What is Reflexology?



Therapeutic Reflexology in South Africa is a registered healthcare profession with the Allied Health Professions Council [AHPCSA]  since 2001. 

The qualified therapist must register with the AHPCSA to practise legally as a Therapeutic Reflexologist and may treat or provide treatment for diagnosed disease, illness or deficiencies in humans or prevent such disease, illness or deficiencies in humans.

From 2016 various Medical Schemes in South Africa have included therapeutic reflexology therapy in their Benefit Plans.  In some countries Reflexology is part of the National Health Service.

  1. Origin of reflexology

There is a general misconception about where and when Reflexology was developed and practised.

It is known that some form of foot and hand massage was practised by a number of cultures in  Arabia,  Australia, Egypt, Japan, East India, North America, Grecian countries and in certain African communities.

In the literature of the historical development of reflexology, from 1582, various physiologists and neurologists from Germany, United Kingdom  and Russia contributed to reflex research, the impact of foot massage and nerve stimulation for healing. 

Development and practice of reflexology in the United States

The development and practice of reflexology in the 20th Century is a result of the studies in zone therapy, the application of pressure applied to specific points on the body such as the feet, hands and face to  relieve pain and improve function in other parts of the body.  These studies were conducted in the United States by the physician and ENT surgeon Dr Fitzgerald [1872 – 1942] and the physician Dr Shelby Riley [1856 -1947].

The nurse and physiotherapist, Eunice Ingham, worked for Dr Riley.  After extensive research she found that the feet and hands were especially sensitive to pressure. She ‘mapped’ the whole body on the feet and  developed a pressure technique, known as the Ingham method,  to apply pressure  to particular points across the soles of the feet.  She wrote the first book on Foot Reflexology in 1938.  

Although the Original Ingham Method® is world-wide used other prominent reflexology trainers in various countries contributed to the development of a number of new reflexology techniques. The various techniques are effectively used today by the modern reflexologists [therapeutic reflexologists] in their practice of reflexology to promote general health and wellbeing.  

The Historical development of Reflexology

 Foot massage

Foot massage spread from Egypt  to Europe via the influence of the Roman Empire, and from Asia to Europe via the trade routes of Marco Polo (1300’s) as well as the missionary travels of the Franciscans.

It is believed that Marco Polo translated a Chinese massage book into Italian in the 1300s, thus introducing reflexology and massage to Europe.


Christine Issel in her book Reflexology: Art, Science & History  wrote about the Modern history of reflexology from about 1850 – 1962:   “As much as the European has contributed to reflex research it was in the United States that the techniques of reflex therapy were eventually formulated into what is commonly termed reflexology.”

2. Reflex and  Reflexology

Dr Johann August Unzer, a German physiologist, used the term ‘reflex’ for the first time in 1771 with reference to motor reactions.  His contribution to science was specifically the study of reflexes following external stimulation of the nervous system. 

Dr Vladimir Bekhterev studied the reflexes from a psychological perspective and  was the first to use the term ‘reflexology’ in his book published in 1907.

3. Reflexmassage 

In Germany massage techniques were developed in the late 1890s and early 1900s.  In 1911, a physician named  Dr. Barczewski introduced the term ‘reflexmassage’.   This term was used by different systems which applied pressure as a method of healing.

4. Pressure Points  

Dr. Alfons Cornelius, a Viennese doctor found that with the application of pressure to certain points on the body  muscle contraction is triggered.  He also observed bodily changes such as variations in warmth and moisture, blood pressure changes and changes in the mental state of patients.

In 1902 his manuscript,  Pressure points, Their Origin and Significance was published and describes his theory on the application of pressure as “a purely mechanical hindering of the sensitive neurons, the neurons of the sympathetic nerve system”  and made the statement that conditions manifest as sensitive pressure points and “introduce the picture of illness long before it is to be recognized as an expression of a neurological problem.”

5. Zone Therapy/Meridians  

Two European physicians Dr Adamus and Dr A’tatis published a book in 1582 on an integral element of reflexology called Zone Therapy. 

Reflex zone therapy is where the body is divided into ten longitudinal zones from head to toe.

It is acknowledged that energy flows in zones or meridians throughout the body and that these pathways link  organ and body parts

meridian is described as an ‘energy highway’ in the human body and  exists in corresponding pairs. Each meridian has many acupuncture points along its path which are used for acupuncture, a  treatment  that involves inserting very thin needles through a person’s skin at specific points on the body to alleviate pain or to help treat various health conditions.

Some systems of reflexology also use these meridians as a basis for reflexology treatment. 

Modern Form of Reflexology

Reflexology as it is known today has its foundations in Zone Therapy, a form of pressure therapy used by the American physician, Dr William Fitzgerald who was drawn to this therapy when he discovered its ability to relieve pain and improve function in other parts of the body.   

Eunice Ingham, a physiotherapist, became known as the Mother of Modern Reflexology after developing Foot Reflexology during the 1900s out of the zone therapy as practised by Dr Fitzgerald and Dr Joe Shelby Riley, a chiropractor.  

Basis for Reflexology

The theory is that the body and organs are reflected on the feet, hands, face and ears.


Reflexology techniques, as known today, were developed by various role-players. The modern  Reflexologist uses specific finger and thumb techniques, including pressure techniques, to systematically stimulate various reflex areas for a therapeutic outcome that could give the patient relief from disorders or pain  in the related part of the body, and to clear congestions to allow energy to flow freely and return the body to a state of balance and wellbeing.


It is well known that Reflexologists do not claim to diagnose or to cure disorders.  Reflexology therapy can be used on its own to promote and maintain wellness or alongside conventional medical or alternative health care treatments.

6. The Scientific evolution of Reflexology   

Dr Vladimir Bekhterev  a  Russian medic, psychiatrist, neurologist, physiologist, psychologist. His study of the reflexes originated from a psychological perspective.  He was the first to use the term ‘reflexology’.

His book published in 1907, Objective Psychology, was translated in 1932 into English under the title of General Principles of Human Reflexology.

In his book he defined reflexology: Reflexology, which is a new doctrine, is the science of human personality studied from the strictly objective, bio-social standpoint.”

Sir Charles Sherrington
an English neurophysiologist, histologist, bacteriologist, and a pathologist  did extensive research into neurons and nerve function. 

In his book The Integrative Action of the Nervous System, published in 1906, Sherrington demonstrated how the nerves co-ordinate and dominate the functions of the body showing the process in which the brain, spinal cord and numerous reflex pathways control the activities of the body.

In 1932, Sir Sherrington received the Nobel Prize for his work on neurons, specifically “proprioceptive action”.  He shared the Nobel Prize with an English doctor, Edgar Adrian whose research had shown that the intensity of nerve stimulation was due to the size of the nerve, and not to the amount of pressure applied.  This also had an impact on the development of modern reflexology techniques. 

7. The Scientific Influence on Reflexology 

Dr William H. Fitzgerald, also known as the father of reflexology, practised as a physician and  otolaryngologist [ear, nose, and throat surgeon] at the Boston City Hospital and as a  laryngologist and head of the ENT Department at St. Francis ENT Hospital in Hartford, Connecticut.  

In 1902 Fritzgerald was drawn to pressure therapy when he discovered that pressure, applied to certain points on the body, could relieve pain and improve function in other parts of the body.  

He divided the body into 10 longitudinal zones that run from the head to the toes and fingers thereby linking parts of the body in that zone and observed that the application of pressure to specific areas corresponded to pain relief in different areas of the body in that zone.

He applied pressure to  the toes and fingers of his patients and realized that this produced considerable analgesia and relieved headaches, earaches, tummy aches etc.

Dr Joe Shelby-Riley ran the Riley School of Chiropractic in Washington DC.  When Dr Fitzgerald and his colleagues came to lecture to Dr Riley’s student, he became interested in the subject of Zone Therapy. He and his wife, Elizabeth Ann became students of Dr Fitzgerald.

Dr Riley also included the hands and ears in his work with reflexes and zones and added eight horizontal divisions to the zones of the feet and hands.

He made the first detailed drawings of reflexes or pressure points on the feet and hands, that suggested the shape of a human body .

Dr Riley used electrical tools but  later  he developed a manual hooking technique to apply pressure on patients. He and his wife Elizabeth Ann lectured Zone Therapy and the Hook technique on patients in many large cities of the United States.  

8. Development of Reflexology techniques

Eunice Ingham was a physiotherapist who worked for Dr. Riley in St. Petersburg, Florida. In 1925, Ingham developed zone therapy into foot reflexology

In the early 1930’s she started developing her foot reflex theory and applied pressure to particular points across the soles of the feet. She discovered that this technique stimulated and helped the body to heal, rather than to provide only pain relief.

After extensive research Ingham made a distinct separation between working on reflex points and zone therapy.

She developed a map of the feet with all the corresponding organs and glands of the body and called it compression therapy before naming it reflexology.  

She developed the alternating pressure technique used by most reflexologists today and  became known as the mother of modern reflexology and a trainer of reflexology.

She travelled around the USA, gave lectures and seminars in Foot Reflexology first to medical staff, and then to non-medical practitioners.

Published books: Stories The Feet Can Tell Through Reflexology [1938]; Stories the Feet Have Told Through Reflexology [1951]

Dwight Byers a nephew of  Eunice Ingham, started in the 50’s to help  her with the workshops.  In 1961 Dwight Byers and his sister Eusebia Messenger, Registered Nurse  joined their Aunt Eunice teaching at workshops  and became responsible for the teaching of Reflexology under the banner of The National Institute of Reflexology.

He and his wife Nancy promoted Reflexology and the Ingham techniques in all the states of the USA and in other countries such as Australia, New Zealand, Singapore, Europe, Israel and South Africa.

Dwight wrote  the book, “Better Health with Foot Reflexology The Original Ingham Method®.

Hanne Marquardt grew up in Germany and trained as nurse in England. Back in Germany she  qualified in medical massage, hydro- and breathing therapy and naturopathy.   

She became interested in the therapy Reflexology and decided to train with Eunice Ingham in 1958 and took the Ingham method and Zone therapy back to Europe.

Due to her own medical training, she understood the connection between the client and his/her reflecting areas on the feet, and created a new technique, Reflexotherapy known as RTF.  She treated a wide range of ailments and several disorders and proved the effectiveness of the therapy RTF.

She founded 15 schools in Germany and abroad and trained Reflexotherapy of the Feet (RTF) to thousands of practitioners with a medical- therapeutic background. 

Her first book appeared in 1975 and was titled ‘Reflexzone Work On the Feet’ and in 1993 she published her book, ‘Reflexotherapy of the Feet’,

Inge Dougans born in Denmark qualified in 1981 as a Reflexologist in Copenhagen and  emigrated to South Africa in October 1981 where she opened a private reflexology clinic.  

Mrs Dougans developed the meridian therapy and moved away from the zone theory.  This technique implies the massaging of  the reflexes in the feet with the focus on  the six meridians that run through each foot. 

She also developed the Vacuflex System, [consisting of two boots & 14 suction cups]. This system applies pressure to the whole foot and stimulates all the reflex areas at the same time in five minutes.  The suction cups are used to stimulate the acupuncture points on the meridians. The system is in fact a modern technology equipment that can be combined with the normal reflexology treatment.

In 1983 she started the training institution the International School of Reflexology and Meridian Therapy (now known as the International Academy of Reflexology and Meridian Therapy) in South Africa  and  incorporating the Chinese Meridian Theory.

She lectures all over the world, including Denmark, Germany, Italy and Poland.

Mrs Dougans  is the author of 11 reflexology books including the following:  1991 “Reflexology – foot massage for total health”; 1992 “The Art of Reflexology – a totally new approach using the Chinese Meridian Theory”, 1996 “The Complete Illustrated Guide to Reflexology” and various others.

Mrs Dougans is a founder member of the South African Reflexology Society established in 1985. She was awarded a trophy in appreciation of her dedication and long service (1985 – 2002) as the Founder Member of the South African Reflexology Society, and received an honorary lifetime membership.

Mapping of the Feet

The underlying theory behind reflexology is that there are “reflex” areas on the feet, hands and ears that correspond to specific organs, glands, and other parts of the body.

The Feet are mapped as follows:

  • the tips of the toes – head and neck area i.e. ears, eyes, nose and mouth.
  • the ball of the foot – thoracic area i.e. the lung, heart and thyroid.
  • the arch of the foot – abdominal area i.e. the liver, stomach, pancreas and kidney
  • the heel – pelvic area i.e. sciatic nerves, lower back and intestines
  • the ankle – reproductive area
  • the inner foot – the spin
  • the outer foot – the outer body i.e. arms, knee and hip

    Copyright: Inge Dougans 2007

Research on Reflexology

Research in hospitals on the international level indicates positive benefits of reflexology for various conditions. 

There are several well-designed studies, funded by the National Cancer Institute and the National Institute of Health that indicate reflexology’s promise as an intervention to reduce pain and enhance relaxation, sleep, and the reduction of psychological symptoms such as anxiety and depression

For more information on treatment and research go to Treatment


  1. Origin of Reflexology

Reflexology was discovered In the 20th Century by three Medical Doctors. DOCUMENTED HISTORY OF FOOT, HAND AND EAR REFLEXOLOGY: http://www.americanacademyofreflexology.com/documented-history-of-foot-hand-and-ear-reflexology/

Modern Institute of Reflexology, History, Dr William H.Fitzgerald: http://reflexologyinstitute.com/reflex_fitzgerald.php

What Is the History of Reflexology? University of Minnesota Taking Charge of your Health &   Wellbeing https: //www.takingcharge.csh.umn.edu/history-reflexology

The Original Ingham Method of Reflexology: International Institute of Reflexology:   https://www.reflexology-uk.net/about/the-original-ingham-method-of-reflexology

Reflexology: Christine Issel, Reflexology: Art, Science & History 1990 page 45.                           ISBN: 0-9625448-1-7

Foot Reflexology: A Brief History http://reflexologyhistory.com/History.html.

  1. The terms ‘reflex’ and ‘reflexology

Christine Issel, Reflexology: Art, Science & History 1990, page 24

Foot Reflexology: A Brief History http://reflexologyhistory.com/History.html

  1. Massage techniques

Dr. Barczewski: The History of Reflexology:

  1. Pressure Points

Dr. Alfons Cornelius : Foot Reflexology: A Brief History : http://reflexologyhistory.com/History.html

  1. Zone Therapy/Meridians

Revisiting reflexology: Concept, evidence, current practice, and practitioner training: https://www.sciencedirect.com/science/article/pii/S2225411015000905

Definition of zone Therapy. https://www.collinsdictionary.com/dictionary/english/zone-therapy Adamus and Dr A’tatis : What Is the History of Reflexology? University of Minnesota Taking Charge of your Health &   Wellbeinghttps://www.takingcharge.csh.umn.edu/history-reflexology.  

Zone Therapy page 29: https://books.google.co.za/books?isbn=0787312215

Acupuncture:  https://en.wikipedia.org/wiki/Acupuncture

Cancer Research UK.  Reflexology: https://www.cancerresearchuk.org

  1. The Scientific evolution of Reflexology

Vladimir Mikhailovich:

 The term ‘reflexology’  Foot Reflexology: A Brief History http://reflexologyhistory.com/History.html;  General Principles of Human Reflexology: A History of Modern Psychologypage page 158:https://books.google.co.za/books?isbn=1107109892;

Foot Reflexology: A Brief History http://reflexologyhistory.com/History.html

Sir Charles Sherrington:

Christine Issel, Reflexology: Art, Science & History 1990, Chapter 2 Modern history of reflexology 1850 – 1962, page 32;

Holistic & Complementary Therapies: http://holisticandcomplementarytherapies.blogspot.com/p/reflexology.html

  1. The Scientific Influence on Reflexology

Dr William H. Fitzgerald/ Dr Joe Shelby-Riley:

Foot Reflexology: A Brief History http://reflexologyhistory.com/History.html

Christine Issel, Reflexology: Art, Science & History 1990,page 25. ISBN: 0-9625448-1-7

Christine Issel. Reflexology: art, Sience & History. Page 51; Documented History of Foot and Hand and Ear Reflexolgy:  http://www.americanacademyofreflexology.com/documented-history-of-foot-hand-and-ear-reflexology/

Arthritis Research » Zone Therapy: https://www.arthritisresearch.us/zone-therapy/introduction.html

Documented History of Hand Reflexology and Foot Reflexology:

http://www.americanacademyofreflexology.com/socumented-history-of-foot-hand-and ear reflexology

Foot Reflexology: A Brief History”  http://reflexologyhistory.com/History.htm| 

History: Dr Riley, Modern Institute of Reflexology: http://reflexologyinstitute.com/reflex_riley.php

  1. Development of the Modern Form of Reflexology

Eunice Ingham and Dwight Byers:

History Of Reflexology thinkhs.com/angie/index.php/reflexololgy/history-of-reflexology

Natural Therapy Pages: https://www.naturaltherapypages.com.au/article/the_history_of_reflexology


Christine Issel, Reflexology: Art, Science & History 1990 page 39

Hanne Marquardt:

ICR Speaker 2011. http://www.icr-reflexology.org/conferences/docs/ICR%202011

Inge Dougans:


REFLEXOLOGY foot massage for total health: Inge Dougans with Suzanne EllisISBN 1-85230-2182.