Marma (मर्म)

The word Marma (Samskrit - मर्म/मर्मन्)means any vulnerable point or core point of something. In reference to human body marma indicates a vulnerable point in the body which upon injury or damage by any external force can lead to sudden ill health or even death. The level of damage depends upon various factors like the type of marma, intensity of injury and the site of damage and its distance from the marma point. According to Ayurveda, Marmas are the points where the life energy is predominantly present. Hence damage to marmas can also lead to death. Therefore Ayurveda treatises discuss in depth about various types of marmas, there composition, effects of damage to all different types of marmas etc.

परिचयः॥ Introduction

Marma or the vital points is one of the important and exclusive topic discussed in Ayurveda. The references for the fundamentals of knowledge about Marma can be traced back to Rigveda (ऋग्वेदः), Upanishads (उपनिषदः) and Puranas (पुराणाः). The knowledge of marma was being widely used during a war to target enemies, for self-defence, for surgical procedures and also as a treatment modality ever since the Vedic period.  The importance of marma from diagnostic and therapeutic perspective is huge. When certain type of marma is affected, specific signs and symptoms arise and making use of this feature a therapy is developed where controlled pressure on these points is created to activate the energy concentrated at these points. This can relieve the probable blocks in the energy pathways linked with marmas in body and help get rid of certain symptoms like pains, aches and disabilities. This is called as marma therapy and it is practiced in may parts of Bharata and outside Bharata as well. It is a modality of treatment which does not require any herb or drug and hence it is widely popular. Some people compare it with that of acupressure therapy from Traditional Chinese

medicine but both these are significantly different. To practice marma therapy, in depth knowledge of marmas is essential. 'Marmaparipalanam' (मर्मपरिपालनम्) i.e. protection of marmas is equated to the selfcare or self protection in Ayurveda.

इतिहासः॥ History

The knowledge of marmas had been acquired by not just the worriers of ancient time in Bharata but also devatas since time immemorial. The original description of marma is found in the rigveda where Indra (इन्द्रः) is said to have used an ayudh (आयुधम् weapon) named Vajra fight demon Vratra (वृत्रः). The asura was killed by Indra's vajra when it was targeted on the marmasthana of vratra located in between his shoulders. Rigveda mentions of varma or shield or body armor used for protection of marma points. Few Upanishads like Shandilya upanishad, Garbha Upanishad, Kshurik Upanishad provide information about the concept and anatomical aspects of marma points. Agni purana mentions 10 locations of marma where the Prana reside. Fire (agni) was used as the greatest weapon to injure the marmasthanas in wars. The great Indian epics mahabharata and bhagavata gita describe that elephants, horses and soldiers wore varma (वर्म) to protect marma (मर्म) points. Arjuna and Karna were only vulnerable to be killed through marma exposure. There are also references about death of Shravan kumara (श्रवणकुमारः), Ravana (रावणः), Shreekrishna (श्रीकृष्णः) happening due to injury to vital marma points.

The story of Shravana kumara, Ravana and Shrikrishna

Shravana kumara took hi parents to the pilgrimage on their wish. While on journey once the parents were thirsty and wanted water. So Shravana took rest and went near the river to get some water for them. King Dashratha (दशरथः), father of lord Rama was on hunting that time and was chasing an animal. That time he thought that the animal is near river and hence aimed at it but unfortunately it was shravana kumar. The arrow hit his forehead at a point known as Sthapani marma (स्थपनी मर्म). The peculiarity of this marma point is that, if this marma is hit by a weapon then it should not be removed or else the person may die while if it is kept at that time the person survives (विशल्यघ्न मर्म Vishlyaghna marma). On realizing that the arrow has inadvertently hit Shravan kumara, in guilt king Dasharatha removed the arrow from the point and Shravana kumara died. Thus knowledge of marmas was considered highly essential.

Similarly there are references in epics that Ravana died only when the arrow targeted by lord Rama hit Ravana's Nabhi (नाभी)and not by any other method. Nabhi is naval which is considered to be one of the Sadyapranahara marma (सद्यप्राणहर मर्म) . It is known in marma science that when such type of marma is hit it immediately causes death.

The kshipra marma (क्षिप्र मर्म) is known as Kalantara pranahara (कालन्तरप्राणहर मर्म) type of marma. It means that an injury to this type of marma leads to death within few days of hit. The legend is mentioned that when lord shree krishna was resting in a jungle reclining on a tree bark, a hunter saw lord krishna's feet and it appeared like a rabbit to him from distance. Considering it a prey his arrow hit the point of lord krishna's feet and it was the ksipra marma. Owing to this marma injury, in few days lord krishna left to heavenly abode.

Ramayana and Mahabharata

In Valmiki Ramayana there are few verses during war wherein there is mention of marma points being used as targets for injury. In Mahabharata there are multiple references where one can find the use of protective shields used by worriers and animals for protection of marma points during war.

निरुक्ती॥ Nirukti

मर्म्म, [न्] क्ली, (मृ + “सर्व्वधातुभ्यो मनिन् ।”

उणा ० ४ । १४४ । इति मनिन् ।) स्वरूपम् ।

तत्त्वम् । जीवस्थानम् । Shabdakalpadruma Pg 641

The word marma is derived from the root 'Mru' (मृ) which means to die. Thus the vital points of body which can lead to death on damage are called as marmas.

परिभाषा॥ Definition

The term marma is defined by Acharya Sushruta in Sushruta samhita in following way,

• On the basis of potential to cause death- The points in body which when injured can lead to death are called as Marmas. The commentator Arundatta on acharya Vagbhata’s Ashtnaga Hrudayam says that, even if injury to marma points does not cause death, it causes severe pain giving a person the experience of death.

मारयन्तीति मर्माण्युच्यन्ते ।

Even though the definition states that injury to a marma leads to death, there are certain types of marma like vaiklyakara marma (वैकल्यकर मर्म) and rujakar marma (रुजाकर मर्म ) Discussed in next part of the article) that do not lead to death but cause some morbidity or pain on injury. With right treatment by a skilled Vaidya these issues can be resolved.

• On the basis of composition and nature- A confluence of mamsa (मांस muscles), sira (सिरा blood vessels), snayu (स्नायु ligaments), asthi- sandhi (अस्थि-संधि 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.

मर्माणि मांससिरास्नाय्वस्थिसन्धिसन्निपाताः; तेषु स्वभावत एव विशेषेण प्राणास्तिष्ठन्ति; तस्मान्मर्मस्वभिहतास्तांस्तान् भावानापद्यन्ते || (Sush. Samh .6.15)

• At the elemental level marma is composed of Soma or jala (सोम/जल) (kapha-water element), maruta (मारुत) (vata- or air element), tejas (तेजः) (agni/pitta -or fire element) as tridosha (त्रिदोषाः) and rajas (रजः), satva (सत्त्वम्), tamas (तमः) as triguna (त्रिगुणाः) resides along with bhuta (पंचमहाभूतानि panchamahabhuta) and atma (आत्मन् soul precisely). This is precisely the reason why marma points should be protected from any injury.

प्राणायतनानि॥ Marmas as vital points or energy points

According to acharya Charaka, there are 10 seats of prana (प्राणः life energy) in body viz. murdha (मूर्धा head), kantha (कंठ throat), hrdaya (हृदयम् heart), nabhi (नाभिः umbilicus), guda (गुदम् anus), basti (बस्तिः urinary bladder), ojas (ओजः), shukra (शुक्रम् semen), shonita (शोणितम्) or rakta (रक्तम् blood), mamsa (मांसः muscles) and among them the first six are the marma points.

दश प्राणायतनानि; तद्यथा- मूर्धा, कण्ठः, हृदयं, नाभिः, गुदं, बस्तिः, ओजः, शुक्रं, शोणितं, मांसमिति| तेषु षट् पूर्वाणि मर्मसङ्ख्यातानि||९||

प्रविभागाः॥ Classification

There are 107 marmas described in Ayurveda. Acharya Sushruta has categorized 107 marma sthana systemically in three ways, Every marma has its own predominant mahabhuta. Understanding the composition of marma from mahabhuta perspective is considered highly important in order to give treatment on marma injury or to practice marma therapy. Acharya Charaka gives importance to only three of the 107 marmas namely, Murdha (मूर्धा head), hridaya (हृदयम् heart), Basti (बस्तिः urinary bladder). The marmas are categorized into various types based on various criteria as below,

धातुभेदेन॥ Based on Composition of the marma

Marmas are basically certain spots in the body which can have dominance of one or the other body elements like mamsa (मांसः muscule) or sira (सिरा vessel) or asthi (अस्थिः bone) etc. Based on the dominance of one or the other body element, marmas are categorized in 5 types as follows. A type of marma and total number of marmas of that type are given below.

1. मांस मर्माणि ॥ Mamsa Marma (Muscle predominant) - 11
2. सिरा मर्माणि॥ Sira Marma (Vascular predominant) - 41
3. स्नायु मर्माणि॥ Snayu Marma (Ligament predominant) - 27
4. अस्थि मर्माणि॥ Asthi Marma (Bone area predominant) - 08
5. सन्धि मर्माणि॥ Sandhi Marma (Joint area predominant) – 20

स्थानभेदेन॥ Based on Location of Marma

All 107 marmas are located at different sites all over the body. Based on the location of the marma over body parts, the marmas are categorized into 3 different types as below,

1. Shakha gata (शाखा गत) - The word Shakha suggest upper and lower limbs viz both hands and legs. Thus marmas present in Both upper and lower limbs are known as Shakhagata marmas. - 44
2. Madhya shareera (मध्य शरीर) – Marmas present in thorax and abdomen (trunk region) - 26
3. Urdhva jatrugata (उर्ध्व जत्रुगत) – Jatru (जत्रुः) is a part of body at the base of neck. Hence marmas present in Head and neck region are known as Urdhwa jatrugata marmas – 37

अभिघातस्य परिणामभेदेन॥ Based on effect of injury on marma

The marmas are known as vital points or even mortal spots. Injury to marmas causes various different effects and even death. The effect of marma injury will depend upon what type of marma is damaged. Thus based on the effect on injury, the marmas are categorized into 5 types as follows,

1. Sadhya pranahara (सद्यप्राणहर) marma – leads to immediate death if injury to these marma sthana happens. Where “sadhya” meaning instant, “prana” meaning life force or energy, and “hara” meaning lost or taken away the name itself suggest immediate death causing marmas. – 19 in number
2. Kalantara pranahara (कालान्तरप्राणहर) marma – leads to delayed death on getting injured. Here kalantara” means delay or after some time.  – 33 in number
3. Vishalyaghna (विशल्यघ्न) marma- If these type of marmas are injured with a weapon they can cause death if the weapon or part of weapon hitting the marma is removed. If that part is kept unmoved or as it is person can survive. Here, 'Shalya' means foreign body which is a part of weapon used for injury – 03 in number
4. Vaikalyakara (वैकल्यकर)Marma – leads to permanent deformity or morbidity on injury. Where 'Vaikalya' means disability - 44 in number
5. Rujakara (रुजाकर) marma – leads to severe pain when injured. here “ruja” means pain. –  08 in number

List of marmas of different types based on the effect on their injury

Sadhya pranahara marma	Kalantara pranahara marma	Vaikalyakar marma	Vishalyaghna marma	Rujakara marma
Shrungatak(4) (शृङ्गाटक)	Vaksha (8) (वक्ष)	Lohitaksha(4) (लोहिताक्ष)	(उत्क्षेपः)	Gulfa(2) (गुल्फः)
adhipati (अधिपतिः)	Seemant (5) (सीमन्त)	Aani(4) (आणि)	sthapani (स्थपनी)	Manibandha(2) (मणिबंधः)
Shankha(2) (शंखौ)	Talahriday(4) (तलहृदयम्)	Urvi(4) (उर्वी)		Kurchashira(4) (कूर्चशिरः)
Matukayen (8) (मातृकाः)	Kshipra(4) (क्षिप्रम्)	Kurcha(4) (कुर्चा)
Guda (गुदम्)	Indrabasti(4) (इन्द्रबस्तिः)	Jaanu(2) (जानु)
Hruday (हृदयम्)	Katiktarun(2) (कटिकतरुणम्)	Vitapa(2) (विटप)
basti (बस्तिः)	Parshavasandi(2) (पार्श्वसन्धिः)	Kurpara(2) (कूर्पर)
naabhi (नाभिः)	Nitamb(2) (नितम्ब)	Kukundara(2) (कुकुन्दर)
	Bhrihati(2) (बृहति)	Kakshadhara(2) (कक्षधर)
		Vidhura(2) (विधुर)
		Krukatika(2) (कृकाटिका)
		Amsa(2) (अंसः)
		Phalaka(2) (फलकः)
		Apanga(2) (अपाङ्गः)
		Neela(2) (नीला)
		Manya(2) (मन्या)
		Phana(2) (फणा)
		Avarta(2) (आवर्त)

Marmas in hand

Various marmas located in upper limbs or hands (from shoulders to fingertips) are listed below. The table provides the exact location of the marma, its area, its composition, effect on its injury and the predominance of mahabhuta in that marma.

Name	Location	Pramana	Composition	Effect on injury	Mahabhuta predominance
kShipra (क्षिप्र)	In between thumb and index finger	½ angula	Snayu	kalantara pranahara	*Soma,**agni
Talahriday (तलहृदयम्)	Mid palm	½ angula	Mamsa	kalantara pranahara	Soma,agni
Kurcha (कूर्चा)	Above on both sides of kshipra	4 angula	Snayu	vaikalyakara	Soma
Kurcha sshira (कूर्चशिर)	Below on one side of wrist joint	½ angula	Snayu	vaikalyakara	Soma
Manibandha (मणिबंध)	Wrist joint	2 angula	Sandhi	vaikalyakara	Soma
indrabasti (इन्द्रबस्तिः)	Mid of forearm	2 angula	Mamsa	kalantara pranahara	Soma,agni
kurpara (कूर्पर)	Elbow joint	3 angula	Sandhi	vaikalyakara	Soma
AAni (आणि)	3 angula above elbow joint both sides.	3 angula	Snayu	vaikalyakara	Soma
Bahvi (बाहवी)	Mid arm	½ angula	Sira	vaikalyakara	soma
Lohitaksha (लोहिताक्ष)	Above bahvi marma, adjacent to auxillary fold.	½ angula	Sira	vaikalyakara	Soma
kakshadhara (कक्षाधर)	In between chest and arm pit	½ angula	Snayu	vaikalyakara	soma
*Soma (सोम)=Jala mahabhuta or water element, ** (अग्निः)=Tejas mahabhuta or fire element

Marmas in legs

Various marmas located in lower limbs or legs (from pelvis to feet) are listed below. The table provides the exact location of the marma, its area, its composition, effect on its injury and the predominance of mahabhuta in that marma.

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

Marmas of head and neck

Multiple marmas are located in head and neck region. These are known as Urdhwa-jatrugata marmas (उर्ध्वजत्रुगत मर्माणि). The table provides the exact location of the marma, its area, its composition, effect on its injury and the predominance of mahabhuta in that marma.

Name	Location	Pramana	Composition	Effect on Injury	Mahabhuta predominance
Nilamanya  (4) (नीलामन्ये)	High up in neck either side of trachea	4 angula	Sira and vaikalyakara	Vaikalyakara	soma
Matrukay(8) (मातृका)	Anterior external, post external jugular veins and common facial veins	4 angula	Sira and sadhya pranahara	Sadya pranahara	Agni
Krukatika(2) (कृकाटिका)	Junction of head and neck	½ angula	Sandhi	Vaikalyakara	soma
Vidhura(2) (विधुरः)	Below and behind the ear	½ angula	Snayu,sira	Vaikalyakara	somas
Phana(2) (फणा)	Both nasal passage near the roof of nose	½ angula	Sira	Vaikalyakara	soma
Apanga(2) (अपाङ्ग)	Lateral end of eyebrows	½ angula	Sira	Vaikalyakara	soma
Avarta(2) (आवर्त)	Above and below eyebrows	½ angula	Sandhi	Vaikalyakara	soma
Utskhepa(2) (उत्क्षेप)	Above temple	½ angula	Snayu	Vishalyaghna	vayu
Shankha(2) (शंखौ)	In between ear and forehead	½ angula	Sandhi	Sadya Pranahara	agni
Sthapani (स्थपनी)	In between eyebrows	½ angula	Sira	Vishalyaghna	vayu
Seemanta (5) (सीमन्त)	5 joints in skull vault	4 angula	Sandhi	Kalantara pranahara
Shrungatak(4) (शृङ्गाटक)	Venous junction of nose, ear, eyes, tongue	4 angula	Sira	Sadya pranahara	agni
adhipati (अधिपतिः)	Inside cranium	½ angula	Sandhi	Sadya pranahara	agni

Marmas of the abdomen region

Marmas located in abdomen or between chest and hips/lower limbs are listed below. The table provides the exact location of the marma, its area, its composition, effect on its injury and the predominance of mahabhuta in that marma.

Name	Location	Pramana	Composition	Effect on Injury	Mahabhuta predominance
Guda (गुदम्)	Anal region	4 angula	Mamsa	Sadya pranahara	agni
Basti/vasti (बस्तिः)	Bladder	4 angula	Snayu	Sadya pranahara	Agni
Naabhi (नाभिः)	umbilicus	4 angula	Sira	Sadya pranahara	Agni

Marmas of the thorax region

Thorax means chest region. The marmas locate din this region are listed below. The table provides the exact location of the marma, its area, its composition, effect on its injury and the predominance of mahabhuta in that marma.

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

Marmas of back region

Various marmas located on back and lower back regiuon are listed below. The table provides the exact location of the marma, its area, its composition, effect on its injury and the predominance of mahabhuta in that marma.

Name	Location	Pramana	Composition	Effect on Injury	Mahabhuta predominance
Katiktaran(2) (कटिकतरुण)	Both side of vertebral column to each hip bone	½ angula	Asthi	kalantara pranahara	Soma,agni
Kukundara(2) (कुकुंदर)	Lateral side of each femur	½ angula	Sandhi	Vaikalyakara	soma
Nitamba(2) (नितंब)	Above hip bone each side	½ angula	Asthi	kalantara pranahara	Soma,agni
Parshavasandhi(2) (पार्श्वसन्धिः)	Gluteal region joining lower part of two flanks	½ angula	Sira	kalantara pranahara	Soma,agni
Brihati (2) (बृहति)	Base of each breast	½ angula	Sira	kalantara pranahara	Soma,agni
Amsaphalaka(2) (अंसफलक)	Near scapular region each side of vertebral column	½ angula	Asthi	Vaikalyakara	soma
Amsa(2) (अंस)	In between scapular region and shoulder	½ angula	Snayu	Vaikalyakara	soma

मर्मप्रमाणम् ॥ Measurement of marmas

Ayurveda acharyas have clearly stated the measurement of marmas in terms of anguli pramana (system of measurement with the use of finger). Knowledge of this is important in order to decide the effect of injury if hit on that part and also to protect the points.

• 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.)

मर्माभिघातजलक्षणानि॥ Indicators of marma sthana injury

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

There are few general indicators of marma abhighata or infliction to marmas which are as follows,

• Bhrama (भ्रम dizziness)
• Pralapa(प्रलाप delirium)
• Pramoha (प्रमोहः insensibility)
• Vicheshtana (विचेष्टन irregular movements)
• murcha (मूर्च्छा giddiness)
• muscular laxity ( शैथिल्य 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 an injury to marma.

मर्ममहात्म्यम्॥ Importance

शूले ॥ Pain intensity

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/life energy) concentrated at that site.

शस्त्रकर्मे ॥ Surgical procedures

Marma sthana or the vital points are advised to be kept intact while performing surgeries meaning they should not be injured.

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

The whole and excellent knowledge of marma is considered as good as half knowledge of entire Shalya Tantra (surgery) branch of Ayurveda. Vaidya who tries to treat the patient with marma sthana injury can only be successful upto the level .

साध्यासाध्यत्वम् तथा चिकित्सा॥ Disease prognosis and management

The ease of getting cured from any disease, the level of damage or possibility of turning into chronic disease and the need of long term treatment for any disease depends upon which rogamarga (pathway of diseases) it is situated in. If any disease originates, manifests or even spreads into marma spots then the disease is said to become difficult to treat and might even turn fatal. Thus knowledge of marmas is essential to understand the disease prognosis and have idea of its probable response to the treatment.

कलरीपायट्टु॥ Kalaripayattu

There is a traditional and the oldest martial art form of India named Kalari or kalaripaywhich 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.

Marma and Acupressure  

Acupressure is an ancient and traditional Chinese healing therapy technique developed 5000 appx years ago. In this therapy specific points are applied upon 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 Acupressure is much more popular, a similar therapy based on Marma points is developed in ancient India. It is called as Marma therapy. Marma therapy is performed by a skilled Vaidya and under standard protocols. In Marma therapy the points are not just energy points but a lot of peculiar details about those are known and based on that the marma points are stimulated in a particular way to get pain relief or other desired outcomes. It is gaining more popularity in west chiefly due to its efficacy, safety and also because of simplicity of procedures.

Therapeutic Applications

Marmas can be affected by any external injury or even as a result of spread of a certain chronic internal disease. Ayurveda acharyas have described different type of treatment methods to manage problems arising due to affliction of different marmas. Various panchakarma procedures like abhyanga, nasya, basti etc. are known to have wonderful results in marma related disorders. The type of panchakarma is decided by a vaidya depending on the type of marma affected.

Marmas are to be protected from various injuries because marma injury affects prana which aggravates vata dosha in the body and that in turn can disturb the complete dosha balance in body. Therefore Basti karma (बस्तिकर्म) is believed to be one of the best treatment methods for marma related diseases.

Abhyanga therapy in marma chikitsa aspect is one quite similar therapy resembling acupressure. Abhyanga (अभ्यङ्गः oil massage), udvartana (उद्वर्तनम् massage technique with medicated powders), massage with herbal paste, kizhi (massage done with palm, wrist, heel) or along with herbal pottali (poultice) are done skillfully 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(शलाका long instrument) is used as a medium of agni, and applied on the skin surface level skillfully by a Vaidya (वैद्यः) in a standard procedure. For example, Agni karma in Katiktaruna (कटिकतरुण) marma for treatment of sciatica. Jaanu (जानु) marma for knee pain, manibandha (मणिबन्ध) 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.