Foot Reflexology: A Brief History

Foot reflexology has been a welcomed complementary therapy for many people since the 1930s as the feet are easily accessible and there is no need to undress. The history of reflexology as an art of stress reduction based on the theory that the body is reflected on the feet in the shape of the body is the work of two American physicians, Dr. William FitzGerald and Dr. Joe Shelby Riley in the 1920s.

Prior to this it has been claimed reflexology started in such places as Egypt, Tibet, China or Native American Indians. However, there is actually no proof of this. The art and sculptures of indigenous cultures do indicate working on the feet. The question is whether or not this actually depicts the application of reflexology as a systematic body of knowledge as it is known today since there have been no verifiable reference or charts found to date.

The Scientific Evolution of Reflexes to the Advent of Reflexology

The first use of the word ‘reflex’ with reference to motor reactions was used by the German physiologist Johann August Unzer in 1771. In 1883 Marshall Hall, an English physiologist introduced the concept and term ‘reflex action’.

In the late 1880s neurology as a branch of science became a field of its own. Often articles regarding the most up-to-date research on reflex action were published in England in Brain, A Journal of Neurology. One article “Reflex Action as a Cause of Disease and Means of Cure” by Dr. T. Lauter Brunton discussed the beneficial use of inducing a blister on the skin for the healing of internal problems.

Sir Henry Head (English physiologist) was able to chart areas according to the spinal segment to which they belonged. After years of research he established Head zones which are labeled in anatomy books today as dermatomes. Head’s work conclusively proved the neurological relationship that exists between the skin and the internal organs.

The Russians pursued the study of reflexology both from the psychological and physiological point of view. Russian work with reflexes began with Ivan Pavlov’s (1849-1936) theory of conditioned reflex response which earned him the Nobel Prize in 1904. His famous theory was a reflex action was a simple and direct relationship between a stimulus and a response (the ringing of a bell and a dog salivating).

A fellow countryman and contemporary, Dr. Vladimir Bekhtrev’s study of the reflexes originated from a psychological perspective and he actually originated the term ‘reflexology’. His 1907 work, Objective Psychology was translated into English in 1932 under the title of General Principles of Human Reflexology. Bekhterev’s opening statement defined reflexology far different than modern reflexologist would. He wrote, “Reflexology, which is a new doctrine, is the science of human personality studied from the strictly objective, bio-social standpoint.”

In the late 1890s and early 1900s massage techniques were developed in Germany that became known as ‘reflex massage’. This was the first time that the benefits of massage techniques were credited with reflex actions. Dr. Alfons Cornelius published a manuscript in Vienna in 1902 titled Pressure points, Their Origin and Significance. In this work he notes that the application of pressure incited changes in the body. He observed pressure to certain spots triggered muscle contraction, changes in blood pressure, variation in warmth and moisture in the body as well as directly affecting the ‘psychic processes’ or mental state of the patients. Cornelius puts forth his theory of how the application of pressure works: “(It is) a purely mechanical hindering of the sensitive neurons, the neurons of the sympathetic nerve system.” He also stated that conditions show themselves as sensitive pressure points and “introduce the picture of illness long before it is to be recognized as an expression of a neurological problem.”

Sir Charles Sherrington (1861-1952) disagreed with Pavlov and his work proved that reflex responses are more complicated in that the whole nervous system adjusts to a stimulus. This he termed proprioceptive action. Sherrington’s work earned him the Nobel Prize in 1932. This award he shared with Dr. Edgar Adrian. Adrian made the discovery that the electrical intensity of the nerve impulse (or response) depended on the size of the nerve rather than upon the strength of the stimulus. To reflexologists this means that applying light pressure can be just as effective as heavy pressure.

Other Germans also contributed to our work. In 1911, a physician named Dr. Barczewski introduced the term ‘reflexmassage’. This term was then used by different systems which applied pressure as a method of healing.

Zone Therapy

Dr. William FitzGerald (1872-1942) is credited with being the father of ‘zone therapy’. FitzGerald never published where he became acquainted with the theory of zone therapy nor does he give any credit to original sources preceding his. FitzGerald does not refer to any Oriental influence either. It is known he worked in Vienna beginning around 1899. It is here he may have learned of the use of pressure in medical practice. Upon his return to the United States several years later he discovered that if pressure were applied to the nose, throat and tongue, sensations in particular areas were deadened. This theory could also be applied to other boney areas including the feet and hands and other joints to provide pain relief. Zone therapy divides the body into ten zones—five on each side of the sagittal plane. The hands/arms and feet/legs were also divided into five zones each. There is no evidence that FitzGerald actually illustrated via charts, where the reflexes appear on the feet. Dr. Edwin Bowers in his book co-authored with Dr. FitzGerald, Zone Therapy in 1917 writes that FitzGerald discovered zone therapy in 1909 but gives no indication where he became acquainted with the theory. From 1915 into the early thirties the subject of zone therapy was controversial, but did meet with a certain amount of success with doctors and dentists as a form of pain relief or analgesia.

Reflex Work

Dr. Joe Shelby Riley (1856 -1947), trained by Dr. FitzGerald further developed zone therapy by adding eight horizontal divisions to the zones of the feet and hands. His work is accurately the beginning of reflexology as it is known today—that is, reflexes found on the feet and hands that follow the anatomy of the body. Riley’s work with reflexes and zones also included the hands and ears. Fitzgerald’s work had produced non-electrical applicators to aid in applying pressure. Riley added both electrical tools and developed a manual hooking technique with which to apply pressure.


During the 1930s Eunice D. Ingham (1889-1972) who met Riley as early as 1919 worked for Dr. Riley in St. Petersburg, Florida and continued to refine and improve his work. From her first book, Stories the Feet Can Tell (1938) she was encouraged by Riley and others to take her work to the public and non-medical community. Eunice’s major contribution to working with reflexes was that alternating pressure, rather than having a numbing effect, stimulated healing. For forty years she lectured and traveled back and forth across the United States. She wrote three books in the process, often using the term ‘compression reflex massage’ though she never envisioned reflexology as part of massage. She saw reflexology as a separate discipline but felt if she used the medical term ‘reflexology’ she could get in trouble with the medical community. Eunice Ingham (Stopfel) limited her book reviews as she called her seminars to cities and towns in the USA and southern Canada. In the 1970s Eunice retired and the lecturing was taken over by her nephew, Dwight Byers who had been touring with her since 1948. Beginning in 1961 Byers took the seminars overseas. Over the years he has presented seminars on six continents. In the 1980s Byers assumed complete ownership of Eunice’s work from his sister, Eusebia Messenger and formed the International Institute of Reflexology (IIR). Today, IIR has instructors around the world.

Reflexology as an International Movement

In the 1950s French medical doctor, Paul Nogier developed charts based on reflex points on the outer ears. This is sometimes referred to as auriculotherapy. In 1955 a German, W. Kohlrausch wrote in his book Reflex Zone Massage that disturbances of the organs follow vascular channels which are associated with the reflexes of the arteries instead of the nervous system.

In 1958, Hanne Marquardt was working in a German sanatorium when she first came in contact with Eunice Ingham's book, Stories the Feet Can Tell. The book had become well-known in Switzerland in the 1950s and from there, it entered into the German-speaking countries. In the 1970s Hanne, who had personally studied with Ingham in America, took Eunice's work to Germany where it was termed Reflex Zone Therapy. Marquardt would go on to instruct many of the future teachers of reflexology throughout countries in Europe in her over 50 year career with reflexology.

Another one of Eunice's students who became an author was Doreen Bayly from England. Doreen was trained in America in the late 50s and was the first teacher in Europe for Eunice introducing the work there. She authored Reflexology Today in 1984.

In 1969, Mildred Carter who had studied with Ingham wrote Helping Yourself with Reflexology. It was the first book published by a major publisher in the United States with sales of over 500,000 copies. This not only created greater public awareness of reflexology but also opened the door for all the self-help books available today. In the 1970s and 80s many books on reflexology were written. Today there are several hundred books on the subject around the world.

In 1991 the International Council of Reflexologists (ICR) was formed in Toronto. The mission of ICR is to meet the needs of the reflexology profession by providing a global forum for the exchange of ideas and information; convening biennial international conferences; and promoting its initiative World Reflexology Week (WRW) to bring public recognition to the work.

Reflexology in Europe Network (RiEN) was founded in 1994. RiEN’s aim is to provide support for members in the form of annual meetings, sharing current standards within each country to assist in further developments, and sharing research information. Membership is composed of schools and organizations with a category for “friends” who do not fit into either category.

The Association of Reflexologists (AoR), founded in 1984, is not for profit and is the only UK reflexology membership association, as an organization, that is a member of both RiEN, and the Reflexology Forum and also the Complementary and National Healthcare Council (CNHC). It has representation at the Parliamentary Group for Integrated and Complementary Healthcare (PGICH).

The New Zealand National Reflexology Association (RNZ) combined the two national organizations into one in 2001. Membership is composed of qualified practitioners and anyone with an interest in reflexology.

The South African Reflexology Society (TSARS) was established in 1985 as a non-profit making organization and as such is not affiliated with any reflexology training institution. As an independent entity TSARS acts in the interest of its members and on professional matters relating to reflexology. The Society has been instrumental in gaining statutory recognition for therapeutic reflexology from the Allied Health Professions Council of South Africa (AHPCSA) in 2007.

Other countries around the globe have their own national organizations, however most often membership is restricted to students from a particular school rather than membership being open to all reflexologists and the association not being an independent not for profit organization. Google reflexology+country to check websites for each country for more information and to determine whether or not the association represents a school or is open to all reflexologists.

The Professional Development of CAM & Reflexology

Quietly in the 1980s began the era of complementary and alternative medicine (CAM) around the world. Along with developments in the large picture of complementary and alternative medicine came the emerging professionalism of reflexology with associations being founded on the state, national, and international levels and conferences being held. Reflexology is endorsed as an accepted profession by the governments in China and South Africa. With government recognition comes restrictions. In many countries reflexology practitioners are questioning if this is a route they wish to take.

The field of reflexology is young and guaranteed to evolve and change. Currently Dr. Jesus Manzanares M.D. (Barcelona) has studied the cross-over of reflex action; Dr. Martine Faure-Alderson, D.O. (UK) reflexology’s effect on cancer; Dr. Gwen Wyatt, Ph.D. (USA) with two NIH grants involving reflexology’s effect on quality of life for those suffering from the effects of chemotherapy on breast cancer patients; and Dr. Marc Piquemal M.D. (Paraguay) mechanism studies investigating how reflexology works are some of the most important work being conducted.


Many may be misled because of reflexology's simple hands-on techniques and think there is nothing to it. However, its dynamic results literally change people's lives. It meets the standards set by the World Health Organization as it is simple and easy to learn, economical, can be readily found, is safe, and most importantly, effective as hundreds of studies have shown. No matter one's age, or gender, or whether an individual is in good health or suffering, reflexology is a great stress reliever. It adds quality to life.

In the USA - Legislation

In the USA the majority of reflexology concerns, including the right to practice, occur at the state level. Many state associations have been formed to exempt the practice of reflexology from being licensed under massage. The first exemption was granted in Maine in 1990 with the first state reflexology law passed in North Dakota in 1993. Today legislative work continues jointly by the American Reflexology Certification Board (ARCB) and the Reflexology Association of America (RAA). To date there are 34 state massage laws where reflexology is exempt and the field has four state laws of its own in North Dakota, Tennessee, New Hampshire and Washington.


Reflexology is a self-regulating profession. In order to safeguard the public and improve services to the client, a Code of Ethics and Code of Business Standards and Conduct, adequately enforced are necessary under a Code of Practice. Generally these codes must be considered legal requirements and normal practices within a field which promote honesty and fairness to all concerned, both practitioner and client, and should be written in plain English. Where relevant the code should address such things as duty of care, professional conduct, client confidentiality, fair marketing and advertising of services, and enforcement of any breach of the codes, other keys include membership in different types of organizations and defending our right to practice. Both the ARCB and RAA have such codes as well as clearly spelled out complaint procedures and investigation and disciplinary measures

The American Reflexology Certification Board was founded in the United States as an independent examining body in 1990. It began testing in January 1992. Its focus is on practitioners in the USA. ARCB's primary goal is to protect the public though certifying the competency of those reflexologists practicing professionally who choose to meet certain national standards. A second objective is to act as a national referral board for its certified practitioners. It is not possible to join ARCB, one must complete all phases of the testing process to become a certificant.

The Reflexology Associationn of America was founded in 1995 as the national membership organization. The RAA is dedicated to unifying reflexologists from all educational programs across the nation who desire to work toward the recognition, excellence and professional strength of reflexology. State associations are also welcome to formally affiliate with the RAA.

It has now been over eighty years since Eunice published Stories the Feet Can Tell. While reflexology may be in its infancy on a professional level or in its efforts to gain recognition and acceptance from the conventional healthcare field, the development of reflexology has spread around the world. Ultimately though her spirit of discovery she has left a monumental challenge for those in reflexology today to continue to develop and explore its depth scientifically as well as provide the opportunity for practitioners to bring comfort to suffering humanity around the globe.

For a more comprehensive history of foot reflexology refer to Reflexology: Art, Science & History by Christine Issel from which this information has been taken by permission.