what is reflex zone therapy

8/2/2019 What is Reflex Zone Therapy

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S E C T I O N O N E

What is reflex zonetherapy?


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1The development and theory

of RZT

Introduction what isreflex zone therapy?Reflex zone therapy (RZT) is the simple applicationof touch by one person to the feet, hands, back orhead of another. Yet for all its simplicity of approachit has the capacity to illuminate much about thehealth of the receiver, to relieve pain and discomfortand, when appropriately given, may be a means ofrestoring health.

Our appearance, demeanour and temper are in ameasure interwoven with the manner in which wehave been fashioned and how we feel. When our

eyes lose their lustre, skin becomes dry or scaly, hairloses its shine and becomes brittle, or there arechanges in skin colour, we and others can seethat we are not well. We suspect also that all is notwell if we lose our appetite, feel excessively tired,lose interest in our surroundings, cant concentrateor feel unusually irritable. Illness is characterised by both signs and symptoms. Signs of illness areobjective pieces of evidence which show a departurefrom normal, for example blueness of the lips or adiscoloured or frothy sputum. Symptoms, such as

shortness of breath, malaise or pain, give us thesubjective experience of illness, and are less easilyquantified.

RZT depends on the premise that body changeswhich occur when there is less than perfect functionin any part are reflected on the mirror of thesurfaces of the feet, hands, back and face. In otherwords, our skin covering, as well as nails, eyes andhair, is an important indicator of how well we arefaring within ourselves, and can provide early clues

to the nature of our ailments when we fall belowpar.

The first signs of illness are often unnoticed or

disregarded until discomfort, limitation ofmovement or pain begin to interfere with theroutine of normal daily activity. Yet these signs aredetectable from the earliest stage of illness in thereflex zones of the body surface. They are visibleto the discerning eye and can be discovered by adiscriminating touch, the basis of the palpationtechnique.

Further to this, those zones indicating internalimbalance or overt illness are treated with a varietyof gentle strokes and dynamic movements, using

thumbs or fingers, to stimulate the bodys ownhealing and self-balancing mechanisms.

As with any other method, RZT has advantagesand limitations. A capable therapist is able to extendit to its full potential, recognises its limitations and,knowing these, is aware of the responsibility forreferring onwards when necessary.

The aims of RZT are:

to discover from a careful examination of thereflex zones whether there is any evidence of

latent disease to prevent such illness from developing wherepossible

to relieve symptoms without masking anyserious underlying illness

to support the bodys natural healingmechanisms

to promote relaxation, and to enhance, in combination with other therapies

where indicated, all treatment.

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HistoryOur human physiology has not changed over thepast few thousand years. Those factors which

promote health and those which erode well-being canand do change in detail over the centuries, but not inprinciple. The effects of touch as a means ofcommunication, support and healing have beenattested to by all cultures since prehistory.

Touch is an instinctive response to pain, and has been adapted to promote healing through many andvaried forms, including massage and pressure (bothWestern and Oriental systems), osteopathy, physio-therapy and reflex zone therapy amongst many others.Usually practical and empirical experience has come

first, to be explained in due course by the expanding body of knowledge in anatomy and physiology. Inconsequence, some of the above therapeutic modes areupheld by a more complete system of knowledge,while for others it is less comprehensive. All have aplace amongst the healing arts, innovative healershaving from earliest times evolved effective andculturally adapted ways in which to relieve the sick.

Although the feet have been used for massage andtreatment by many cultures and peoples, the writtenand oral records of this practice which survive to dateare sketchy and incomplete, and we can only guess atthose methods which were used centuries ago. Yet,despite the obscurity in which past practice isshrouded, the observable and often lasting benefits ofRZT have over the course of this century given reliefand comfort to many, and growing confidence to itspractitioners.

The many forms of practice and schools ofthought from various individuals have given rise tothe different terms zone therapy, reflex zone therapy,reflexotherapy, reflex therapy and reflex zonemassage, all of which are included in the collectiveterm reflexology.

Early history and antecedents

Whether reflex zone therapy was first used in theOrient or in Egypt and Assyria we do not know.Ancient pictographs from these civilisations suggestthat the feet were a source of information andpossibly treatment.

The West

Massage is known to have been practised in theOrient before the birth of Christ, and was prescribedin the West by physicians in Greece and Rome, aswas mentioned by Plato (375 BC). The opinions ofearly writers on Greek medicine (Alcmaeon ofCroton, Sicily 470 BC, Heraclitus 540 BC, Parmenides ofElea 515BC, Pythagoras, Sicily 530 BC) are difficult tointerpret. Their views on health and sickness aresimilar to those found in the Hippocratic corpus440340BC (Baas 1889, Lloyd 1978, Porter 1997, Singer1962). It is the opinions and comments of Plato(427347BC) about Hippocrates that are best knownto us, as dialogue and debate were a vital part ofGreek intellectual life. Philosophical speculation

about nature included debate about sickness andhealth.

Hippocratic medicine was cautious, had a goodknowledge of and observed closely both surfaceanatomy and its changes, and depended on detailedobservation and reason. Plato refers to theseHippocratic virtues of reason over magic, a themethat is fully developed in the Timaeus (375 BC). Thehuman frame was constructed with a purpose thesoma affected the psyche. Behaviour can bedetermined by organic weakness or deficiencies;

madness could have a physiological cause. Healthdepended on self-control in diet, exercise andmassage as practised by trainers of gymnasts.(Sophrosyne soundness of mind in a healthy body was the ideal. But it was more the Greekadmiration for athleticism that produced instructorsin exercise, diet and massage.)

Celsus ( AD30) wrote in Latin eight books ofmedicine and, like Hippocrates, stated that medicinerequired not just experience but also reason. Hewrote about medicine, drugs and surgery for all parts

of the body, and very importantly detailed the fourcardinal signs of inflammation doctors must be alertto after surgery: pain, redness, heat and swelling(rubor, calor, tumor and dolor), to which has beenadded the fifth loss of function (Singer 1962, p. 54).Celsus was the first major Latin author, and he wasfollowed by Galen, AD129216. Both authorsincorporated ideas of diet, exercise, rest and bodymassage within regimes of care (Baas 1889, Porter1997, Singer 1962).

4 W H A T I S R E F L E X Z O N E T H E R A P Y ?


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The Orient

More than 4000 years ago in the Orient, traditionalChinese medicine (TCM) codified a system oftreatment in which was acknowledged an intimaterelationship between the internal systems of the bodyand its outer surfaces, and which embraced adifferent model of the persons relationship to theworld or universe.

Oriental philosophy and cosmology was shaped byTaoism and Confucianism, which held that thecosmos is a whole eternal, uncreated yet constantlyrecreating itself, in which everything is related toeverything else under the interaction of the twofundamental polar yet complementary principlescalled Yin (female, dark, etc.) and Yang (male, light,

etc.). All natural phenomena were also classifiedaccording to their physical composition, being eitherliquid, mineral, earth, heat or plant. A furtherclassification into the natural elements or phases, ofWood, Metal, Water, Fire and Earth, was then made.

Human beings are a microcosm of thismacrocosm, therefore in their physiological andpsychological make-up one can observe all theelements, movements, patterns, changes,relationships and forces of the universe. Like thelarger universe, human beings are suffused with Qi

(Chi) (sometimes translated as essential or vitalenergy, though there is no precise conceptualtranslation), Blood (which is not the Westernunderstanding of a physical fluid, but rather itsqualities such as transport and nourishment),Essence, Spirit and Body Fluids. The archetypalprinciples of Yin and Yang are always present too, inconstant interplay, and all change is effected by shiftsin their balance within any given situation.

When an indescribably harmonious coexistence,movement and functioning of any one of the above is

disrupted, the disruption spreads to affect all theother components which make up the whole. Theresult is called a pattern of disharmony in the East,and sickness in the West. According to this view, nosign, symptom or event can be isolated and viewedon its own, but only interpreted and subsequentlytreated in the context of its relationship to the whole.

An example of this is acupuncture which,although only one of the pillars of TCM, is the onewhich is best known in the West. In its diagnostic

methods, changes which are taking place internallymust be discerned by observing outward changes by looking, listening, smelling, asking and touching.Much emphasis is given to visual examination of thetongue and its surface, and to the complex art ofpulse taking, both of which help to reveal theprevailing pattern of disharmony.

Access to internal functions, organs and structuresis gained through meridians. Meridians are invisiblechannels or pathways which connect the interior ofthe body to its exterior. Qi (Chi) and blood coursethrough meridians, whose pathways link allcapacities, organs and structures, and it is along orthrough these channels that information about theirdynamic relationship flows.

Of these channels, the most important (in

acupuncture) are the 12 organ meridians and 8extraordinary vessels, of which both the Governor(major Yang) and Conception (major Yin) Vessels areconsidered to be major meridians. (As the function ofeach organ, as well as its relation to the vitalsubstances and all other organs and structures in the body, is considered more important than its anatomicalstructure, named meridians do not always correlate toa Western construct of the bodys anatomy.)

In this way each meridian serves many morefunctions and parts of the body than the organ whose

name it bears. Acupuncture points ( tsubos), or pressurepoints, occur at intervals along each meridian. Thesestructures allow access to the meridian, the functionsand organs it serves, and the vital substances.

Treatment aims to restore imbalance in function ofinternal organs, as well as that of the emotions and themind. A TCM practitioner may choose betweenneedling, pressure, or local heat either asmoxibustion, in which a substance (primarilymugwort, Artemesia vulgaris) is burnt just above theskin, or as cupping to apply suction to one or more

specific points on the chosen meridians. The intentionis to effect a change in the pathway, therebyinfluencing the vital substances and subsequentlyinfluencing energy patterns and relationships of allfunctions, organs and structures maintained by thatmeridian. In this fashion, intervention on the surface ofthe body is used to bring about deep internal changes.

The TCM conception did not depend on theextending knowledge of anatomy, physiology, biochemistry and pathology, which are the hallmarks

5T H E D E V E L O P M E N T A N D T H E O R Y O F R Z T


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of Western scientific discipline. Also, in the latter thephysical, psychological and spiritual factors oftenappear to be separated in considering both thecausation and treatment of illness. This perceivedemphasis on technical brilliance to the exclusion ofother factors may account in part for the modern cryfor wholism, although good doctors everywherehave always (and still do) give full consideration toevery aspect of the effect of illness on the life of theirpatients. Traditional Oriental medical systems do notrecognise this separation of the emotional dispositionand activity from the bodys physical function.

Modern developments in scientificunderstanding

The tradition of therapies involving touch remainedobscure in the West until about two centuries agowhen, in Sweden, Professor Per Henrik Ling (1859)devised a system of remedial massage andgymnastics, based on his clinical observations of therelationship between internal organs and specificareas of the skin. His prescriptions were so effectivethat for a century and a half they enjoyed a reputation

for excellence throughout Europe and Professor Lingswork was being acknowledged in English textbooksuntil the middle of the 20th century (Johnson 1897).

ReflexesIn Edinburgh, Professor Robert Whytt (171466)confirmed 17th century observations that the spinalcord was integral to reflex action such as blinking andcoughing, and that such action is carried out withoutconscious control or awareness (Whytt 1765, Whytt1768). In London, the eminent neurophysiologistMarshall Hall (17901857) deduced that the nervoussystem was composed of many segmental reflex arcs(Figs 1.1 and 1.2), and showed that the spinal reflexarc could function even if the spine was injured or

severed (Hall 1833, 1836, 1838, 1839, 1842, 1850).

Referred pain

On the other side of the Atlantic Ocean, in 1834, two brothers, W. and D. Griffin, observed that clinicaldisease states changed the structure and function ofone or more vertebrae (1834, 1845). In the last half of


Anterior aspect

Connector neuronMotor

nerve fibre

Striped muscle

Motorend plateSpinal cord

Posterior rootganglion

Mixed nerve

Sensorynerve fibre

Skin with nerve endings

Fig. 1.1 The basic three-neuron ipsilateral arc (After Anthony & Thibodeau 1983, with kind permission of C V Mosby)


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the 19th century, Dr Andrew Still further shapedthese ideas in his American practice to develop thediscipline of osteopathy (Still 1902, Northrup 1979).

The term transferred pain (which we now callreferred pain) was first coined by three Americans; J. Ross (1881), Dana (1899) and Abrams (1904).

Together they distinguished between the differentialdiagnoses of visceral disease (which could be madeon the spinal column), when pain and sensitivity ofthe vertebrae is bilateral; and intercostal neuralgia,when it is unilateral. The first European reference toreferred pain was made by Sir Henry Head in 1893.


Ascending branch

Axon sensory neuron

Lateral branch

Interneuron

Descending branch

Axon motor neuron

Fig. 1.2 Intersegmental contralateral reflex arc, showing a sensory fibre splitting into ascending and descending branches that giverise to lateral branches which synapse with their respective interneurons (After Anthony & Thibodeau 1983, with kind permission of C V Mosby)


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Trigger points and kinetic chains

Trigger points were first described by Dr A. Weihein 1886 (Fig. 1.3). These are specific points on the skin

which become sensitive to pressure when an organ becomes diseased. There is a different pattern oftrigger points on the skin for each organ, anddiagnosis can be facilitated by palpating the triggerpoints to discover which are painful.

Although the concept had not then been developed,we now know that trigger points become painful alongkinetic chains. Kinetic chains are groups of muscleswhich are mobilised in the performance of anycomplex movement such as walking or talking, andform a pattern of use which is individual to each

person. Although we all use the same groups ofmuscles for similar activities, each of us walks andtalks distinctively. One of the best-known trigger pointslies at the tip of the right scapula, and is frequently thepresenting symptom when stones are forming withinthe gall bladder or when it becomes inflamed. In theearly stages of this condition mobilising the muscles ofthe right shoulder gives rise to pain, whilst in acuteconditions the pain arises suddenly and spontaneously,and can be severe and debilitating.

Today painful trigger points and the areas towhich their pain is usually referred are increasinglywell defined (Fig. 1.4). Travell & Simons (1983, 1992)demonstrated that there is a specific pattern of trigger

point pain referral for each muscle in the body. Therelationship of trigger points to internal organs andfunctions is emphasised today in treatment usingapplied kinesiology.

The routes by which pain is referred may provideinteresting clues as to why some pinpoint size reflexzones in the feet may be painful in specific conditions.When pain is referred from a myofascial trigger pointto a muscle, it causes painful spasm in that muscle.This can lead to the formation of painful secondarymyofascial trigger points, called satellites, which in

turn radiate their effect to still further distantmyofascial trigger points. It is just possible that thereflex zone at the junction of the scaphoid, talus andcuneiform bones becomes painful when there issacroiliac joint strain or pain because satellitemyofascial trigger points have become enmeshed in thenetwork of referred pain. The pain in the reflex zonerecedes as the spasm or strain on the muscle is relieved.

The existence of latent myofascial trigger points,which are not painful except on firm palpation, was


Fig. 1.3 Trigger points described by Dr Weihe in 1886 (From Gleditsch 1983, with kind permission of MBH & Co.)


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complexion as described earlier, but discretephysiological changes (see p. 12) occurring in thetemperature, sweat secretion and behaviour of hairson the skin resulting from projection within a givenspinal segment via the sensory motor system.

A reflex picture of disease noticed by Dr Voltoliniin 1883 involved a change in the consistency of nasalmucous membranes in pregnant women. Hesubsequently discovered other small but significantchanges in these membranes for other diseases. Yetthe first known European description of a smallarea of the body providing a mirror image of all itsorgans and structures was given by Dr W. Fliess in1893. In this depiction specific areas of the roof, floor,lower and middle musculature of the nosecorresponded to particular visceral organs (Fliess

1893, 1926).In 1893, Sir Henry Head, a neurologist working in

London (and who is remembered in Heads zones),was the first person to describe the reflex signs ofdisease, showing how any disturbance of internalfunction is quickly reflected to an external bodysurface, thereby giving notice of disorder. Accordingto Head, internal organs are not well supplied withpain receptors and when their function becomesimpaired they cannot transmit pain impulses toconscious areas in the brain. Instead, they send

urgent messages of discomfort to the related skin(dermatome) (see Fig. 1.6), subcutaneous tissues(sclerotomes) and muscles (myotomes) of thesegment to which they belong, and it is in these areasthat pain is first perceived.

For this reason the pain of pleurisy or of biliarycolic is first felt at the uppermost tip of the rightshoulder blade, and the warning signs of angina areperceived in the neck, left shoulder girdle or arm, andsometimes the stomach.

Heads zones are areas of:

reflex (distant) cutaneous (of the skin) hyperaesthesia (increased sensitivity) and hyperalgesia (diminished sensitivity to pain)

which result from visceral disease. He had already in1893 described the sensory nerve roots involved ineach segment of the body, and since then a definedarea of skin supplied by a spinal nerve has beencalled a dermatome (Fig. 1.6).


Cortex

9 2Thalamus

Hypothalamus

Prefrontalcortex

Descendinginhibitorypathway

Brainstem

Spine S p

i n o

t h a

l a m

i c t r a c t

Midbrain

OP

5HT

St

PAG

Greymatter

High thresholdmechanoreceptor

Pain receptorPainful scar

Skin

Acupuncture orother stimulus

RF

E N K

8

3

5

67

1

4

RF

A

C

ExcitatoryKey Inhibitory

Fig. 1.5 Diagram to illustrate the gate control theory of paincontrol and the serotonergic mechanism of acupuncture andmanual therapies. Thumb pressure or needling causes informationto be transmitted along A nerve fibres and then up the spine tothe thalamus (1 ), from where it is further projected up to thecortex (2 ) and becomes conscious. In the midbrain (hypothalamus)these axons give off a collateral branch (3 ) to the periaqueductal

grey matter (PAG). The PAG projects down to the brainstem (4)and this in turn sends serotonergic (5HT) fibres to special cells

called stalked cells (St) (5 ); these last cells trigger anenkephalinergic (ENK) mechanism (6 ) to prevent noxious (pain)information arriving along C fibres from skin nociceptors frombeing transmitted to cells deep in the spinal grey matter andthence up to the brain reticular formation (RF) (7 ). The PAG isalso influenced by opioid endorphinergic fibres descending fromthe hypothalamus (8 ) (OP = opioids), which in turn receives projections from the prefrontal cortex (9 ) (After Thompson &Filshie 1993, derived from Bowsher 1992 (see Fig. 11.3, p. 118),with kind permission of Oxford University Press)


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The researches in 1892 and 1893 of Dr (later Sir) J. Mackenzie, a colleague of Sir Henry Head, greatlyrefined the understanding of the segmentalorganisation of the body. A segment is that area of

skin, subcutaneous tissue and muscle which receivesits nerve supply from a particular level of the spinalcord (see Fig. 1.6). He described subcutaneous tissueand muscle which receives its nerve supply from a


C2

C6C5 C4

C5C6

C7C8

C6

S5S3

S2

S22

C4C5

C6

D2D2

D4

D5

D1

D1

D12

D10

D12

D12

L1

L1

L1

L3

L4

S2L5

L5

L55

L4

L4

L4

L2

L2 L3

L3

L3

L2

L2L1

L1

L5S1

S2S3

S4, 5 C7C8

6

D12

D12

D1

D1C7

C8C6

5

C3C3

C2 C2

C4

D2

C4C5

C6

C68

C7

C7

D1

D2

D2

L5S1

S1

S1S1

S1

S2

D2, 3

C2

C6C5 C4

C5C6

C7C8

C6

S5S3

S2

S2S2

C4C5

C6

D2D2

D4D5

D1

D1

D12

D10

D12

D12

L1

L1

L1

L3

L4

S2 L5

L5

L5L5

L4

L4

L4

L2

L2 L3

L3

L3

L2

L2L1

L1

L5S1

S2S3

S4, 5 C7C8

C6

D12

D12

D1

D1C7

C8C6

C5

C3C3

C2 C2

C4

D2

C4C5

C6

C6C8

C7

C7

D1

D2

D2

L5S1

S1

S1S1

S1

S2

D2, 3

Fig. 1.6 Dermatomes of the body, according to Head (From Gleditsch 1983, with kind permission of MBH & Co.)


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particular level of the spinal cord. He also describedwhich areas of muscle were innervated at any givenlevel within the spinal cord, since when they have been called myotomes. By testing for differentsensations on the skin, any delay or abnormality inperception enables the physician to decide whichnerve root is damaged, and at which level.

Between 1896 and 1921 Head and Mackenziedescribed the two directions in which impulsestravelled:

viscerocutaneous impulses carry informationfrom viscera to skin

cutaneovisceral impulses carry informationfrom the skin to the viscera

viscerovisceral pathways carry informationfrom one organ to another.

When the functions of an organ are impaired, analteration to the autonomically controlled functions inthe related segment follows. Sir James Mackenzie isalso remembered in Mackenzies point, which is apoint of tenderness in the upper segment of the rightrectus abdominis muscle which becomes present indisease of the gall bladder.

In the same way, but the reverse direction, afferentnerves carry impulses mediated by touch, heat,cold, massage, water, poultices and the like to theinternal organs. To obtain the desired effect, the rightstimulus has to be applied precisely to the rightplace, with due regard to its intention, strength andduration. These pathways are not under conscious orvoluntary control and, unless they are severed ordiseased, they appear as functioning pathways for alifetime.

The reflex signs of disease, mediated through theautonomic nervous system, can appear in anysegment, depending on the stage the illness hasreached, and are now recognised as follows:

in the skin, which becomes pale, cold andclammy, with the appearance of gooseflesh and araised dermatographia due to vasoconstrictionand flushing due to vasodilatation

in subcutaneous tissue, which becomes shiny,oedematous and dense; as the tension withinthe tissues increases they become less pliableand more difficult to roll because persistentvasoconstriction has adversely affected tissue

perfusion, leading to poor oxygen and nutrientsupply (trophic changes)

in the muscles, which become less contractile;their trigger points become sensitised owing totrophic changes

in the joints, with degenerative changesappearing in ligaments, capsule and cartilage,and reduction of synovial fluid leading topainful and restricted movement

in the organs, whose function becomes impairedas a result of reduced circulating blood andtissue fluids.

Such changes in the colour and texture of the skin, orsweating, are present from the earliest stages ofdisease, albeit that they are little noticed on cursoryexamination. These tissue changes may becomeirreversible if the disease process is not halted andreversed.

It is not understood why the workings of the bodyshould be reflected as a mirror image in the feet, norwhy there should be either changes in the skin orautonomic nervous system reactions when reflexzones in the feet are palpated if the organs to whichthey correspond are underfunctioning. (These are notthose zones described by Sir Henry Head, but theyare reflex signs of disease.)

Development of tissue layers

To understand why treatment should have such anorganised effect, we need to look at the developmentof the fetus. Before the somites develop, the embryo isformed of ectoderm and the disc-like endoderm(Fig. 1.7). Within the ectoderm a groove (called theprimitive streak) appears at what will be the tail end,and funnels towards the future head (Fig. 1.7a). Theembryo is now made up of two equal halves, each ofwhich will, from this point, be a mirror image of the

other. At the same time a cellular rod-shapedstructure, called the notochord, is formed at thecranial end of the primitive streak, and grows between the ectoderm and endoderm towards whatwill be the head (Fig. 1.7b). Mesoderm (from whichall future tissues are developed) then grows outfrom the sides of the primitive streak into regularlyarranged blocks called somites (or segments)(Fig. 1.7c), leaving the ectoderm and endoderm incontact with each other at just two places: the



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buccopharyngeal membrane and the cloacalmembrane. It is possible that the reason why thecentral and autonomic nervous systems can be soreadily influenced on this superficial surface of the body is the result in part of embryonic developmentin the first weeks of life.

The ground regulating system

Most recently Professor Pischinger has put forward atheory of how the physiological functions and biological tasks of connective tissue are organised, bringing about neurohumoral regulation via a systementitled the ground regulating system (GRS)

(see Ch. 2). Therapies such as acupuncture, shiatsu,massage, osteopathy and RZT, when applied to partsof skin and subcutaneous tissues whose structureand function show any departure from normal, areshown to strengthen the regulating capacity of thissystem.

The development of modern reflex zonetherapy

William Fitzgerald

Towards the end of the last century Dr WilliamFitzgerald, an ear, nose and throat (ENT) specialist


Neural plate(closing)

Forebrain

C

Midbrain

HindbrainFormed and

closedneural tube

Somites 110

Amniotic sac

Spinal cord

Chorionic villi

Primitive streak

Yolk sac

Ectoderm

Endoderm

Extraembryonicmesoderm

A

Fig. 1.7 Fetal development: A The primitive streak appears at the tail end of the ectoderm and begins to funnel its way toward the futurehead. B The notochord forms at the cranial end of the primitive streak and grows between the ectoderm and endoderm toward the futurehead. C Mesoderm grows out from either side of the primitive streak to form somites the future segments. The ectoderm and endodermremain connected at the buccopharyngeal and cloacal membranes.

Cloacalmembrane

Bucco-pharyngealmembrane

Notochord

Neural plate

Primitive streak

Yolk sac

B

Extraembryonicmesoderm


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from Connecticut, America, began to experiment withthe practice of zone therapy. He reported successfultreatment in a wide variety of complaints, and in1917, in collaboration with Dr Edwin Bowers, hewrote Zone therapy. This was the first publishedWestern book describing a particular kind of pressureapplied to skin or mucous membranes with theintention of relieving pain or symptoms at somedistance away from the point of pressure. (Prof.Henry Head (1893, 1920) and Dr Mackenzie (1893,1921) had both described successful treatment ofgastric and eye disturbances by the application ofmustard seeds and other poultices to the relatedsegmental trigger points as part of their great outputof medical writing.)

Dr Fitzgerald concentrated his treatment on parts

of the head, ears, nose, tongue and throat, as well asthe abdomen, hands and feet. His division of the body into 10 equal zones five on each side of amedian line running from the feet up to the head andacross the chest and back down to the hands, or viceversa from hands to feet, on both anterior andposterior aspects of the body (Fig. 1.8) providedthe original, simple framework by means of whichreflex zones to organs and structures could be relatedto one another and described within theirlongitudinal zones. His early diagrams drew a line

through the centre of each respective zone, with zone1 being closest to the midline, and zone 5 being themost lateral. The diagrams were later simplified,dividing the body into two equal halves at themidline, with 4 imaginary lines on either side, thusdividing each half of the body into 5 equal zones. Theconnections so postulated were empirical, having atthat time no known anatomical or physiological basis.

Joseph Riley, Eunice Ingham and Doreen Bayly

Dr Joseph S. Riley continued with and promoted thework of Dr Fitzgerald, refining specific points fortreatment in his book Zone therapy simplified,published in 1919. One of his pupils was theAmerican masseuse, Eunice Ingham. She appliedthose methods described by Drs Fitzgerald and Rileywhich did not demand their medical training, andfound that discomfort frequently accompaniedpressure to some areas of the feet. This discomfortwas not uniform, but varied according to the

constitution and complaints of the person beingtreated. In her book Stories the feet can tell (1938)were published the first descriptions of treatmentconfined to the feet. This was followed by a secondvolume: Stories the feet have told (1951). A pupil ofEunice Ingham, Doreen Bayly, popularised thetreatment in the UK in the 1960s.

Hanne Marquardt

In Germany, Hanne Marquardt, after training as anurse, developed in 1958 a keen interest in the resultsclaimed for compression massage touch/treatmentto the feet which had been made by Eunice Ingham,and she undertook a serious study of the subject. Byimposing Dr Fitzgeralds 10 longitudinal zones on to

the anatomical structure of the feet she enabled reflexzones to be located with greater precision. She alsodescribed and imposed three transverse zones: one atthe level of the shoulder girdle, one over the waistline and one at the level of the pelvic floor, andrelated them to anatomical landmarks on the feet(Fig. 1.9) (see also p. 16). (The longitudinal andtransverse zones were later combined into a zonegrid Fig. 1.10.) The early charts were amplified,with many new reflex zones on both dorsum and sole being added (Marquardt 1984, 1993).

Hanne Marquardt developed a remarkablecompetence in what she now termed reflex zonetherapy. Her more complete and organised depictionof the zone map on the feet has since been widelyacknowledged and used. She realised how closely thesmall seated human form in the feet reflected thecomplex, global totality of a person (Fig. 1.11). Herprofessional colleagues quickly acknowledged herability and skill, and at their request she began togive training courses in 1967. By 1985 there wereaffiliated schools in Denmark, Holland, Switzerland,

the UK, Israel, Spain, Italy and eastern, northern andwestern Germany. Physiotherapists, midwives, andnaturopathic, osteopathic and acupuncturepractitioners started to learn and practice RZT as anadjunct to their professional training.

Walter Froneberg

Walter Froneberg, who had been a pupil of MrsMarquardt, had a particular interest in the nervous



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system. His work on people in whom there had beendamage to nerve pathways led him to the discoveryof several reflex zones to motor nerves and majormuscle groups. In his continuing practice over the

next decade he identified reflex zones to theautonomic nervous system, uterine supports, andmuscles of the eyes and teeth. His work gave rise by1980 to a form of treatment, manuelle neurotherapie


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1 2 345

1

2345 1

2 3 45

Midline

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1 2 345

11 22 33 44

The body is dividedinto two equal halves

at the midline

Shoulders

Waist

55

1

2345 1

2 3 45

Midline

Pelvic floor

Fig. 1.8 The 10 longitudinal body zones according to Dr W. Fitzgerald


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(manual neurotherapy), which could be used whennerve pathways were maimed or functionallyimpaired.

Present state 1980onwardsReflexology in any of its variant forms has always

been widely used in the Far East. It is increasinglyused in the Americas, in India and in Europe, whereit has become considerably better known over thepast 30 years. In Western Europe, RZT has over thepast 40 years been taught to people who already havea professional training in the care of the sick, andcontinues to be valued by givers and receivers.Properly used, it enhances other treatments, and maydiminish the need for medicines. Over the past threedecades there has been a gradual incorporation of

complementary therapies into nursing,physiotherapy, midwifery and occupational therapypractice. The bodies which regulate these professionsallow the use of complementary therapies, butdemand that practitioners:

are well taught are personally accountable in all circumstances are able to justify their choice of therapy,

whether orthodox or complementary, and avoid any abuse of their privileged relationship

with patients.

To date, however, the practice of RZT and reflexologyis unregulated. An individual is generally protectedunder the common law of England (it was KingAlfred ( c AD893) who first decreed in his Book oflaws, or dooms, What ye will that other menshould not do to you, that do ye not to other men)against ignorance and malpractice from anyoneprofessing to give care. There is not, as yet, anylegislation by a national or international body to:


Shoulder girdle

Waist line

Pelvic floorand hip joint

Plantar view Dorsal view

Fig. 1.9 The three transverse zones in the feet (After Marquardt 1984, reproduced with kind permission)


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Dorsal view Plantar view

Medial view

Lateral view

Pelvic girdle

Pelvic girdle

Waist line

5 43 2

1

Shoulder girdle

Shoulder girdle

Waist line

Waist line

Shoulder girdle

Shoulder girdle

Waist line

Pelvic girdle

Pelvic girdle

5

43

2 1

5

4

3

2 1

Fig. 1.10 Zone grid (right foot only shown) (After Marquardt 1984, reproduced with kind permission)


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lay down commonly recognised standards ofpractice

organise a syllabus oversee its teaching

arrange for the examination and licensing ofsuccessful candidates

allow them to practise as long as agreedstandards are maintained

make provision for complaints from the publicand

discipline any person found to be negligent intheir duty towards those for whom it professesto care.

Tentative steps are being taken towards setting upsuch a body. A national consensus on the content of

the syllabus, length of training and form ofapprenticeship or experience learning undersupervision has still to be reached.

Of the Western European countries reflexologyappears to be most widely used in Denmark, where40% of the population are known to have hadexperience of the therapy. Since 1977 a number ofshort studies to examine and document the effects of

reflexology have been made by the DanishReflexologists Association (Eriksen 1993, Feder et al1988, Johannessen 1993, 1994, Launso 1993).

In the UK the oncology department atHammersmith Hospital in London was one of thefirst to practice, in an orthodox setting,complementary therapies which had been pioneeredat the Bristol Cancer Centre. A recent survey showsthat the services most in demand are for reflexologyand massage (Bell 1996, Burke et al 1994).

In London, The Royal London HomeopathicHospital, Mount Vernon and the Royal MarsdenHospitals were in the vanguard, being soon followed by other hospitals and hospices nationwide. Manysupport groups and day care centres have foundthat a balance of allopathic and complementary care

is helpful, whether by lessening the need for drugssuch as inhalers, laxatives, muscle relaxants andsedatives, or by more effective pain and symptomrelief.

However, RZT is not only for those suffering fromcatastrophic illness and trauma. It is increasinglyused in individual physiotherapy, maternity,intensive care, specialist units and general wards,where nurses, physiotherapists and midwives have been working to discover where, when and how itshould most usefully be given.

ConclusionNeither RZT nor any of the complementary therapiesare at the cutting edge of modern Western medicine.Their place is not in accident and emergency units,operating theatres or research laboratories. Theirplace is rather in the community, to build up apersons resilience, to detect early any changes in

well-being, to foster recovery in illness, alleviatediscomfort, pain and infirmity, and to complement allother care.

If the claims made for RZT are not tooextravagant, if it is appropriately used and if itspractitioners do not pretend to a knowledge whichthey do not have then it will have more to offer inthe future.


Fig. 1.11 Diagram showing the miniaturised sitting human formreflected in the reflex zones in the feet (Reproduced with kind permission of Hanne Marquardt)


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Abrams A 1904 The concussional vertebral reflexes.American Medicine Publishers, Philadelphia, pp 115118

Alfred the Great c AD893 Dmbc (doom or judgement book).Quoted in Hodgkin R H A history of the Anglo Saxons, 3rdedn, vol 1. Oxford University Press, Oxford, pp 59, 67

Anthony C P, Thibodeau G A 1983 Textbook of anatomy andphysiology, 11th edn. C V Mosby, St Louis, pp 238239

Baas J H 1889 History of medicine. J H Vail, New York, p 138Baldry P E 1998 Trigger point acupuncture. In: Filshie J

White A (eds) Medical acupuncture: a Western scientificapproach. Churchill Livingstone, New York, p 38

Burke C, Macnish S, Saunders J, Gallini A, Warne I,Downing J 1994 Clinical oncology, the development of amassage service for cancer patients. The Royal College ofRadiologists 6:381385

Bell L 1996 Complementary therapies and cancer care.Complementary therapies in nursing and midwifery2:5758

Dana C L C 1899 In: Baker W M, Harris V D Handbook ofphysiology, 15th edn, revised by Coleman W, Dana C L.William Wood, New York, pp 559566

Eriksen L 1993 Reflexology and research. DanishReflexologists Research Association Research Committee,Vallensbaek

Feder E, Liisberg G, Lenstrup C, Roseno H, Taxbol D 1988Reflexology in relation to birth. Danish ReflexologistsAssociation Research Committee, Vallensbaek

Fitzgerald W H, Bowers E F 1917 Zone therapy. I W Long,Columbus

Fliess W 1926 Nasale Fernleiden. Deutsche Verlag, LeipzigFliess W 1893 Die nasale Reflexneurose. Bergman, WiesbadenFroneberg W 1980 Reflexzonentherapie: Nerven, Muskeln,

Statik, Bewegung. Eigenverlag W Froneberg, Mnchen-GladbachGleditsch J M 1983 Reflexzonen und Somatotopien als

Schlssel zu einer Gesamptschau des Menschen. W B VBiologisch-Medizinische Verlagsgesellschaft, MBH & CoKG, Schorndorf

Griffin W, Griffin D 1834 Observations on functionalaffections of the spinal cord and ganglionic systems ofnerves, in which their identity with sympathetic, nervousand imitative diseases is illustrated. Burgess and Hill,London, pp 147168, 201202, 212215

Griffin W, Griffin D 1845 Medical and physiologicalproblems being chiefly researches for correct principles oftreatment in disputed points of medical practice, 8 vols.Sherwood, Gilbert & Piper, London, pp 6073

Hall M 1833 On the reflex function of the medulla oblongataand spinalis, on the principle of tone in the muscularsystem. Abstracts of the papers printed in thePhilosophical Transactions 18801884 (18301837): 210

Hall M 1836 Lectures on the nervous system and itsdiseases. Sherwood & Piper, London

Hall M 1838 Lectures on the nervous system and itsdiseases. W. Taylor, London

Hall M 1839 Extract from a lecture on the nervous system. JMallett, London

Hall M 1842 On the mutual relation between anatomy andphysiological pathways in therapeutics and in the practiceof medicine. Baillire, London

Hall M 1850 A synopsis of the spinal system. Lancet1:469472, 495496, 521522, 554557

Head H 1893 On disturbance of sensation with especialreference to the pain of visceral disease, part 1. Brain16:1133, 127

Head H 1894 On disturbance of sensation with especialreference to the pain of visceral disease, part 2. Brain17:339480

Head H 1920 Disorders of sensation in the skin arising fromvisceral disease. Studies in Neurology. Oxford UniversityPress, London, p 328

Head H, Rivers W, Sherren J 1905 The afferent nervoussystem from a new perspective. Brain 28:99115

Hodgkin R H 1952 A history of the Anglo Saxons, 3rd edn,vol. 2. Oxford University Press, Oxford, p 602

Ingham E 1938 Stories the feet can tell. Ingham Publishing,New York

Ingham E 1951 Stories the feet have told. Ingham PublishingNew York

Johannessen H 1993 Reflexology in Denmark anoverview. Danish Reflexologists Association ResearchCommittee, Vallensbaek

Johannessen H 1994 The hologram approach to reflexology.Danish Reflexologists Association Research Committee,Vallensbaek

Johnson T 1897 The Swedish system of physical educationin medical and general aspects. Wright, Bristol

Launso L 1993 A description of reflexology practice andclientele in Denmark. Danish Reflexologists AssociationResearch Committee, Vallensbaek

Ling P H 1859 Lings educational and curative exercises, 3rdedn. Baillire, London

Lloyd G E R (ed) 1978 Hippocratic writings. Penguin,Harmondsworth. First published 1950 by Blackwell,Oxford

Mackenzie J 1892 Cutaneous tenderness in visceral disease.Medical Chronicle. John Heywood, London, XV: 302

Mackenzie J 1893 Some points bearing on the associationof sensory disorders and visceral disease. Brain16:321354

Mackenzie J 1909 Symptoms and their interpretations. Shawand Son, London, pp 37, 68

Mackenzie J 1920 Symptoms and their interpretations, 4thedn. Shaw and Son, London, pp 4856, 7483

Mackenzie J 1921 The theory of disturbed reflexes in theproduction of symptoms of disease. British Medical Journal Jan 29:143147

Marquardt H 1984 Reflex zone therapy of the feet, 1stEnglish edn. Thorsons, NorthamptonMarquardt H 1993 Praktisches Lehrbuch der

Reflexzonentherapie am Fuss. Hippokrates Verlag GmbH,Stuttgart

Melzack R, Wall P D 1965 Pain mechanisms: a new theory.Science 150:971979

Northrup G W 1979 Osteopathic medicine an Americanreformation. American Osteopathic Association, Chicago,p 45

Plato c 375BC Timaeus, with an English translation by Rev. GBury, 2nd edn, 1942. William Heinemann, London,pp 241243


References


19/19

Porter R 1997 The greatest benefit to mankind. FontanaPress, London, pp 51, 5564

Rasmussen et al. 1988 Danish Reflexologists AssociationResearch Committee, Vallensbaek

Riley J S 1919 Zone therapy simplified. Health Research,Mokelumne Hill, CA

Ross J 1881 A treatise on diseases of the nervous system.Churchill Livingstone, New York pp 2961Singer C, Underwood E 1962 A short history of medicine,

2nd edn. Clarendon Press, Oxford, pp 2741Sola A E, Kuitert J H 1955 Myofascial trigger point pain in

the neck and shoulder girdle. North West Medicine54:980984

Still A 1902 The philosophy and mechanical principles ofosteopathy. Hudson Kimberly, Kansas City, p 121

Thompson J W, Filshie J 1993 Tens and acupuncture. In:Doyle D, Hanks G, MacDonald N (eds) Oxford textbookof palliative medicine. Oxford University Press, Oxford,ch 428

Travell J G, Simons D G 1983 Myofascial pain anddysfunction. The trigger point manual, vol 1. Williams &Wilkins, Baltimore

Travell J G, Simons D G 1992 Myofascial pain anddysfunction. The trigger point manual, vol 2. Williams &Wilkins, Baltimore

Voltolini R 1883 Der Krankheiten der Nase und desNasenrachenraumes: nebst einer Abhandlung berElektrolyse fr Spezialisten, Chirurgen und praktischeAertzte. E Morgenstern, Breslau, pp 521

Weihe A 1886 Zeitschrift d. Berliner Vereinshomoop. ArzteV, Berlin, pp 206244

Whytt R 1765 Observations on the nature, causes and cureof those disorders which have previously been callednervous, hypochondriac or hysteric, to which are prefixedsome remarks on the sympathy of the nerves. T Becketand P A de Hondt, Edinburgh

Whytt R 1768 The works of R Whytt. T Becket and P A deHondt, Edinburgh, pp 229266


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