Marma

Marma are the vital areas of the body. Injury to these areas can cause death or serious damage to body or health. Marma is one of the unique and important topics discussed in Ayurveda. It plays an essential role in surgery. Hence it is called Shalya Vishayardha (half knowledge of surgery).

Marmas are the sites of prana (soul), agni (light or heat: a source of eternal energy), soma (water or an eternal source of calmness) and panchamahabhuta (five fundamental elements). Prognosis after injury, significantly depends on the composition of these vital energies.

The science of Marma was known to mankind from Vedic period, and it has especially been designed to determine the prognosis of injuries at the time of war. Simultaneously, marma knowledge was applied to cause fatal trauma to the enemy leading to victory on the battlefield. Acharya Charaka mentions the 107 Marmas in Charak Samhita (100BCE-200BC). However, being a physician, Charak has emphasized three major marmas, which are shira (head), hridaya (heart), and basti (urinary bladder). He gave a vivid description in Charak Samhita [Cha. Sa. Chikitsa Sthana 26/01]. Acharya Sushruta also identified 107 Marmas in the human body. As a surgeon, he contributed detailed explanations on this topic. Acharya Vagbhata also mentioned 107 marmas in Sharira Sthana of Ashtanga Hridaya with slight variation. The present article describes marma concept, surface anatomy, and practical application.

Contributors

Section/Chapter/topic	Concepts/Marma
Author	Kasar N.V.1
Reviewer	Basisht G.2,
Editor	Deole Y.S.3
Affiliations	1 Department of Rachana Sharir, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India 2 Rheumatologist, Orlando, Florida, U.S.A. 3 Department of Kayachikitsa, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India
Correspondence emails	drnileshvk@gmail.com, carakasamhita@gmail.com
Publisher	Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India
Date of publication:	November 12, 2022
DOI	In process

Etymology

The word ‘Marma’ is derived from the basic Sanskrit word ‘mri’, meaning ‘death’. The vital points of the body causing death after infliction is called ‘Marma’ [Su. Sa. Sharira Sthana Dalhana 6] [Ash. Sa. Sha. 7]. It is also considered to be the vital part of body causing death, unbearable pain, or permanent disability after injury. [Ash. Hri. Sha. Arundatta Tika 4]

Definition

Marma is defined as the anatomical structure where mansa (fleshy part or muscles), sira (vessels), snayu (ligaments), asthi (bones) and sandhi (articulations) are assembled and form a complex structure, which is also the site of prana (vital energy). [Su. Sa. Sharira Sthana 6/15] The body part that shows uncharacteristic pulsation with severe pain after infliction is called marma [Ash. Hri. Sha. 4/37]. Injury to marmas show fatal signs such as hypoxia, hypotension, hypovolemic shock (due to profuse blood lose) and severe pain. It can cause sudden death due to injury to cardiovascular center or respiratory center, as seen in capital punishment. Injury to marma may result in permanent disability as seen in upper or lower motor neuron lesions or injury to peripheral nerves or may be due to avascular necrosis. Or it may produce severe intolerable pain on infliction; such remarkable areas are known as ‘Marma’.

Classification of marma

Marmas are classified based on body part, structure, prognosis, dimension, and its basic constitution.

I. Based on body parts

Marmas are classified into five categories based on their location on body:

1. Sakthi marma (located in lower extremities)
2. Bahu marma (located in the upper extremities)
3. Ura and udarastha (in the region of thorax and abdomen)
4. Prushtha (in the back)
5. Jatrurdhva (in head and neck) [Su. Sha. Ghanekar Tika 6/4].

There are 11 Marmas in each extremity, making the total number 44. 12 marmas are in the trunk. On the back, the number is 14, and 37 marmas are present in the head and neck region.