An inferior person; a subordinate; also, an insignificant person. / A younger person; a junior. / Alternative spelling of puisne

Of inferior significance, size, or strength; ineffective, small, weak. / (chiefly Southern US, south Midland US) (Frequently) ill; poorly, sickly. / Inferior in rank; specifically, of a judge: junior.

The quality of being puny

superlative form of puny: most puny