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. Soem eople compare it with that of accupressure 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
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 armor used for protection of marma points. (Rigveda 6/75/18). 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.(ref?) In Valmiki Ramayana there are few verses during war wherein there is mention of marma points being used as targets 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 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.
निरुक्ती॥ Nirukti
मर्म्म, [न्] क्ली, (मृ + “सर्व्वधातुभ्यो मनिन् ।”
- उणा ० ४ । १४४ । इति मनिन् ।) स्वरूपम् ।
- तत्त्वम् । जीवस्थानम् । Shabdakalpadruma Pg 641 [1]
- 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 – Sush Shar 6/3 (dalhan teeka)
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. sha .6.15)
- 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. (Sush sha 6.35-36)
Marmas as vital points or energy points
According to acharya Charaka, there are 10 seats of prana (life energy) 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.
दश प्राणायतनानि; तद्यथा- मूर्धा, कण्ठः, हृदयं, नाभिः, गुदं, बस्तिः, ओजः, शुक्रं, शोणितं, मांसमिति| तेषु षट् पूर्वाणि मर्मसङ्ख्यातानि||९|| cha sha 7.9
प्रविभागाः॥ Classification
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.
Based on 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
Based on 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
Based on 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 force 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 | 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.
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.