Exploring the Science of Marma-An Ancient Healing Technique: Definition and Properties of Marma

In the vast sea of the knowledge of Ayurveda, Marma is one of the extremely important topics. Marma points have been unanimously accepted as the ‘seats of life’ (Prana the vital life force). If these locations are injured, then it may lead to severe pain, disability, loss of function, loss of sensation, or death. Therefore, the ancient scriptures have strictly directed that these vital locations should not be injured, and due care should be taken in this regard even while doing surgeries. However, recent researches indicate that if there is inflammation or pain at any Marma point, then stimulating its nearby Marma points can help in alleviating this pain. This Marma Therapy has been used in treating various physical and mental disorders, with encouraging results. In view of the importance of Marma Science mentioned in scriptures and with regards to surgeries, as well as the encouraging outcomes of Marma Therapy in recent times, the present study was undertaken for an in-depth study of the Science of Marma. Part-1 of this study gave an account of various ancient / classical Indian scriptures that mention different aspects of the Science of Marma. The present article, which is Part-2 of this study, gives a detailed description of the number of marmas, their location, structures involved, correlation with Panchamahabhutas, classification, as well as a detailed explanation of marmaghata or viddha lakshanas (effect of trauma), as given in classical texts written during Samhita kala. The anatomical correlation with modern science is also presented.

However, recent researches indicate that if any Marma point is inflamed or painful, then stimulating its nearby Marma points can help in alleviating this pain (4). Several studies and texts have reported the therapeutic benefits of Marma Therapy in treating various physical and mental disorders .
Looking at the importance of the Marma Science with regards to surgeries, as well as their recent use and future possibilities as an effective therapeutic procedure, the present study has been undertaken for an in-depth study of the Science of Marma.
Thus, based on the above descriptions, Marma is derived from the root word 'mri' with suffix 'manin'. The word 'Marman' is the singular form, which means jeevasthanam (seat of life) or sandhisthanam (meeting place).
Etymologically each letter of word marma has got specific meaning -'Ma' means prana or vayu, Repha denotes house or seat. In case of affliction in any marma point, there is more pain (excruciating type) than any other part of the body, because of the specific attachment of chetana (consciousness) to these spots (51). All the above lakshanas show the importance and vitality of Marma points. Any injury, trauma or disease affecting Marma will cause death or miseries equal to death.

Classification of Marmas
In the ancient scriptures, Marmas have been classified in different ways, such as their location in different regions of the body, anatomy, size, effect of trauma on these, etc. This section illustrates the different types of classifications of Marmas. Table 1 gives the classification of Marmas according to their location in different regions of the body, i.e. upper limbs (22), lower limbs (22), abdomen and chest (12), back (14), supraclavicular region (neck and head) (37).

Rujakara (Painful) (8)
The nature of Kalantar Pranahara marma is Saumyagneya, i.e. having qualities of both fire and water; therefore, although due to their fire like nature, an injury to these marma kills the affected person quickly, but because of the cold and stable nature of soma (water), the occurrence of death is delayed (Sushruta Sharira 6/16) (1). For Kalantar Pranahara marma, the fatal time period is from fifteen days to one month (Sushruta Sharira 6/23) (1). These are thirty three in number (Sushruta Sharira 6/8) (1). If an injury occurs at the border or nearby area of the location of Kalantar Pranahara marma, it causes deformity, i.e. the effect is similar to that of Vaikalyakara marma (Sushruta Sharira 6/22) (1).
Vishalyaghna marma are Vayavya, i.e. having qualities of air. If these marma are injured by a shalya (foreign body), then because of their Vayavya nature, as long as the air remains obstructed inside (i.e. prevented from coming out) by the mass of the shalya (foreign body), the person stays alive, but as soon as the foreign body is pulled out, the air residing in the fatal spot comes out and the person dies. However, after the injury, if the shalya is not pulled out before the completion of the auto healing process, then it provides protection to the Prana at that location untill the wound is healed normally, and the shalya is pulled out along with pus (Sushruta Sharira 6/16) (1). Vishalyaghna marma may also sometimes lead to death if these are heavily injured (Sushruta Sharira 6/23) (1). These are three in number (Sushruta Sharira 6/8) (1). If an injury occurs at the border or nearby area of the location of Vishalyaghna marma, it causes deformity, i.e. the effect is similar to that of Vaikalyakara marma (Sushruta Sharira 6/22) (1).
Vaikalyakara marma are Saumya, i.e. having qualities of moon / water. Because of the stability and cold property of Soma guna, these help in the sustenance of life (Sushruta Sharira 6/16) (1). Vaikalyakara marma may also sometimes lead to death if these are heavily injured (Sushruta Sharira 6/23) (1). These are forty four in number (Sushruta Sharira 6/8) (1). If an injury occurs at the border or nearby area of the location of Vaikalyakara marma, it harms the body after some time and also produces pain, i.e. the effect is similar to that of Rujakara marma (Sushruta Sharira 6/22) (1).
Rujakara marma predominantly have the properties of fire and air, both of which produce pain (Sushruta Sharira 6/16) (1). Although Agni is diminished because of trauma, yet Vayu causes constant pain at the affected part. These are eight in number (Sushruta Sharira 6/8) (1). If an injury occurs at the border or nearby area of the location of Rujakara marma, it causes severe pain (Sushruta Sharira 6/22) (1).

S. Marma
Location ( Table 6. Location, anatomical correlation, size and number of Marmas of Lower Extremities.

Marmaghata (Injury to the Marma Points)
As described earlier, injury to the Marma points, i.e. Marmaghata, can lead to severe pain, loss of sensation, loss of function, disability, and death. A significant portion of Shalya Tantra (science of surgery) deals with the knowledge of the fatal spots (marmas), because any injury to these fatal spots leads to sudden death, and if anyone survives due to the efficiency of the physician, the occurrence of deformities is almost a certainty (Sushruta Sharira 6/33) (1).

Samprapti of Marmabhighata
The Samprapti of Marmabhighata can be understood from the following flowchart ( Figure 2) (Sushruta

Conclusion
The present article explored the foundational elements of the Science of Marma with regards to the number of marmas, their location, structures involved, correlation with Panchamahabhutas, classification, as well as a detailed explanation of marmaghata or viddha lakshanas (effect of trauma), as given in classical texts written during Samhita kala. The anatomical correlation with modern science has also been presented.
It is observed that the Marmas are of different sizes varying from ardha-anguli (half finger) to hatheli (palm). If injured, different Marmas lead to different kind of symptoms varying from pain to immediate death.
In such a case, several methodologies for the treatment of Marmabhighata have also been suggested in the scriptures. Thus, an in-depth knowledge about the properties of Marmas is available in the scriptures.
The Part-3 of the exploration of the Science of Marma will deal with the foundational elements and current status of Marma Therapy, which is a relatively recent application of this ancient science.