May 9, 1872] 



NATURE 



23 



between the articulating surfaces of the affected joint, an 

 operation which is so frequently successful that it forms 

 the very basis of the bone-setting craft. 



It is here that the bone-setter steps in front of tlie 

 scientific surgeon, and we must confess to a feeling of 

 disappointment that their relative positions are not re- 

 versed, that the surgeon is not called in to rectify the 

 malpractices of the quack, instead of the latter being sought 

 out to complete the shortcomings of the former. Let us 

 see how this manipulation is performed. The bone-setter 

 has a clearly defined system of treatment for each separate 

 joint, if not for each specific affection to which each joint 

 is subject. Next to the list of authenticated cases of 

 successful treatment, this is, perhaps, the most valuable 

 part of the treatise ; for in addition to the ample and de- 

 tailed modes of procedure with each joint, diagrams 

 showing the act of manipulation are given, taking in succes- 

 sion those of the upper and lower limbs, and also of the 

 several regions of the spinal column. One example may 

 here be given : — 



" The proximal side of the aflected joint being firmly 

 held, and the thumb-pressure made in the ordinary way, 

 the tarsus is so grasped as to give the greatest attainable 

 leverage, the fool twisted a little inwards or outwards, 



then sharply bent up upon the leg and again straightened. 

 As a rule it is desirable to execute this manoeuvre twice 

 over with an inward and once with an outward twist, and 

 also to take care that the movements of the joint are free 

 in all directions." 



Bone-setters, we are told, are for the most part un- 

 educated men, wholly ignorant of anatomy and patho- 

 logy ; but we are not told what we greatly wish to know, 

 and that is, the manner and method in which the secrets, 

 the mysteries, and the traditions of their craft, are com- 

 municated to each other. No doubt there exists a free- 

 masonry in the craft, so that when individual members 

 meet revelations are made and notes compared, but we 

 are not informed of any regular or organised system of 

 instruction, either for the maintenance and extension of 

 the craft, as a craft, or for the enlightenment of the sepa- 

 rate and detached members of the fraternity. The most 

 celebrated, we may even say distinguished, bone-setter of 

 our day was the late Mr. Hutton, whose successful treat. 



ment of cases that had baffled the skill of the foremost 

 surgeons now living, cases related in detail by Dr. Hood, 

 and about the accuracy of whicli there can be no question 

 or doubt, is little short of marvellous ; and the question 

 is ever recurrent while we read, " How and where was 

 this skill acquired?" for a bone-setter of Mr. Hutton's 

 calibre could put his finger on the spot where lurked the 

 seat of an affection that had crippled a patient for half-a- 

 dozen years, and had defied the scientific treatment of the 

 ablest surgeons of our time ; nay, he could point to this 

 spot without ever seeing the limb affected, guided merely 

 by observing the attitude, gait, or action of the patient. 

 Now, whence comes this undoubted skill of these illiterate 

 men ? It appears to be obtained solely by observation 

 of symptoms and results of treatment, the accumulated 

 knowledge of from day to day experience ; and as we 

 often see that one sense is quickened and functional 

 power increased by the loss or impairment of some other 

 sense, so perhaps the narrowing of the field of instruction, 

 the limiting of the sources of information, may have inten- 

 sified the powers of observation of the bone-setters, 

 atoning in a measure for the absence of the revelations of 

 science. 



It was from Mr. Hutton himself that Dr. Hood received 

 the secrets of the craft. The motive for, and the manner 

 of, making this revelation are so interesting, that we must 

 give them in Dr. Hood's own words : — 



" About si.x years ago my father, Dr. Peter Hood, in 

 conjunction with Dr. lies, of Watford, attended the late 

 Mr. Hutton, the famous bone-setter, through a long and 

 severe illness. On his recovery my father refused to take 

 any fees from Mr. Hutton, out of consideration for the 

 benefit which he had rendered to many poor people. Mr. 

 Hutton expressed himself as being thereby placed under 

 great obligation, and as being very desirous of doing 

 something to show his gratitude. He offered as an 

 acknowledgment of the kindness he had received to 

 explain and show all the details of his practice as a bone- 

 setter. Pressure of work prevented my father from 

 availing himself of this offer, and Mr. Hutton then ex- 

 tended it to me. After some consideration I determined 

 to accept it, and accordingly I went, when I could spare 

 the time, to Mr. Hutton's London house, on the days of 

 his attendance there. My decision was prompted, not 

 only by the curiosity I felt to see how he treated the cases 

 that came under his care, but also by the desire to make 

 known to the profession, at some future time, any insight 

 that I could gain into the apparent mystery of his frequent 

 success." 



By this means Dr. Hood in time found himself, as he 

 tells us further on, able to take charge of all Mr. Hutton's 

 poorer class of patients, " whom he was accustomed to 

 attend gratuitously," and found that he could accomplish 

 all that he had seen done. "And this practice," he else- 

 where emphatically says, " gave me knowledge of a kind 

 that is not conveyed in ordinary surgical teaching — that 

 when guided by anatomy is of the highest practical value, 

 as well in preventive as in curative treatment." 



With this knowledge, thus acquired, the author's course 

 was clear. In a series of letters in the Lancet he com- 

 municated to his professional brethren some of its most 

 important facts, and now to the general reading public he 

 submits the whole in the shape of a well-arranged and 

 clearly-written volume. 



Archibald Maclaren 



