A conceptual study on Marma and its practical application in Chikitsa

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[Find the meaning and references behind the names: Raja, Guna, Rita, Sharma, Anand, Soma, Sapna, Manas, Nisha, Tamas, Pooja, Ayush]

REVIEW ARTICLE February 2023 Journal of Ayurveda and Integrated Medical Sciences | February 2023 | Vol. 8 | Issue 2 126 A conceptual study on Marma and its practical application in Chikitsa Pooja Tekam 1 , Rita Marwaha 2 , Nisha Bhalerao 3 , Shiba Dutta Panda 4 , Sapna Anand 5 1,5 Post Graduate Scholar, PG. Department of Rachana Sharir, Pt. Khushilal Sharma Govt. Ayurved College & Institute, Bhopal, Madhya Pradesh, India. 2 Professor & HOD, PG. Department of Rachana Sharir, Pt. Khushilal Sharma Govt. Ayurved College & Institute, Bhopal, Madhya Pradesh, India. 3 Reader, PG. Department of Rachana Sharir, Pt. Khushilal Sharma Govt. Ayurved College & Institute, Bhopal, Madhya Pradesh, India. 4 Lecturer, PG. Department of Rachana Sharir, Pt. Khushilal Sharma Govt. Ayurved College & Institute, Bhopal, Madhya Pradesh, India. I NTRODUCTION Marma is an anatomical location that connects muscles, veins, ligaments, bones, and joints [1] There are 107 Marmas (vital spots) in total, with eleven in each limb, twenty-six in the trunk (three in the belly, nine in the thorax, fourteen in the back), and thirty- Address for correspondence: Dr. Pooja Tekam Post Graduate Scholar, PG. Department of Rachana Sharir, Pt. Khushilal Sharma Govt. Ayurved College & Institute, Bhopal, Madhya Pradesh, India. E-mail: pooja.tekam 10@gmail.com Submission Date: 13/12/2022 Accepted Date: 19/01/2023 Access this article online Quick Response Code Website: www.jaims.in Published by Maharshi Charaka Ayurveda Organization, Vijayapur, Karnataka (Regd) under the license CC-by-NC-SA seven in the head and neck area [2] They are also the places where not just Tridosha , but also their subtle forms Prana, Ojus , and Tejas , as well as Sattva, Raja , and Tama , may be found [3] Marma , according to Vagbhata , is the meeting point of Mamsa, Asthi, Sira, Snayu, Damni, and Sandhi , as well as the location of Prana . However, it is also believed that Marma can be made up of any or all of the aforementioned [4] Though Marma is mentioned and described in the Charaka Samhita, no specifics are provided. Marma , according to Sushruta , is the site of convergence of all the Dhatus save Dhamani [5] He utilized the term Marma to describe both disorders of the vital organ system and topographical cure points, implying that topographical cure points should be stimulated to rescue the Marma in the system. Marma spots, according to Siddhar , are the locations in the body where the subtle Marma energy may be detected [6] A B S T R A C T Ayurveda is a living science that believes in treating the mind, body, and spirit to achieve total health, and this ancient wisdom is mirrored in the unique idea and composition of Marma as well. Marma is not just anatomical markers, but also locations where the Tridosha , in its subtle forms Prana , Ojusa ( soma ), and Tejas , may be found (Agni). They also have three Gunas : Sattva, Raja , and Tamas ( Manas contents) as well as the soul or life force ( Bhutatma ). Sushruta Samhita and Siddha , respectively, include detailed descriptions of Marma and Marma Chikitsa . Marma Chikitsa / Therapy are the manipulation or stimulation of Marma in the treatment of different ailments. The Prana (vital energy) present in Marmas may be directed to eliminate blockages (even in distant locations) and promote energy flow, resulting in a state of healthy body, mind, and spirit, through various ways of Marma stimulation. The purpose of this page is to give a general understanding of Marma and Marma treatment. Ancient science literature, Ayush physicians/surgeons, the internet, and personal experience are all used to gather information. Key words: Marma, Marma Chikitsa, Marma point, Prana

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[Find the meaning and references behind the names: Ayu]

Pooja Tekam et al. A conceptual study on Marma and its practical application in Chikitsa ISSN: 2456-3110 REVIEW ARTICLE February 2023 Journal of Ayurveda and Integrated Medical Sciences | February 2023 | Vol. 8 | Issue 2 127 Marma is the location on the body where an energy obstruction is perceived. It is the nexus of physiology and awareness, and touching it modifies the biochemistry of the body, allowing profound and alchemical changes to occur in one's makeup [7] The body is signalled to manufacture exactly what it needs, including hormones and neurochemicals that repair the body, mind, and awareness when these inner pharmacy pathways are stimulated [8] Marma points are unique places on the body that are linked to various internal organs, Doshas , and Srotas via Pranic channels. To activate internal organs, these spots are employed during Abhyanga , coupled with the administration of various types of medicinal and fragrant oils. Marma is a subtle energy that, according to Siddar , aids in the healthy functioning of the body and life force. Marmas are imperceptible, yet they may be tracked to a place where the energy of the body, mind, and spirit are all gathered together. These points can be found on Nadis , nerves, blood vessels, bone, muscle, and tissue junctions, and are found throughout the body. Even though Marma books indicate 8000 Marma points in the body, the common consensus is that 108 Marma points serve as the foundation for the art of Marma . They are divided into 12 Padumarma (points that are directly or indirectly connected to the nerves of the brain and help in the relief of brain-related diseases) and 96 Thodu Marma . Ayurveda is a living science that believes in treating the mind, body, and spirit to achieve total health. Marma Chikitsa is the art of manipulating or stimulating Marma points for the treatment of ailments, and it is the human body's natural ability to cure itself through these points. The Prana (vital energy) present in Marma may be directed to eliminate blockages (even in distant locations) and boost energy flow, resulting in a state of healthy body, mind, and spirit, by many ways and procedures [9] Properly applied pressure on suitable Marma can restore normal Prana functioning (in sick body parts), but inappropriate manipulation can result in extreme discomfort, incapacity, deformity, and even death. M ETHODOLOGY The material has been collected from different articles, literature, and different websites like (NCBI, PubMed, AYU, etc. History of Marma Marma is a branch of Vedic science. Naturally, it has affected all other sciences mentioned in the Veda (400 BC), such as Ayurveda , Yoga , Martial Arts, and the Sidha medical system. The first mention of Marma or Drapi , which is some form of body Armor or corselet to guard the body against the onslaught of enemy weapons, can be found in the Rig Veda . The phrase Kavacha , corselet, or breastplate for protection is also mentioned in the Atharva-Veda . Many allusions to Marma or Varma may be found throughout the Mahabharata , the ancient epic. Because monks were able to defend themselves against weapons thanks to their mastery of Marma , martial arts became effective and popular for self-defence [10] Types of Marmas and their significance in Ayurveda Several ancient Ayurved Acharya have described Marma , including Charaka and Vagbhata , among others. In the Sushruta Samhita, Sushruta , the 'father of surgery,' gives the finest description. In this centuries-old treatise, he covers many topics of anatomy and surgery. Marma points, according to Sushruta , are the seats of life. The three Doshas ( Vata , Pitta , and Kapha ), as well as their subtle versions, are present in Marma ( Prana or vital force, Tejas or inner radiance, and Ojas or essence of life). There are also the three Gunas of Satva (beingness), Rajas (activity), and Tamas (darkness) [11] Marma is defined by Aacharya Sushruta as the key area of the body that produces numerous deadly signs and symptoms in the event of catastrophic damage. The location or flow of Prana (vital energy). Despite its prominence, Ayurvedic literature makes no clear reference to therapeutic application. Various forms of Marmas are discussed in Ayurveda based on traumatic consequences and prognosis. 1. Sadhyapranahara

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Pooja Tekam et al. A conceptual study on Marma and its practical application in Chikitsa ISSN: 2456-3110 REVIEW ARTICLE February 2023 Journal of Ayurveda and Integrated Medical Sciences | February 2023 | Vol. 8 | Issue 2 128 2. Kalantarpranahara 3. Vaikalyakara 4. Vishalyaghna 5. Rujakara These are body locations that are both superficial and deeply rooted. ▪ Mamsa (10 numbers) ▪ Sira (41 numbers) ▪ Snayu (27 numbers) ▪ Asthi (8 numbers) ▪ Sandhi (20 numbers) The Marma opinions Here's how the 107 Marma points are classified based on one's constitution, or the primary tissue or physical matrix present. ▪ In the muscular tissue, there are 11 Marma points. Mamsa Marma is the name for these. ▪ In the blood arteries, 41 Marma points are prevalent. Sira Marma is the name for them. ▪ In the ligaments and tendons, 27 Marma points are prevalent. Snayu Marma is the name for them. ▪ In the bones, eight Marma points are very prominent. Asthi Marma is the name given to them. ▪ In the joints, there are 20 Sandhi Marmas or Marma points. Location ▪ In both upper limbs, there are 22 Marma points (11 Marma in each upper limb). ▪ In both lower limbs, there are 22 Marma points (11 Marma in each lower limb). ▪ In the thorax and abdomen, there are 26 Marma points. ▪ In the head and neck, there are 37 Marma points. The Marma points to the effect of Injury This description was more appropriate in ancient times when people lived in forests and tribes and there were conflicts and warfare. It is no longer valid in current times since medical care of wounds and injuries has evolved dramatically with the introduction of modern surgery, trauma management, life-saving equipment, drugs, and procedures. These Marma , on the other hand, might be seen as those who require protection against unintentional accidents. These Marma require rapid medical treatment and management if they are harmed, to reduce death and morbidity. ▪ Sadhya Pranahara Marma - Marmas that induce instant death when afflicted with damage. ▪ Kaalantar Pranhar Marma - When these Marma are harmed, they die slowly and gradually. ▪ Marma Vishalyaghana - If these Marma are damaged, they may die. ▪ If these 44 Vaikalyakar Marma are harmed, deformity and suffering may follow. ▪ Rujakara Marma , when these eight Marma are harmed, it causes agony. Marmabhighata Lakshana [12] Shakha Marma (44) Marma Location of Marma Marmabhighat Lakshan 1 Kshipra Angusta Anguli Madhaya Aakashepaen Maranam 2 Talhridya Madyamaangul im Anupurvaena Talasaya Madyae Rujabhi Marnam 3 Kurcha Kshiprasayopari stat Ubhayatah Bhramana, Vaepanae 4 Kurchasira Gulpha Sandhaeraadha Ubhyatah Ruja, Shofa 5 Gulfa (Manibandha Upper Limb) Paadjangyo Sandhanae Ruja, Stabda Padata, Khanjata

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[Find the meaning and references behind the names: Shosho, Rohit, Janu, Ata, Ito, Sakthi, Ani]

Pooja Tekam et al. A conceptual study on Marma and its practical application in Chikitsa ISSN: 2456-3110 REVIEW ARTICLE February 2023 Journal of Ayurveda and Integrated Medical Sciences | February 2023 | Vol. 8 | Issue 2 129 6 Inderavasti Janga Madhyae Shonit Kshyae Maranam 7 Janu (Kurpar) Jangourvu Sandhanae Khanjata 8 Aani Jaanunurdavam ubyat Trayangulam Shophabhivridh i, Stabdha Sakthi 9 Urvi Urumadhyae Shonitkshyata Sakthishosh 10 Lohitaksha Urvyourdavama dhovankshan Sandhaer Moolae Lohikshyan Pakshaghata 11 Vitap (Kakshadhar) Vankashana Vrishanyor Antarae Shandaya, Alpasukarata Udarar- Ura Marma (12) Marma Location of Marma Marmabhighat lakshan 1 Guda Vatavarchonirs nam, Sthulantra Pratibadham Sadyomarnam 2 Vasti Alpamansashon ito Abhyantartah Katyam Mutrashayo Sadyomarnam 3 Nabhi Pakvaamashay ormadhyae Shira Prabhava Sadyomarnam 4 Hridya Stanyormadhya m, Satvarajatama Adhisthanam Sadyamamarna m 5 Stanamool (2) Stanyoradastad Dwayangulam Ubayataha Kaphapuran Kostataya Kasa Swasabhyam Mriyatae 6 Stana Rohit(2) Stanachuchaka yorurdhavam Dwayangulam Ubayatah Lohitapuranako staya Kasa Swasabhyam Mriyatae 7 Aplap (2) Ansakutyo Adastad Pasharvo Upari Bhag Raktaenpuyabh avam Marnam 8 Apstambha (2) Urso Ubhya, Nadyo Vatavahae Vatapurankosta ya Kasaswasabya m Marnam Prista Marma (14) Marma Location of Marma Marmabhighat lakshan 1 Kukunder Parsharvajagha nbahirbagae Pristavanshamu byatah Natinimnae Saparshagyana m, Adhakayae Chesto Upgatah 2 Nitamba Sronikandyaupa ryaashayaaacha danae Parshavaantar Pratibadho Adhakayashos o Daurbalyanch Cha Marnam 3 Parshava Sandhi Jagahan Parsharvamadh yo Tiryak Udharvam Cha Jaghanat Lohitapurnakos taya Mriyatae 4 Katikaturuna Pristavanshamu bayatah Pratishronikand am Asthini Shonitakshayat Panduvivrano, Heenaroopa Mriyatae. 5 Vrihati Stanmoolatubay ata Pristavanshasya Shonit Atipravriti Nimitair Updravye Mriyatae 6 Ansaphalaka Presto Upari Pristavansham Ubyata Bahvo Swapa Shosho

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[Find the meaning and references behind the names: Buddhi, Sun, Heart]

Pooja Tekam et al. A conceptual study on Marma and its practical application in Chikitsa ISSN: 2456-3110 REVIEW ARTICLE February 2023 Journal of Ayurveda and Integrated Medical Sciences | February 2023 | Vol. 8 | Issue 2 130 Trikasambdhae Ansapalakae 7 Ansa Bahumurdha Grivamadhyae Nibandhanansa peethaskandha Stabadha Bahuta Udarva jatruga t Marma (37) Marma Location of Marma Marmabhighat lakshan 1 Dhamaninela Manya - 4 Kanthanadimau bayatochatsro Damnayo Mookta, Swaravaikrita m, Ras Agrahita 2 Siramatrika -8 Grivayam Ubayatah Sadhyo Marnam 3 Krikatika - 2 Shiro Grivyo Sandhanae Chalmurdhvata 4 Vidura - 2 Karnapristto Adhah Badhirta 5 Fana - 2 Ghranamargaub ayatah Srotomargaprati badhae Abyantartah Gandhaagyana m 6 Apanga - 2 Brupuchantayo Akshanobahyat o Aandhya, Dristiupghata 7 Aavarta - 2 Bruvoupari Nimnayor Aandhayam, Dristiupghato 8 Shankha - 2 Bruvoantryoupa ri Karnlalatmadha yae Sadhyomarna m 9 Utkshep - 2 Shankhyo Upari Keshanta Sashalyojivetpa katpatita Shalyova, Na Udrit Shalya 10 Sthapani - 1 Bruvo Madhyae Like Utkshep Marma 11 Simanta -5 Pancha Sandhyah Shirsi Vibhakta Unmad, Bhaya, Chitanasha 12 Shringataka - 4 Ghranashrotaks hijihva Santarpaninama Sadhyomarna m 13 Adhipati - 1 Mastakabyantar atuparistata Sirasandhisanni pato Romavartavata Sadhyomarna m Trimarmam Eminent scholars place a premium on Basthi, Hrudaya , and Siras ( Trimarma ) among the 107 Marmas described previously in Sutrasthana . The reason for this is because these three Marmas are Sthana for Prana , and any form of Pida (physical or mental harm) might result in the patient's death. Hrudaya : The ten vessels, Prana Vayu, Apana Vayu, Manas, Buddhi , awareness, and Mahabhutas , are connected to the heart in the same way as the spokes of a wheel are connected to the centre. Siras : As the sun is the dwelling of its beams, the head is the habitation of senses, sensory channels, and conduits conveying elen vitae. The urinary bladder , which is situated in the middle of the Sthula Guda (rectum), (testicles), Sevani , and seminal as well as urinary channels, is the receptacle of urine into which all of the body's liquid-carrying channels converge, just like all of the world's rivers pour into the ocean. Samanya Lakshanas Because the destruction of the Asrayas leads to the destruction of superstructures, serious harm to Trimarma causes the body to be destroyed. Partially injuring these organs causes major disorders, thus they should be specifically safeguarded against external harm and Vayu application, among other things. Role of Marma Therapy in Chikitsa ▪ Clears clogs in energy pathways ( Srotas ).

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[Find the meaning and references behind the names: Govind, Indu, Bhaskar, Deep]

Pooja Tekam et al. A conceptual study on Marma and its practical application in Chikitsa ISSN: 2456-3110 REVIEW ARTICLE February 2023 Journal of Ayurveda and Integrated Medical Sciences | February 2023 | Vol. 8 | Issue 2 131 ▪ Calms the Doshas and restores the body's natural balance (especially vyanvayu which controls the autonomic nervous system). ▪ Develops physical, mental, and emotional adaptability. ▪ Establishes a positive relationship with the unconscious mind, allowing for tremendous and dynamic development on a physical, mental, emotional, and spiritual level. DISCUSSION The science of Marma is one of Ayurveda's unique notions that has been thoroughly developed via careful study, particularly during surgical treatments. These are unique and crucial superficial spots that may be found throughout the body. They are unique because they are the 'Prana' locations (Life processes). Furthermore, Vishama Spandana is one of these Marma points' most remarkable properties [13] In their Marma Adhyaya , Acharya Charaka in his Trimarmiya Siddhi Adhyaya , and Chikitsa Adhyhaya , Ashtanga Hridayam in his Marma Vibhaga , Acharya Sushruta, Acharya Charaka , and Chikitsa Adhyhaya , Ashtanga Hridayam in their Trimarmiya Siddhi Adhyay from a traumatological standpoint, the Marmas are crucial [14] Any trauma at this point has been demonstrated to be more dangerous or to cause a delay in healing from injuries. In Marmabhighta Lakshanas , Acharya Sushruta mentions this. Marma's Lakshanas following trauma or damage is also affected by its structural kind. CONCLUSION Marmas are key locations and Prana centres. They can be used to diagnose and cure illness, or they can be utilized to promote overall health and lifespan. When the human body is subjected to trauma, it exhibits a variety of signs and symptoms, which vary depending on the intensity and kind of damage. When 107 deep or superficial locations on the human surface are injured, they create varied indications and symptoms according to the sort of injury as well as its contents, according to Acharya Sushruta . Our bodies are made up of veins, muscles, bones, joints, nerves, ligaments, and other structures that are distributed throughout the body in varying degrees of proportion. Marma , according to Acharya Sushruta, is the location where all of the aforementioned structures unite and are the source of Prana (vitality). Marma's primary components are " Agni Soma Vayu." Anatomical knowledge was stressed in Ayurveda as part of diagnosis and treatment. Surgical operations need careful evaluation of anatomical perspectives; any misunderstanding of the anatomical framework may result in medical treatment failure. All Ayurvedic remedies, from basic self-treatments to complicated clinical procedures, rely on Marmas . They are one of the most important aspects of Ayurvedic philosophy and practice. This article discussed the Marma points that must be covered during Marmaghatha to avoid deadly situations. REFERENCES 1 Sharma SP. Shareera Sthana chapter 7 verse 24 Astanga Sangraha with Sashilekha Sanskrit commentary of Indu. 2 nd ed. Varanasi (India): Chaukambha Orientalia; 2008; p.326 2 Sushruta Samhita Dalhana Acharya Virachita Nibhandhasangraha vyakhya, Vaidya Yadavaji Trikamaji Acharya, Choukhambha Surabharati Prakashana, Varanasi, reprint 2010. Page no: 369 3 Acharya YT. Shareera Sthana chapter 6 verse 26 Sushruta Samhita with Nibhandhasangraha commentary of Dalhanacharya. Reprint ed. Varanasi (India): Chaukambha Sankrit Sansthan; 2010.;p.55 4 Bhaskar Govind Ghamekar, Sushruta Samhita, Ayurveda sandipika, Hindi, vyakhya, 3 rd edition 1997, Meherechandre Lakashamendas (Sanskrit) 6/44 5 Bhaskar Govind Ghamekar, Sushruta Samhita, Ayurveda sandipika, Hindi, vyakhya,3 rd edition 1997, Meherechandre Lakashamendas (Sanskrit) 6/14 6 Bhaskar Govind Ghamekar, Sushruta Samhita, Ayurveda sandipika, Hindi, vyakhya,3 rd edition 1997, Meherechandre Lakashamendas (Sanskrit) 6/24 7 Sushruta Samhita with Hindi commentary by Kaviraj Ambikadutta Shastri, Part-1, page no. 67,Sharir Sathan 6/4, by Chaukhambha Sanskrit Sansthan, 2011 8 Sushruta Samhita with Hindi commentary by Kaviraj Ambikadutta Shastri, Part-1, page no. 67,Sharir Sathan 6/5, by Chaukhambha Sanskrit Sansthan, 2011 9 Sushruta Samhita with Hindi commentary by Kaviraj Ambikadutta Shastri, Part-1, page no. 67, Sharir Sathan 6/8, by Chaukhambha Sanskrit Sansthan, 2011

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[Find the meaning and references behind the names: Sri, Shankar, Kumari, Nil, Med, Swamy, Satyanarayana]

Pooja Tekam et al. A conceptual study on Marma and its practical application in Chikitsa ISSN: 2456-3110 REVIEW ARTICLE February 2023 Journal of Ayurveda and Integrated Medical Sciences | February 2023 | Vol. 8 | Issue 2 132 10 Caraka Samhita of Agnivesha revised by Caraka and Drdhabala with an introduction by Vaidya samrata Sri Satyanarayana Sastri, Chikitsa sthana part 2 published by choukamba Bharati Academy, Varabasi reprint:2001, pg no:716 pp:1208 11 Caraka Samhita of Agnivesha revised by Charaka and drdhabala with an introduction by Vaidya samrata Sri Satyanarayana Sastri, Siddhi sthana part 2 published by choukamba Bharati Academy, Varabasi reprint:2001, pg no:1050 pp:1208 12 Negi Vineeta Kumari, Marma, and Marma Therapy: A Review, Research Officer Regional Ayurveda Research Institute for Nutritional Disorders, CCRAS, Ministry of Ayush, Jaral Pandoh Mandi, World Journal of Pharmaceutical Research Volume 7, Issue 15, 258-271. 15 13 Mamatha TS, Shankar S. Swamy, S. V. Shailaja. Understanding the concept of Marma and their clinical application in Shalya Tantra w.s.r. to Vital points. J Ayurveda Integr Med Sci 2018;5:89-92 14 Negi Vineeta Kumari, Marma, and Marma Therapy: A Review, Research Officer Regional Ayurveda Research Institute for Nutritional Disorders, CCRAS, Ministry of Ayush, Jaral Pandoh Mandi, World Journal of Pharmaceutical Research Volume 7, Issue 15, 258-271 ******************************* How to cite this article: Pooja Tekam, Rita Marwaha, Nisha Bhalerao, Shiba Dutta Panda, Sapna Anand. A conceptual study on Marma and its practical application in Chikitsa. J Ayurveda Integr Med Sci 2023;02:126-132. Source of Support: Nil, Conflict of Interest: None declared. Copyright © 2023 The Author(s); Published by Maharshi Charaka Ayurveda Organization, Vijayapur (Regd). This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc-sa/4.0), which permits unrestricted use, distribution, and perform the work and make derivative works based on it only for non-commercial purposes, provided the original work is properly cited

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