Marma (मर्म)

The word Marma literally 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, Upanishadsand Puranas. 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' 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 is said to have used an ayudh (weapon) named Vajra fight demon Vratra. 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 to protect marma points. Arjuna and Karna were only vulnerable to be killed through marma exposure. There are also references about death of Shravan kumara, Ravana, Shreekrishna 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, 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. 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 (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 and not by any other method. Nabhi is naval which is considered to be one of the Sadyapranahara marma. It is known in marma science that when such type of marma is hit it immediately causes death.

The kshipra marma is known as Kalantara pranahara 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 heavely 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.

In Mahabharata, during the ( has many references about protective shields used to cover marma sthana of both humans and animals.

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' 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 and rujakar marma (Discussed in next part of the article) that do not lead to death but cause some morbodity 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 (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.

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

• At the elemental level marma is composed of Soma or jala (kapha-water element), maruta(vata- or air element), tejas (agni/pitta -or fire element) as tridosha and rajas, 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.

Marmas as vital points or energy points

According to acharya Charaka, there are 10 seats of prana (life energy) in body viz. murdha (head), kantha (throat), hrdaya (heart), nabhi (umbilicus), guda (anus), basti (urinary bladder), ojas, shukra (semen), shonita or rakta (blood), mamsa (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 (head), hridaya (heart), Basti (urinary bladder). The marmas are categorized into various types based on various criteria as below,

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 (muscule) or sira (vessel) or asthi (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. Mamsa Marma (Muscle predominant) - 11
2. Sira Marma (Vascular predominant) - 41
3. Snayu Marma (Ligament predominant) - 27
4. Asthi Marma (Bone area predominant) - 08
5. Sandhi Marma (Joint area predominant) – 20

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 - marmas present in Both upper and lower limbs - 44
2. Madhya shareera – Marmas present in thorax and abdomen (trunk region) - 26
3. Urdhva jatrugata – marmas present in Head and neck region – 37

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 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 marma – leads to delayed death on getting injured. Here kalantara” means delay or after some time.  – 33 in number
3. Vishalyaghna marma- If these type of marmas are injured with a weapon they can casue death if teh 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 Marma – leads to permanent deformity or morbidity on injury. Where 'Vaikalya' means disability - 44 in number
5. Rujakara 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)	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 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	In between thumb and index finger	½ angula	Snayu	kalantara pranahara	*Soma,**agni
Talahriday	Mid palm	½ angula	Mamsa	kalantara pranahara	Soma,agni
Kurcha	Above on both sides of kshipra	4 angula	Snayu	vaikalyakara	Soma
Kurcha sshira	Below on one side of wrist joint	½ angula	Snayu	vaikalyakara	Soma
Manibandha	Wrist joint	2 angula	Sandhi	vaikalyakara	Soma
indrabasti	Mid of forearm	2 angula	Mamsa	kalantara pranahara	Soma,agni
kurpara	Elbow joint	3 angula	Sandhi	vaikalyakara	Soma
AAni	3 angula above elbow joint both sides.	3 angula	Snayu	vaikalyakara	Soma
Bahvi	Mid arm	½ angula	Sira	vaikalyakara	soma
Lohitaksha	Above bahvi marma, adjacent to auxillary fold.	½ angula	Sira	vaikalyakara	Soma
kakshadhara	In between chest and arm pit	½ angula	Snayu	vaikalyakara	soma
*Soma=Jala mahabhuta or water element, **Agni=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	Between great toe and second toe	½ angula	Snayu	kalantara	Soma,agni
Talahriday	Mid of the foot sole	½ angula	Mamsa	kalantara pranahara	Soma,agni
Kurcha	Above both sides of kshipra	4 angula	Snayu	vaikalyakara	Soma
Kurcha shira	Both sides of ankle joint	1 angula	Snayu	vaikalyakara	Soma
Gulfa	Ankle joint	4 angula	Sandhi	rujakara	Agni,vaayu
Indrabasti	Mid of thigh in the line of heel	½ angula	Mamsa	kalantara pranahara	Soma,agni
Jaanu	Knee joint	3 angula	Sandhi	vaikalyakara	soma
Aani	3 fingers above knee joint both sides	½ angula	Snayu	vaikalyakara	soma
Urvi	Mid of thigh	1 angula	Sira	vaikalya kara	soma
Lohitaksha	Root of thigh above urvi marma, below hip joint	½ angula	Sira	vaikalyakara	soma
vitapa	In between groin and testes	1 angula	Snayu	vaikalyakara	somas

Marma sthana of head and neck

Name	Location	Pramana	Composition	Mahabhuta predominance
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)

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. (Asht.sang. Sharirs 7.47) http://vedotpatti.in/samhita/Vag/esangraha/?mod=read

Importance| mahatva

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. (Cha sidd 9.3)

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.

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 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.