Marma (मर्म)

INTRODUCTION

Marma or Marma sthana or the vital points is one of the important as well as exclusive topic in Ayurveda. The importance is vast and broad spectrum when it comes to healing wounds, curing various ailments and if not protected can cause death or serious damage as well. The fundamentals of the knowledge of Marma dates to Rigveda, Upanishads, and Purana’s. The knowledge of marma was being widely used during a war, for self- defence, surgical procedures, therapeutically etc ever since the Vedic period.  

Marma in literal translates to a vulnerable point. A spot or an area in the human body which if hit or damaged can cause death, and as part of therapy used in treatment of various ailments. Knowledge of marma is a quite distinctive aspect of therapy in not just Ayurveda Samhita’s, but in puranas, Veda’s and Upanishad’s as well.

History|Itihaasa

Practice of marma therapy has been mentioned in various Vedic texts alongside Ayurveda.

Rigveda, one of the oldest Vedic Sanskrit texts composed during 1500 – 1000 BCE has mentions of varma or shield or body armour used for protection of marma points. (Rigveda 6/75/18). Few Upanishads like Shandily upanishad,

Garbh Upanishad, Kshurik Upanishad provides information about the concept and anatomical aspects of marma points. Agni purana mentions 10 locations of marma where the Prana (?) resides. In Valmiki Ramayana there are few verses during war wherein there is mention of marma points being used as target for injury. In Mahabharata during the (Bhishma Parva) 114/56, 119/5, 119/47, 119/61, 119/65) (48), (Drona Parva 92/7, 92/22), (Karna Parva 19/61),

(Shalya Parva 32/63, 36/64) has many references about protective shields used to cover marma sthana of both humans and animals.

There is a traditional and the oldest martial art form of India named Kalari which describes 365 marma points. The kalari warriors used this knowledge to harm their enemies. Also, they were nurtured using the same technique for healing wounds of the battle.

Definition| Paribhasha

मारयन्तीति मर्माण्युच्यन्ते – Sush Shar 6/3 (dalhan teeka)

Meaning - Marma points are the vital points in the human body which when injured can lead to death.

(Asht.hrud.sha. arundatta teeka)

Also, if injury to marma sthana or point does not cause death, then it causes severe pain giving a person the experience of death.

मर्माणि मांससिरास्नाय्वस्थिसन्धिसन्निपाताः;

तेषु स्वभावत एव विशेषेण प्राणास्तिष्ठन्ति; तस्मान्मर्मस्वभिहतास्तांस्तान् भावानापद्यन्ते || (sush. sha .6.15)

A confluence of mamsa (muscles), sira (blood vessels), snayu (ligaments), asthi- sandhi (bones-joints) is known as marma sthana. These marma sthana is where prana(?) resides, thus any kind of injury or infliction will lead to death.

Sush sha 6.35-36

At the elemental level marma is composed of Soma (kapha-water element), maruta(vata- or air element), tej(pitta -or fire element) as tridosha and raja, satva , tamas as triguna resides along with bhuta(panchamahabhuta) and atma (soul precisely). This is precisely the reason why marma points should be protected from any injury.

दश प्राणायतनानि; तद्यथा- मूर्धा, कण्ठः, हृदयं, नाभिः, गुदं, बस्तिः, ओजः, शुक्रं, शोणितं, मांसमिति|

तेषु षट् पूर्वाणि मर्मसङ्ख्यातानि||९|| cha sha 7.9

Also, according to acharya Charaka there are 10 seats of prana (energy points) which are murdha(head), kantha(throat), hriday(heart), naabhi(umbilicus), guda(anus), basti(urinary bladder), ojas(?), shukra(semen), shonita(blood), mamsa(muscles) and among them the first six are the marma points.

Even though the definition states that injury to a marma leads to death, but there are certain types of marma like vaiklyakara marma and rujakar marma for example wherein with right treatment of a skilled Vaidya, an individual can be saved.

Classification|Pravibhaga

There are 107 marmas described in Ayurveda. Acharya Charaka whereas gives importance to three mainly, named Murdha(head), hriday(heart), Vasti/Basti (urinary bladder).

Whereas Acharya Sushruta has categorised 107 marma sthana systemically in three ways,

Every marma has its own predominant mahabhuta, which later is essential in the treatment aspect.

1.   Composition of the marma (sush.sha.6.3-5)

Mamsa Marma (Muscle predominant) - 11

Sira Marma (Vascular predominat) - 41

Snayu Marma (Ligament predominant) - 27

Asthi Marma (Bone area predominant) - 08

Sandhi Marma (Joint area predominant) – 20

2.   Location of Marma (sush. shar.6.7)

Shakha gata - marmas present in Both upper and lower limbs - 44

Madhya shareera – Marmas present in thorax and abdomen (trunk region) - 26

Urdhva jatrugata – marmas present in Head and neck region – 37

3.   According to effect of injury on marma

Sadhya pranahara marma – leads to immediate death on injury to these marma sthana, where “sadhya” meaning instant, “prana” meaning life forec or energy, and “hara” meaning lost or taken away. – 19 in number

Kalantara pranahara marma – leads to delayed death on getting injured. Here kalantara” means delay.  – 33 in number

Vishalyaghna marma- marma injured with foreign body, when removed from the area leads to death. Here “vishalya” means foreign body – 03 in number

Vaikalyakara Marma – leads to permanent deformity on injury. Where Vaikalya” means disability - 44 in number

Rujakara marma – leads to severe pain when injured. here “ruja” means pain. –  08 in number

Sadhya pranahara marma	Kalantara pranahara marma	Vaikalyakar marma	Vishalyaghna marma	Rujakara marma
Shrungatak(4)	Vaksha (8)	Lohitaksha(4)	Utsksepa(2)	Gulfa(2)
adhipati	Seemant (5)	Aani(4)	sthapani	Manibandha(2)
Shankha(2)	Talahriday(4)	Urvi(4)		Kurchashira(4)
Matukayen (8)	Kshipra(4)	Kurcha(4)
Guda	Indrabasti(4)	Jaanu(2)
Hruday	Katiktarun(2)	Vitapa(2)
basti	Parshavasandi(2)	Kurpara(2)
naabhi	Nitamb(2)	Kukundara(2)
	Bhrihati(2)	Kakshadhara(2)
		Vidhura(2)
		Krukatika(2)
		Amsa(2)
		Phalaka(2)
		Apanga(2)
		Neela(2)
		Manya(2)
		Phana(2)
		Avarta(2)

Marmas of upper extremity

Name	Location	Pramana	Composition	Mahabhuta predominance
kShipra	In between thumb and index finger	½ angula	Snayu and kalantara pranahara	Soma,agni
Talahriday	Mid palm	½ angula	Mamsa and kalantara pranahara	Soma,agni
Kurcha	Above on both sides of kshipra	4 angula	Snayu and vaikalyakara	Soma
Kurcha sshira	Below on one side of wrist joint	½ angula	Snayu and vaikalyakara	Soma
Manibandha	Wrist joint	2 angula	Sandhi and vaikalyakara	Soma
indrabasti	Mid of forearm	2 angula	Mamsa and kalantara pranahara	Soma,agni
kurpara	Elbow joint	3 angula	Sandhi and vaikalyakara	Soma
AAni	3 angula above elbow joint both sides.	3 angula	Snayu and vaikalyakara	Soma
Bahvi	Mid arm	½ angula	Sira and vaikalyakara	soma
Lohitaksha	Above bahvi marma, adjacent to auxillary fold.	½ angula	Sira and vaikalyakara	Soma
kakshadhara	In between chest and arm pit	½ angula	Snayu and vaikalyakara	soma

Marmas of lower extremity

Name	Location	Pramana	Composition	Mahabhuta
kShipra	Between great toe and second toe	½ angula	Snayu and kalantara	Soma,agni
Talahriday	Mid of the foot sole	½ angula	Mamsa and kalantara pranahara	Soma,agni
Kurcha	Above both sides of kshipra	4 angula	Snayu and vaikalyakara	Soma
Kurcha sshira	Both sides of ankle joint	1 angula	Snayu and vaikalyakara	Soma
Gulfa	Ankle joint	4 angula	Sandhi and rujakara	Agni,vaayu
Indrabasti	Mid of thigh in the line of heel	½ angula	Mamsa and kalantara pranahara	Soma,agni
Jaanu	Knee joint	3 angula	Sandhi and vaikalyakara	soma
Aani	3 fingers above knee joint both sides	½ angula	Snayu and vaikalyakara	soma
Urvi	Mid of thigh	1 angula	Sira and vaikalya kara	soma
Lohitaksha	Root of thigh above urvi marma, below hip joint	½ angula	Sira and vaikalyakara	soma
vitapa	In between groin and testes	1 angula	Snayu and vaikalyakara	somas

Marma sthana of head and neck

Name	Location	Pramana	Composition
Nilamanya  (4)	High up in neck either side of trachea	4 angula	Sira and vaikalyakara	soma
Matrukay(8)	Anterior external, post external jugular veins and common facial veins	4 angula	Sira and sadhya pranahara	Agni
Krukatika(2)	Junction of head and neck	½ angula	Sandhi and vaikalyakara	soma
Vidhura(2)	Below and behind the ear	½ angula	Snayu,sira, vaikalyakara	somas
Phana(2)	Both nasal passage near the roof of nose	½ angula	Sira, vaikalyakara	soma
Apanga(2)	Lateral end of eyebrows	½ angula	Sira, vaukalyakara	soma
Avarta(2)	Above and below eyebrows	½ angula	Sandhi, vaikalyakara	soma
Utskhepa(2)	Above temple	½ angula	Snayu vishalyaghna	vayu
Shankha(2)	In between ear and forehead	½ angula	Sandhi, sadhya pranahara	agni
Sthapani	In between eyebrows	½ angula	Sira, vishalyaghna	vayu
Seemanta (5)	5 joints in skull vault	4 angula	Sandhi, kalantara pranahara
Shrungatak(4)	Venous junction of nose, ear, eyes, tongue	4 angula	Sira, sadhya pranahara	agni
adhipati	Inside cranium	½ angula	Sandhi and sadhya prana hara	agni

Marmas of the abdomen region

Name	Location	Pramana	Composition	Mahabhuta predominance
Guda	Anal region	4 angula	Mamsa and sadhya pranahara	agni
Basti/vasti	Bladder	4 angula	Snayu, sadhya pranahara	Agni
Naabhi	umbilicus	4 angula	Sira and sadhya pranahara	Agni

Marmas of the thorax region

Name	Location	Pramana	Composition	Mahabhuta predominance
hridaya	heart	4 angula	Sira, sadhya pranahara	Agni
Stanamula(2)	Bilaterally two fingers below the Stana (breast)	2 angula	Sira, kalantara pranahara	Soma, agni
Stanarohita (2)	Two fingers above the Nipples of both the Stana Granthi	½ angula	Sira, kalantara pranahara	Soma,agni
Apasthamba (2)	Both sides of chest	½ angula	Sira, kalantara pranahara	Soma, agni
Apalapa (2)	Both axillary region	½ angula	Sira, kalantara pranahara	Soma,agni

Marmas of back region

Name	Location	Pramana	Composition	Mahabhuta predominance
Katiktaran(2)	Both side of vertebral column to each hip bone	½ angula	Asthi, kalantara prana hara	Soma,agni
Kukundara(2)	Lateral side of each femur	½ angula	Sandhi, vaikalyakara	soma
Nitamba(2)	Above hip bone each side	½ angula	Asthi, kalantara pranahara	Soma,agni
Parshavasandhi(2)	Gluteal region joining lower part of two flanks	½ angula	Sira, kalantara pranahara	Soma,agni
Brihati (2)	Base of each breast	½ angula	Sira, kalantara pranahara	Soma,agni
Amsaphalaka(2)	Near scapular region each side of vertebral column	½ angula	Asthi, vaikalyakara	soma
Amsa(2)	In between scapular region and shoulder	½ angula	Snayu, vaikalyakara	soma

Measurement of marmas|Pramana

Urvi, kurchashira, vitapa, kakshadhara, parshva and stana moola each measure 1 angula.

Manibandha and gilfa marma are 2 angula each.

Kurpara and jaanu marma are 3 angula each.

Hriday, basti,kurcha, guda , naabhi, shira are 4 angula.

Shrungataka measures 5 angula.

Seemant and 12 marmas of head and neck region are mushti pramana.

Other remaining marmas measure ½ angula.

(Here Anguli pramana is “swa anguli pramana” meaning length equal to the transverse length of one’s own middle phalanx (middle segment of bone) of middle finger.)

Indicators of marma sthana injury| marma abhighata lakshanas

There are certain symptoms which indicate injury to marma sthana. These symptoms occur when any of the marma is inflicted and are essential for a Vaidya to plan further treatment.

Such as when sadhya pranahara marmas are injured, there occurs inability to perceive objects, alterations in intellect and various kind of pain in and around the marma sthana.

When kalantara pranahara marma is afflicted, dhatu kshaya (depletion of sapta dhatus) occurs along with severe pain which further leads to death of the individual.

(sush.su.25.34-35) Asht.sang.7.47

There are few general indicators of marma abhighata or infliction to marmas which are bhrama(dizziness), pralapa(delirium), pramoha(insensibility), vicheshtana (irregular movements), murcha(giddiness), muscular laxity(looseness), severe pain, bleeding from the sthana etc. Also, Numbness of body, heaviness, cold flushes, excessive sweat, vomiting, breathlessness are few symptoms which indicate there has been a n injury to marma.

Importance| mahatva

Cha sidd 9.3

The trauma or injury occurred to any part of body is comparatively less than that experienced on marma sthana, this is due to presence of Chetana (consciousness/soul) at that sthana or site.

Marma sthana or the vital points are to be kept intact while performing surgeries meaning they should not be injured. (sushrut Samhita 6.31)

The whole and excellent knowledge of marma is as good as half knowledge of Shalya Tantra (surgery). Vaidya who tries to treat the patient with marma sthana injury can only be saved with a disability. Sush.shar. 6.34

There is a concept of disease pathways Ayurveda called as rogamarga which are three in number namely, shakha (periphery), marma-asthi-sandhi (vital spots and bones and joints) and koshta (internl organs). Here the middle pathway is Marma sthana. This makes marma important in disease manifestation, diagnosis and in treatment aspects.

The knowledge of marma is an important aspect in the study of ayurvedic anatomy or Shareera Rachana. Anatomy of marma sthana helps give a broader scope and understanding while treatment of injuries and especially surgical procedures.

Marma and Acupressure  

Acupressure is an ancient and traditional Asian healing therapy technique developed 5000 appx years ago. In this therapy specific points are applied gentle pressure to release the tension in muscles which increases circulation and relieves pain. This paves way for appropriate flow of energy in the bodily channels.

Acupressure is based on meridians (routes of psychic energy), 12 in number which are assessed differently, and the cumulative result was developed as acupressure and other Oriental medical practices like Shiatsu, Moxibustion, tsubo etc.

There is usage of certain kind of rhythm and pressure for stimulating the points, using not only the fingers, but also the hands, arms, legs and even feet. Acupressure Points have a high electrical conductivity at the surface of the skin, and thus conduct and channel healing energy most effectively. Therefore, the most potent healing energy work uses acupressure points.

Though these kinds of therapy look like Marma therapy, but marma therapy Is far more accurate, ancient and the sthanas (points) have much more importance than being just pressure points. Marma therapy is performed by skilled Vaidya and under standard protocols.

https://mrityunjaymission.org/marma-and-acupressure/

https://www.boloji.com/articles/49656/marma-and-acupressure

Therapeutic Applications

Cha.si.9.7

Marmas are to be protected from various injuries because that aggravates vata dosha in the body and that aggravates pitta and kapha dosha as well. Thus, basti karma (enema therapy) the prime treatment for vata dosha imbalance is given as marma therapy.

When marma present in the murdha (head region) or shiras as a marma according to Acharya charaka is afflicted, abhyanga (oil massage), swedana (fomentation therapy), upanaha (poultice therapy), snehapana(internal fats like ghee,oil etc administration), nasya (nasal administration of oil) especially avapidana (nasya with churna) and dhumapana (nasya with medicated smoke) are administered as therapy.

When vasti or basti is afflicted which is one of the sadhya prana hara marma (present in trunk region) kumbhisweda which is precisely an under bed sudation, described in [Cha.Sa.Sutra Sthana 14/56-58] is given. Varti prayoga is done (urethral suppository), niruha and Anuvasana basti therapy (decoction enema and medicated oil enema) and Uttara basti (urethral route enema) therapy.

Abhyanga therapy in marma chikitsa aspect is one mildly similar therapy which resembles acupressure. Abhyanga (oil massage), udvartana (massage technique with medicated powders), massage with herbal paste, kizhi (massage done with palm, wrist, heel) or along with herbal pottali (poultice) are done skilfully with accurate pressure for required results and are few prime therapies for treatment in marma sthana injury.

Agni karma is done in marmas which are predominant in Agni Mahabhuta for example sadhya pranahara marma. Precisely a method wherein a heated shalaka(long instrument) is used as a medium of agni, and applied on the skin surface level skilfully by a Vaidya in a standard procedure. For example, Agni karma in Katiktaruna marma for treatment of sciatica. Jaanu mama for knee pain, manibandha marma for wrist pain etc.

Shirodhara which in short means pouring medicated oil from a certain height over sthapani marma (marma of the head region). Also, a broad spectrum panchakarma procedure which has various advantages in different diseases.  

These techniques are to be done in a standard procedure by a skilled Vaidya only.

There are few research studies as well carried out which proves the efficacy of various marma therapy. Hrudbasti(oil retention and oil pouring) over the marma sthana, greevabasti(retention of oil over cervical region), kati basti(retention of oil over low back area) and many more like abhyanga (oil massage) as well, with certain skill which applies pressure over marma sthana.