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In certain cases, the injured person can't die soon after injury. But after 15 days he/she may show severe complications such as infection, septicemia, electrolytes imbalance, toxisity, mal functioning of vital organs or blood loss. This type of condition seen in burn cases or injury to pectoral region (lungs or pleura), hypochondriac region (partial rupture of liver or spleen), extremities (blood vessels) or some part of back. This type of conditions can be due to injury to kalantara pranahara marma.  

In certain cases, the injured person can't die soon after injury. But after 15 days he/she may show severe complications such as infection, septicemia, electrolytes imbalance, toxisity, mal functioning of vital organs or blood loss. This type of condition seen in burn cases or injury to pectoral region (lungs or pleura), hypochondriac region (partial rupture of liver or spleen), extremities (blood vessels) or some part of back. This type of conditions can be due to injury to kalantara pranahara marma.  

Sometimes it is seen that injury to hollow organ can cause death if an untrained person tries to remove the foreign body from the site. The content of that organ may come out (it may be blood, urine, body fluids) and may lead to pain shock or severe acute inflammation causing death. This is seen in injury to urinary bladder or liver. Such type of cases are only handled by skilled person or else the symptoms mentioned in vishalyaghna pranahara marma ocours and the life of patient may be in danger.  

Sometimes it is seen that injury to hollow organ can cause death if an untrained person tries to remove the foreign [[Sharira|body]] from the site. The content of that organ may come out (it may be blood, urine, body fluids) and may lead to pain shock or severe acute inflammation causing death. This is seen in injury to urinary bladder or liver. Such type of cases are only handled by skilled person or else the symptoms mentioned in vishalyaghna pranahara marma ocours and the life of patient may be in danger.  

During road traffic accident or surgery the muscles, peripheral nerves, tendons, ligaments, bones or joints may get affected. It can cause long term or permenant disability as seen in Earb’s palsy, Klumpke’s palsy. Injury to axillary nerve causes loss of abduction of shoulder. Injury to radial nerve causes wrist drop. Injury to common peroneal nerve causes foot drop. Injury to ligaments and joints causes mal functioning of joints. Mal-union of fracture causes difficulty in movement. Hamstring tear in soccer player can affect flexion of knee. Tear in tendon of pectoralis major muscle is seen in weight lifters. It can affect adduction and flexion of shoulder. Such type of  permanent disabilities seen in injuries to vaikalyakara marma.  

During road traffic accident or surgery the muscles, peripheral nerves, tendons, ligaments, bones or joints may get affected. It can cause long term or permenant disability as seen in Earb’s palsy, Klumpke’s palsy. Injury to axillary nerve causes loss of abduction of shoulder. Injury to radial nerve causes wrist drop. Injury to common peroneal nerve causes foot drop. Injury to ligaments and joints causes mal functioning of joints. Mal-union of fracture causes difficulty in movement. Hamstring tear in soccer player can affect flexion of knee. Tear in tendon of pectoralis major muscle is seen in weight lifters. It can affect adduction and flexion of shoulder. Such type of  permanent disabilities seen in injuries to vaikalyakara marma.  

=== V. Based on predominance of elements ===  

=== V. Based on predominance of elements ===  

As each marma has a predominance of one or two basic elements, it has been divided into five groups:   

As each marma has a predominance of one or two basic elements, it has been divided into five groups:   

# Agni dominant   

# [[Agni|Agni]] dominant   

# Agni-soma dominant   

# Agni-soma dominant   

# Vayu dominant   

# Vayu dominant   

== Importance of marma in preservation and prevention of health ==  

== Importance of marma in preservation and prevention of health ==  

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Understanding the vital areas of our body is essential while treating the patient with yantra (medical equipment), shastra (surgical instruments), kshara (corrosive chemicals like alkali) and agni (cautery) [Su.Sa. Sutra Sthana 1/1].  During these procedures, the surgeon should have complete knowledge of marma (vital parts). Otherwise, instead of benefits, the patient may land in specific complications. Injury to the marma or in the periphery of the marma site can bring patient’s life in danger [Su. Sha. Ghanekar Tika 6/40]. For this reason, knowledge of marma sharira is considered as half part of surgery. [Su. Sha. Ghanekar Tika 6/44] The treatment of certain marmas with their signs and symptoms of infliction is mentioned. Infliction to kshipra and talahridaya marma (located in palms and soles) causes profuse bleeding that aggravates vata and may prove fatal for life. In such a condition, a surgeon can amputate the distal part of the extremity from the wrist or ankle to save the patient. [Su. Sha. Ghanekar Tika 6/42-43]   

Understanding the vital areas of our body is essential while treating the patient with yantra (medical equipment), shastra (surgical instruments), kshara (corrosive chemicals like alkali) and agni (cautery) [Su.Sa. Sutra Sthana 1/1].  During these procedures, the surgeon should have complete knowledge of marma (vital parts). Otherwise, instead of benefits, the patient may land in specific complications. Injury to the marma or in the periphery of the marma site can bring patient’s life in danger [Su. Sha. Ghanekar Tika 6/40]. For this reason, knowledge of marma [[Sharira|sharira]] is considered as half part of surgery. [Su. Sha. Ghanekar Tika 6/44] The treatment of certain marmas with their signs and symptoms of infliction is mentioned. Infliction to kshipra and talahridaya marma (located in palms and soles) causes profuse bleeding that aggravates [[Vata dosha|vata]] and may prove fatal for [[Ayu|life]]. In such a condition, a surgeon can amputate the distal part of the extremity from the wrist or ankle to save the patient. [Su. Sha. Ghanekar Tika 6/42-43]   

While performing surgery the surgeon should know the vivid structural anatomy and its variation with probabilities of that particular region. In Cholecystectomy, the surgeon should know the variations in biliary apparatus otherwise bile leaks in peritoneum leads to biliary peritonitis and causes death. Similarly during open reduction surgery on elbow joint dislocation with fracture may damage ulnar, radial, or median nerve can cause paralysis.  

While performing surgery the surgeon should know the vivid structural anatomy and its variation with probabilities of that particular region. In Cholecystectomy, the surgeon should know the variations in biliary apparatus otherwise bile leaks in peritoneum leads to biliary peritonitis and causes death. Similarly during open reduction surgery on elbow joint dislocation with fracture may damage ulnar, radial, or median nerve can cause paralysis.  

During spinal surgeries there may be the chances of trauma to spinal roots that leads to lower motor neuron palsy.   

During spinal surgeries there may be the chances of trauma to spinal roots that leads to lower motor neuron palsy.   

The neck is the most delicate region of our body while performing the surgeries on neck region for example in thyroidectomy severe bleeding may obstruct air way leads to respiratory distress, or sometime injury to recurrent laryngeal nerve cazuses permanent hoares voice.  

The neck is the most delicate region of our [[Sharira|body]] while performing the surgeries on neck region for example in thyroidectomy severe bleeding may obstruct air way leads to respiratory distress, or sometime injury to recurrent laryngeal nerve cazuses permanent hoares voice.  

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== Marma therapy in Siddha medicine ==  

== Marma therapy in Siddha medicine ==  

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According to Siddha medicine, Varmam points (vital points) are the places in the body where the subtle Varmam energy is found.[i] There are 108 such vital points in the human body divided into two groups: Padu Marma and Thodu Marma. The Padu Marmas are 12 and Thodu Marmas are 96 in number. Clinically the Padu Marmas are essential. Manipulating or stimulating Marma points in the management of diseases is called ‘marma chikitsa (marma therapy)’ and humans have the inherent power to heal through these points. Through stimulation of marma by various means and methods, the prana (vital energy) existing in it may be directed to remove blockages (even in remotely connected areas) and stimulate energy flow thus resulting in a state of healthy body, mind, and spirit. A judicious application of pressure on appropriate Marma can restore the normal functioning of prana (in affected body parts) where improper manipulation may cause severe pain, disability, deformity and even death.[ii]   

According to Siddha medicine, Varmam points (vital points) are the places in the [[Sharira|body]] where the subtle Varmam energy is found.[i] There are 108 such vital points in the human [[Sharira|body]] divided into two groups: Padu Marma and Thodu Marma. The Padu Marmas are 12 and Thodu Marmas are 96 in number. Clinically the Padu Marmas are essential. Manipulating or stimulating Marma points in the management of diseases is called ‘marma chikitsa (marma therapy)’ and humans have the inherent power to heal through these points. Through stimulation of marma by various means and methods, the prana (vital energy) existing in it may be directed to remove blockages (even in remotely connected areas) and stimulate energy flow thus resulting in a state of healthy [[Sharira|body]], [[Manas|mind]], and spirit. A judicious application of pressure on appropriate Marma can restore the normal functioning of prana (in affected body parts) where improper manipulation may cause severe pain, disability, deformity and even death.[ii]   

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There are 12 methods of varmam application as follows,[iii]  

There are 12 methods of varmam application as follows,[iii]  

Manipulating or stimulating marma points in managing diseases is called ‘Marma Chikitsa (Marma therapy)’. In the Southern part of  India, some traditional practitioners have developed specific therapies based on vital points different from ayurvedic classics. In Kerala, the knowledge of Marma is preserved in the form of ‘Kalaripayattu’. Practitioners of Kalaripayattu employ the knowledge of marma for self-defence techniques & healing purposes.   

Manipulating or stimulating marma points in managing diseases is called ‘Marma Chikitsa (Marma therapy)’. In the Southern part of  India, some traditional practitioners have developed specific therapies based on vital points different from ayurvedic classics. In Kerala, the knowledge of Marma is preserved in the form of ‘Kalaripayattu’. Practitioners of Kalaripayattu employ the knowledge of marma for self-defence techniques & healing purposes.   

According to the practitioner of Siddha medicine, there are total 108 such vital points in human body. Manipulating or stimulating marma points in the management of diseases is called ‘Marma Chikitsa (Marma therapy)’ and it is an inherent power of humans to heal itself through these points. Through stimulation of marma by various means and methods, the prana (vital energy) existing in it may be directed to remove blockages (even in remotely connected areas) and stimulate energy flow, thus resulting in a state of healthy body, mind and spirit. A judicious application of pressure on appropriate marma can restore the normal functioning of prana (in affected body parts) where as their improper manipulation may cause severe pain, disability, deformity and even death.  

According to the practitioner of Siddha medicine, there are total 108 such vital points in human body. Manipulating or stimulating marma points in the management of diseases is called ‘Marma Chikitsa (Marma therapy)’ and it is an inherent power of humans to heal itself through these points. Through stimulation of marma by various means and methods, the prana (vital energy) existing in it may be directed to remove blockages (even in remotely connected areas) and stimulate energy flow, thus resulting in a state of healthy [[Sharira|body]], [[Manas|mind]] and spirit. A judicious application of pressure on appropriate marma can restore the normal functioning of [[Prana|prana]] (in affected body parts) where as their improper manipulation may cause severe pain, disability, deformity and even death.  

There are 12 methods of varmam application as we have seen earlier. All these methods can be executed on varmam point. The Siddhas had propounded that the application of these 12 techniques on a single point is capable of curing 48 different diseases.   

There are 12 methods of varmam application as we have seen earlier. All these methods can be executed on varmam point. The Siddhas had propounded that the application of these 12 techniques on a single point is capable of curing 48 different diseases.   

This therapy is able to remove blocks in energy channels (srotas), pacify dosha bringing it to the normal path (especially vyana vayu, which controls the autonomic nervous system), creates physical, mental, and emotional flexibility, and create an opportunity to experience powerful and dynamic transformation at a physical, mental, emotional and spiritual level by building a positive link with the subconscious mind.  

This therapy is able to remove blocks in energy channels (srotas), pacify dosha bringing it to the normal path (especially vyana vayu, which controls the autonomic nervous system), creates physical, mental, and emotional flexibility, and create an opportunity to experience powerful and dynamic transformation at a physical, mental, emotional and spiritual level by building a positive link with the subconscious [[Manas|mind]].  

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== Advantages of marma knowledge in modern surgery ==

== Advantages of marma knowledge in modern surgery ==

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Marma is one of the unique and vital topics discussed in Ayurveda. It plays an essential role in surgery. Hence it is called Shalya Vishayardha (half knowledge of surgery). Unless one has not obtained proper knowledge of vital parts of body,  he/she will not be a good surgeon. While performing the surgeries on upper and lower limb surgeon should know the Urvi, Bahavi, Aani, Indrabasti Marmas etc. Because major blood vessels pass through these areas, injury to these vessels during surgery can cause severe blood loss. Similarly, injury to Gulfa, Janu, Kurpara, Manibandha, causes trauma to any one or more ligaments of joint leads to severe pain and disability. During the surgeries on cubital or popliteal fossa, the surgeon should know the position of blood vessels and nerves; otherwise the patient will be in severe complications. So to avoid complications and get the desired outcome surgeon should have proper knowledge of marma sharira.   

Marma is one of the unique and vital topics discussed in [[Ayurveda|Ayurveda]]. It plays an essential role in surgery. Hence it is called Shalya Vishayardha (half knowledge of surgery). Unless one has not obtained proper knowledge of vital parts of [[Sharira|body]],  he/she will not be a good surgeon. While performing the surgeries on upper and lower limb surgeon should know the Urvi, Bahavi, Aani, Indrabasti Marmas etc. Because major blood vessels pass through these areas, injury to these vessels during surgery can cause severe blood loss. Similarly, injury to Gulfa, Janu, Kurpara, Manibandha, causes trauma to any one or more ligaments of joint leads to severe pain and disability. During the surgeries on cubital or popliteal fossa, the surgeon should know the position of blood vessels and nerves; otherwise the patient will be in severe complications. So to avoid complications and get the desired outcome surgeon should have proper knowledge of marma sharira.   

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