The article presents historical medical analysis of the activities of N. A. Kasyan (1935–2009), hereditary bone-setter and physician from city of Kobelyaki in Poltava Oblast, who played key role in legalization of manual methods of treatment in the USSR. On the basis of published sources subjected to systematic historical medical analysis for the first time, are reconstructed main stages of his career: dynastic succession of bone-setting mastery across at least four generations, persecution by health authorities (1960s–1980s), role of press in breaking through information blockade, formation of mechanism of “elite patronage” and transition from persecution to public recognition (1982–1990). The particular attention is paid to description of Kasyan's technique, which was fundamentally different from formalized manual therapy and constituted traditional bone-setting based on tactile diagnostics and individual skill defying standardization mastery. The analysis of problem of reproducibility of method (less than 1.5% of physicians who underwent training) demonstrates that institutionalization inevitably transforms tradition. It is demonstrated that activity of Kasyan became decisive catalyst of legalization of manual therapy in the USSR — not through channels of scientific expertise, but through a convergence of journalistic resonance, elite patronage and mass popular demand although legalized specialty fundamentally differed in its content from his bone-setting technique.

N. A. Kasyan, bone-setting, manual therapy, folk medicine, history of medicine, the USSR, legitimization of medical practices..