The Bonesetters Behind Modern Orthopaedics

By Eswar Kumar · 9 August 2026

Modern orthopaedics did not arrive to replace bonesetting from the outside. It grew, in part, out of it. What is usually described as the first English book on manipulation by a qualified doctor was written by a surgeon who learned the technique from an unlettered bonesetter; the man usually called the father of British orthopaedics was born into a Welsh bonesetting family; and the founder of osteopathy advertised himself as a bonesetter before he had a name for what he did.

This article traces those lines. It is history, not an argument for anything: nothing here claims that bonesetting works, and the cures described in the eighteenth- and nineteenth-century sources below are claims recorded at the time, not findings. Where the standard version of a story does not survive checking — and one very famous statistic does not — this article says so rather than repeating it.

Before orthopaedics, there were bonesetters

For most of British history, a person with a wrenched knee or a stiff shoulder did not see a surgeon. Surgeons were expensive, and until the nineteenth century most of them had little to offer a damaged joint beyond rest. What existed instead was a lay craft, carried in families and villages, with no anatomy, no register and no theory beyond the practitioner’s own explanation — usually that a bone was “out.” The same pattern held far beyond Britain, as the parallel traditions described in bonesetting around the world show.

The hinge moment in the English record is a lecture. On 5 January 1867, the British Medical Journal opened its volume with Sir James Paget’s Clinical Lecture on Cases that Bone-Setters Cure, delivered at St Bartholomew’s Hospital. Paget did not endorse bonesetters. He set out to explain their results in surgical terms, and he was often condescending about them. But he told his students something the profession had not said in print before: that these men were curing patients the profession had failed, and that the remedy was to study them. “Learn, then, to imitate what is good, and avoid what is bad in the practice of Bone-setters,” he said.

Four years later a young surgeon took that instruction more literally than Paget can have intended. Wharton Hood, MRCS, published a series of papers in the Lancet in March and April 1871 and then a book, On Bone-setting (so called). His preface explains how he came by the material, and it is one of the frankest passages in Victorian medical writing. Hood’s father had attended the bonesetter Richard Hutton through a long illness and refused to take a fee. Hutton, wanting to repay the kindness, offered “to explain and show all the details of his practice as a bone-setter.” The father was too busy; the son accepted, and spent months at Hutton’s London consulting days.

Hood was clear-eyed about his teacher. Hutton, he wrote, “had received but a plain education, was entirely destitute of anatomical knowledge, and firmly believed the truth of his ordinary statement that ‘the joint was out.’” And he was equally clear about what he had gained: “knowledge of a kind that is not conveyed in ordinary surgical teaching, and that, when guided by anatomy, is of the highest practical value.”

Richard Hutton died on 6 January 1871, which is why Hood felt free to publish. His nephew Robert Howard Hutton (1840–1887) carried the line on. The Dictionary of National Biography records him as descended from “a family of farmers who for upwards of two hundred years have resided in the north of England, where they have been bonesetters for the benefit of their neighbours.” He farmed at Milnthorpe in Westmorland and set bones in his spare time until about 1869, then moved to London and built a fashionable practice at 36 Queen Anne Street, off Cavendish Square. His reputation, the DNB says, rested on “his mechanical tact and acute observation of the symptoms of dislocations.” A farmer with no anatomy, consulting in Marylebone: that is the shape of the whole story in one biography.

The Thomas family of Wales

The best-documented case of a bonesetting family becoming a medical dynasty is Welsh. In the early eighteenth century a boy was shipwrecked off Anglesey, adopted locally and given the name Evan Thomas. His descendants set bones on the island for generations. The Dictionary of Welsh Biography describes the family plainly as “a well-known family of bonesetters whose origin was tinged with tragedy and romance.”

A later Evan Thomas (1804–1884) moved the practice to Liverpool in the 1830s and became one of the most sought-after bonesetters in the north of England — and, as an unqualified man treating the industrial injured, a target for the local profession. His answer was to send his sons to medical school. The most consequential of them, Hugh Owen Thomas (1834–1891), was born at Bodedern on Anglesey, trained at Edinburgh and University College London, qualified MRCS England in 1857, and set up at 11 Nelson Street, Liverpool, in a house he rebuilt to hold four consulting rooms and a workshop.

That workshop matters. Thomas designed and made his own appliances, and in Diseases of the Hip, Knee, and Ankle Joints (1875) he introduced the splints that carry his name. He also left the manoeuvre and the test still taught as Thomas’s. He was a qualified surgeon working in the family trade with better tools — and the profession largely ignored him during his lifetime.

The transmission is visible from the other side too. In The Art of the Bone-setter (1884), the bonesetter George Matthews Bennett wrote of Evan Thomas of Liverpool that he “is now represented by a relative (a son I believe) who has taken out a diploma as a surgeon, and is therefore a ‘bone-setter’ according to Act of Parliament.” The sarcasm is doing real historical work: the craft had not changed hands, only status.

Hugh Owen Thomas had no children. He trained his wife’s nephew, Robert Jones, who is generally credited with bringing his uncle’s teaching and splints before the profession after Thomas died in 1891, and who organised orthopaedic care for the British Army in the First World War. Thomas and Jones are together routinely called the fathers of orthopaedic surgery.

The statistic you should be careful with

You will constantly read that the Thomas splint cut mortality from compound femoral fractures from 80% to 20% during the First World War. Treat that number with suspicion. The sources do not agree with each other: the figure appears variously as 80% to 20%, 80% to 15.6% and 80% to 8%. A 2025 historical review in Military Medicine uses 80% to 15.6% but attributes it to a 2021 secondary paper rather than to primary wartime data. Other historians note that mortality also fell because of advances in wound debridement and casualty evacuation — the splint cannot be isolated as the cause.

What is well supported is narrower and still remarkable: the Thomas splint was adopted for battlefield evacuation of femoral fractures, contemporaries credited it with a large fall in deaths, and it is still in use. The precise percentage is folklore that has hardened into a citation.

Sarah Mapp and Georgian England

A century before any of this, the most famous bonesetter in England was a woman. Sarah Mapp (baptised 1706, died 1737) was the daughter of a bonesetter named Wallin, of Hindon in Wiltshire, and she learned the craft from him. Known as “Crazy Sally,” she practised at Epsom, and in 1736 the town offered her a retainer of 100 guineas a year to stay — Epsom’s racing crowd valued a bonesetter. She travelled to London twice a week and saw patients at the Grecian Coffee House, where she is said to have treated a niece of Sir Hans Sloane.

Almost everything else about her is contested, and was already contested within living memory. Bennett, writing in 1884, put it exactly right: “The accounts of her life and career, which have come down to us, are very contradictory.” The surviving material is largely magazine gossip and satire. She was celebrated on the London stage in a 1736 comedy, The Husband’s Relief; or the Female Bone-setter, and the Worm Doctor, and she was pilloried by Hogarth in the same year: his print The Company of Undertakers shows her holding a bone, flanked by the oculist John Taylor and the nostrum-seller Joshua Ward, three notorious irregulars presiding over a shield of physicians. Percivall Pott later abused her in print in terms it is not worth repeating.

Her marriage to Hill Mapp in August 1736 lasted weeks; he left with a large part of her savings, though the sources differ on the amount. She died the following year in Seven Dials and was buried by the parish. The arc — enormous public demand, elite patients, professional contempt, no institutional standing, and a short life — is the standard shape of a bonesetting career before the profession decided the skill was worth annexing.

Herbert Barker: the bonesetter who was knighted

The most extraordinary case is the most recent. Sir Herbert Atkinson Barker (1869–1950) was never medically qualified. He was apprenticed to his cousin John Atkinson, a bonesetter, after discovering at eighteen that he could reduce a dislocation, and by the 1900s he was practising in Park Lane with a waiting room full of MPs, judges and sportsmen.

The medical establishment’s response was to punish the doctors who worked with him. In 1906 Frederick Axham, a qualified physician then in his sixties, began acting as Barker’s anaesthetist. He knew what it would cost. In 1911 the General Medical Council struck him off the Medical Register for assisting an unqualified practitioner. He was not rehabilitated until 1926, the year he died aged 86, and even then the GMC had not formally confirmed his reinstatement.

Barker, meanwhile, kept rising. In April 1920 hundreds of public figures — MPs, the Lord Chancellor, the Attorney General — petitioned the Archbishop of Canterbury to grant him an honorary Lambeth degree in medicine. The Archbishop refused, on the reasonable ground that it would imply a qualification Barker did not have. Senior surgeons including Sir Henry Morris and Sir Alfred Fripp then wrote to Lloyd George, and Barker received a knighthood in the King’s Birthday Honours of 1922 — nominally for his wartime services, not for bonesetting, which the profession was careful never to endorse.

The strangest coda is documentary. In 1936 Barker demonstrated his methods to the British Orthopaedic Association, and the orthopaedic department of St Bartholomew’s Hospital filmed it. Two silent reels survive in the Wellcome Collection, catalogued as made “as a result of a demonstration Barker gave of his methods to the British Orthopaedic Association in 1936.” An unqualified bonesetter, filmed by a teaching hospital, so that surgeons could study his hands.

How chiropractic and osteopathy absorbed the craft

Both American manual professions were founded in the same Midwestern decades, and both founders passed through bonesetting on the way.

Andrew Taylor Still (1828–1917) moved to Kirksville, Missouri in 1875 and, in the words of the State Historical Society of Missouri, “advertised himself as a ‘Lightning Bone Setter.’” That was not a later historian’s label; it was his own advertising. He opened the American School of Osteopathy in Kirksville on 1 November 1892. Osteopathy did not descend from bonesetting in a straight line — Still also came out of magnetic healing, and he built a theory neither tradition had — but the hands-on repertoire he was selling in the 1870s was bonesetting, and he said so.

D.D. Palmer, a magnetic healer in Davenport, Iowa, dated chiropractic to a single adjustment performed on the janitor Harvey Lillard on 18 September 1895. (Lillard’s daughter later gave a different account of that day, and historians treat Palmer’s origin story with caution.) The link from Palmer to bonesetting is real but weaker and more indirect than it is often stated to be. What is documented is that he was accused of taking his method from Still — the chiropractic historian Joseph Keating notes contemporary criticism that Palmer had “stolen” osteopathy from “the ‘lightning bonesetter’ of Kirksville” — and that Palmer answered by insisting on a difference of technique, not of ancestry. His 1899 advertisement reads: “The Osteopath and the Chiropractic both aim to put in place that which is out of place, to right that which is wrong; but the movements are entirely different.”

That is the honest version. Claims that Palmer trained under a named bonesetter, or lifted specific techniques from a particular lineage, circulate widely and are not well evidenced; this article does not make them. What the record supports is that both professions emerged from a landscape thick with bonesetters, that one founder worked openly as one, and that both defined themselves partly by distinguishing their movements from his. For the practical differences between the traditions today, see bonesetting versus chiropractic.

What was lost in the professionalisation

The absorption was real, and so was the cost, and the people it happened to noticed at the time.

Bennett, in 1884, watched surgeons start using techniques they had called quackery a decade earlier and wrote that they “now want to secure our practice as well as our reputation as skillful manipulators.” He was describing something that did in fact happen. Paget told students to imitate what was good in bonesetting; Hood published a bonesetter’s methods within two years of his death; Barker’s hands were filmed by a hospital that would not have registered him.

Three things went with the transfer. Attribution: the techniques entered orthopaedic and osteopathic practice detached from the families who developed them. Access: the manipulation Paget recommended became something only a licensed practitioner could legally provide, which is a genuine protection for patients and also a closure. Transmission: apprenticeship, in which a child watches, assists and eventually works, was replaced by curricula and examinations. That is a real gain in accountability and a real loss in a particular kind of learning, and both statements can be true at once.

None of this is an argument that regulation was a mistake. Bonesetting produced serious harm as well as relief, and it produced no way of telling the two apart — a bonesetter cannot see a fracture line. But the common framing, in which bonesetting is a fringe alternative that orthodoxy left behind, gets the history backwards. In Britain, orthodoxy read the bonesetters, hired their methods and then made their practice illegal. The living traditions that were never absorbed — including the Indian lineages described in what is Indian bonesetting — are not survivals from before medicine. They are the branch that did not get professionalised.

Frequently asked questions

Did modern orthopaedics really come from bonesetting?

In part, yes. Hugh Owen Thomas, whose splint is still in use and who is often called the father of British orthopaedics, came from a Welsh bonesetting family and his father practised as an unqualified bonesetter in Liverpool. What is usually called the first English book on manipulation by a qualified doctor, Wharton Hood’s On Bone-setting (1871), was written from months spent watching the bonesetter Richard Hutton. Orthopaedics has other ancestors too — military surgery, anaesthesia, radiography — but bonesetting is one of them.

Was Sir Herbert Barker a qualified doctor?

No. Barker was never medically qualified. He learned bonesetting as an apprentice to his cousin John Atkinson, and he was knighted in 1922, nominally for his wartime services, not for his method, which the medical profession never formally endorsed. His anaesthetist, Frederick Axham, was struck off the Medical Register in 1911 simply for working with him.

Is it true the Thomas splint cut wartime deaths from 80% to 20%?

That figure is repeated everywhere and is not reliably sourced. Different accounts give the post-adoption rate as 20%, 15.6% or 8%, and a 2025 review in Military Medicine attributes its own figure to a secondary paper rather than primary wartime records, and historians point out that improvements in wound care also reduced mortality. The splint was clearly important; the specific percentage should not be quoted as fact.

Who was Sarah Mapp?

Sarah Mapp (baptised 1706, died 1737), known as “Crazy Sally,” was an English bonesetter who learned the craft from her father, a bonesetter named Wallin of Hindon in Wiltshire. She practised at Epsom, which offered her 100 guineas a year in 1736 to remain in the town, and saw London patients at the Grecian Coffee House. Hogarth caricatured her among the quacks in The Company of Undertakers. Much of what is told about her comes from hostile or satirical sources and the accounts contradict each other.

Did chiropractic and osteopathy come from bonesetting?

Partly, and more clearly for osteopathy than for chiropractic. Andrew Taylor Still advertised himself as a “Lightning Bone Setter” in Kirksville, Missouri from 1875, seventeen years before founding the American School of Osteopathy. D.D. Palmer’s connection is less direct: he came from magnetic healing, and his documented relationship to bonesetting is mainly that he had to distinguish chiropractic from it and from Still’s osteopathy.

Are bonesetters still practising?

Yes, in many countries, under many local names, and in most places outside any regulatory framework. India has family lineages that have never been absorbed into a profession; comparable traditions continue in Japan, China, Portugal, Turkey, Nigeria, Ghana and elsewhere. Their legal status varies enormously, and in most jurisdictions with regulated health professions, treating musculoskeletal injuries without registration is an offence regardless of lineage.

Sources

This article is history and is not medical advice. Historical claims of cure quoted above are reported as their sources recorded them and are not evidence that any technique works. Bonesetting techniques should only be practised after supervised, in-person training and in line with the laws where you live.