Review Article
Year: 2025 |Volume: 6 | Issue: 09 |Pages: 99-102
An Overview on Medicosurgical Importance of Marma Therapy
About Author
Correspondence Address:
Dr. Shubhangini Rajendra Waratkar PhD Scholar, Assistant Professor, Dept. of Rachana Sharir, Shri Ayurved Mahavidyalaya Nagpur, Maharashtra, India. Email: id-shubhangiwaratkarchakole@gmail.com.
Date of Acceptance: 2025-08-09
Date of Publication:2025-09-27
Article-ID:IJIM_439_09_25 http://ijim.co.in
Source of Support: Nil
Conflict of Interest: Non declared
How To Cite This Article: Waratkar S., Choudhari V. An Overview on Medicosurgical Importance of Marma Therapy. Int J Ind Med 2025;6(09):99 -102 DOI: http://doi.org/10.55552/IJIM.2025.60918
Abstract
Marma Chikitsa, an ancient therapeutic modality rooted in Ayurveda, emphasizes the stimulation and regulation of marmas—the vital energy points distributed throughout the human body. Traditionally regarded as centers where prana (life force), doshas, and structural elements converge, marmas are considered gateways to both health and disease. In recent years, Marma Chikitsa has gained renewed attention for its potential role as a complementary approach in surgical care. By activating specific marma points, practitioners aim to optimize physiological responses, alleviate perioperative pain, reduce stress, and accelerate the natural healing process. Emerging clinical observations and preliminary studies suggest that Marma Chikitsa may contribute to improved post-surgical outcomes, including enhanced wound healing, minimized scar formation, better tissue regeneration, and reduced incidence of complications. Integrating marma-based interventions into surgical protocols offers a holistic dimension that addresses not only the physical but also the psychological aspects of recovery. This abstract examines the foundational principles of Marma Chikitsa, explores its mechanisms of action in the context of surgery, and highlights its therapeutic potential in enhancing recovery and patient quality of life. However, rigorous scientific validation, standardization of techniques, and evidence-based clinical trials are imperative to establish Marma Chikitsa as a recognized adjunct in contemporary surgical practice.
Keywords: Ayurveda, Marma, Marma Therapy, Trimarma.
Introduction
There are total 107 Marma point mentioned in the Sushruta Samhita and Charak Samhita present in body[1]. Marma sthanas are the point of junction of the Mansa, Sira, Asthi, Dhamni and Sandhi where the Prana situated[2]. Ayurvedic Acharyas have classified the Marma sthanas on the basis of location, number, composition, effects of injury etc. Marmas are vital parts of the body. Any injuries directly affecting the Marma sthana (sites of Marmas) results to death immediately or later or serious complications. Diseases which are aries from marma sthan are difficult to cure. Acharya charak mentioned that Vyadhi of Trimarma is difficult to treat for example disease of Shira, Hridya and Basti. Therefore the knowledge of Marma is very essential for the surgeon to protect the patient from any harm during the surgery. Sushruta mention that “knowledge of Marmas is half of the knowledge of surgery” because knowledge on various classification, their nature, extent of area, consequence & consequential prognosis of Marma plays an important role for the Vedhya particularly during procedure over the Marma area of the body. So Vedhay should be known about Marma during diagnosis & treatment the disease. So Marma points should always be protected from injury.
AIM AND OBJECTIVES- To study the Medico surgical importance of Marma Therapy.
METHODOLOGY- It includes reviewing of Ayurvedic classics including relevant commentaries regarding Marma Chikitsa as well as contemporary research articles and clinical studies related to Marma Sharir.
Classification of Marmas-
A. According to their Location in different Regions of the Body-
i.e. upper limbs (22), lower limbs (22), abdomen and chest (12), back (14),neck and head(37).
B. Anatomical classification of Marmas according to Acharya Sushruta-
Acharya Sushruta has classified Marmas into five types according to the Dhatu from which they are made. These types include Mamsa-11 (Muscle), Asthi- 8(Bone), Snayu-27 (Ligament), Sira-41(Vessel) and Sandhi-20 (Joint).
C. Anatomical Classification of Marmas according to Acharya Vagbhata-
Acharya Vagbhata has classified Marmas into six types according to the Dhatu bheda. He has added one additional Marma named 'Dhamani Marma'. These types include Mamsa-10 (Muscle), Asthi-8 (Bone), Snayu-23 (Ligament), Dhamani-9 (Artery), Sira-37 (Vein) and Sandhi-20 (Joint).
D. According to the Size of Marmas-
The Size of Marma varies from ardha-anguli (half finger) to hatheli (palm) or mushti (fist). Out of 107 marmas, 56 are of half finger size, 12 are of one finger size, 6 are of two finger size, 4 are of three finger size, and 29 are of one palm or one fist size.
E. According to the Result/Outcome (Symptoms if Injured)-
Sadyah Pranahara (Immediate death causing) (19), Kalantara Pranahara (Death causing after some time) (33), Vishalyaghna (Fatal after removal of foreign material) (3), Vaikalyakara (Disabling) (44), and Rujakara (Painful) (8).
Importance of Trimarma:
Acharya Charaka accepting the 107 marmas, specially explains the three marmas Shira, Hridaya and Basti in Trimarmeeya chikitsa[3,4]. In this chapter Acharya highlights the importance of these marmas and diseases and their treatment protocols. Acharya Charaka in Siddhistana explains the importance of these three marmas as follows:
Hridaya: Hridaya has ten dhamanies, seat of prana and vyana vata, sadhaka pitta, Avalambaka kapha, manas, buddhi and chetana sthana, moolasthana of pranavaha and rasavaha srotas and also the seat of para ojus. Because of all these facts Hridaya is one among the Dasha pranayatana and Sadyapranahara marma.
Shira: Shira is the seat of all jnanendriyas and their paths of Indriya vishaya gnana, if in-jured results in cheshtanasha, chakshuvibhrama, hanugraha etc.
Basti: Basti is situated in midst of Guda, mushka, sevani, Shukra and mutra vahininadi and controls their integrity.
Marmaghata Lakshanas: When a Marma is injured results in either death or deformity. Depending upon the site there may be common and specific symptoms. Common lakshanas includes Bhrama, pralapa, Moha, Moorcha, teevra ruja, Rudhira srava, Urdhwavata and so on[5].
Vishesa viddha lakshanas are specific to each Marma for Eg: If injury to Urvee/Bahvee marma located in mid of thigh /arm results in sakthishosha(Dystrophy of Thigh / arm) due to Shonita kshaya. If injury over Vitapa marma located in between Vankshana (inguinal) and Vrushana area (scrotal) results in impotence and Alpa shukrata.
Precautionary Measures: While doing some surgical procedures, to avoid the impact of Marmaghata Acharyas have enlisted certain precautions. Ashmari Chikitsa: Acharya Sushruta has instructed the surgeon to take the permission from King or higher authority before Ashmari nirharana shastra karma. When the surgeon locates the Ashmari during Shastrakarma of Ashmari, he has to inspect the face of the patient before taking the incision, if Vivrataksha and loss of conscious (vichetana) is observed then instructed to stop the procedure[6]. At the concluding shloka of the chapter highlights eight parts in and around Basti as Ashta marmas and instructed always to protect them from injury during Surgery[7]. Kshara Karma: In Pradesha vishesha (location wise) contra indications of Kshara prayoga, Sushruta lists marma pradesha as a first place where kshara karma should not to be done.
Agnikarma, Application of kshara and visha Dravyas should be avoided in Marma Pradesha as area of Marma is vital[8].
Shalya nirharana: When a Marma is injured, Vata aggrevates in and around the affected area and results in the pain. The pain may be intensified to the extent of loss of consciousness, so it is the duty of the surgeon to examine the patient thoroughly before removing the Shalya.
Discussion
Marmas are the vital areas of the body which need to be protected from injuries, if injured may result in chronic pain, deformity or even death. If an injury occurs even nearer to a Marma , results in same effects when marma is directly injured. Marmas are classified in a realistic manner as in Marmaghata site of the injury becomes more important rather than type of injury. Classification of Marma based on Effect of injury and measurement are the basic clues to the surgeon to proceed further. Types and Rules of incision to be taken have been stressed on during each surgery to highlight the importance of possible Marmasthana and its avoidance during surgery.
Conclusion
An Injury on Marma results in medical or surgical emergencies leading to fatal consequences. Marmaviddha lakshanas are the first ever documentation of Applied and surgical anatomy. As, Marma Sharir refers to the vital points or sensitive areas of the body where vital energy (prana) is believed to be concentrated, So Marma points should always be protected from injury while doing surgical procedures.
References
- Shastri A, Sharira sthana, Susrut samhita, Chaukhamba Sanskrit Sansthan, Varanasi, 1997; 6: 50-58 and charak Samhita chikitsa sthan chapter 26 Svimarsh Vighotni hindi tika Chokhambha Bharti akadmi Varanasi.
- Shastri A, Sharira Sthana, Susrut Samhita, Chaukhamba Sanskrit Sansthan, Varanasi, 1997; 6: 16.
- Acharya Vidyadhar Shukla, Prof. Ravi Dutt Tripathi, Charaksamhita of Agnivesha elaborated by Charaka and redacted by Drdhabala, Vol 2 edited with ‘Vaidyamanorama’ hindi commentary along with special deliberation etc.; the Vrajajivan ayurvijnana granthamala 24; Chaukhambha Sanskrit Pratishthan Delhi Reprint 2011, Siddhi sthana sloka 9/3;P-945
- Acharya Vidyadhar Shukla, Prof. Ravi Dutt Tripathi, Charaksamhita of Agnivesha elaborated by Charaka and redacted by Drdhabala, Vol 2 edited with ‘Vaidyamanorama’ hindi commentary along with special deliberation etc.; the Vrajajivan ayurvijnana granthamala 24; Chaukhambha Sanskrit Pratishthan Delhi Reprint 2011. Chikitsa sthana sloka 26/3;P-622
- Dr. Anant Ram Sharma, Susruta Samhita of Maharsi Susruta Vol 2 Edited with ‘Susrutavimarsini’ Hindi commentary along with special deliberation etc. foreword by Acharya Priya Vrat Sharma, The Chaukhamba Ayurvijhan Granthamala 71, Chaukhamba Surbharati Prakashan Varanasi 2012. Sutra sthana sloka 25/34-35,P-214
- Acharya Sushruta, Sushruta samhita with Nibandha sangraha commentary of dalhanacharya and Nyaya Chandrika Panchika of Gayadasa on nidanasthana edited by Vaidya Jadavaji Trikamji Acharya Reprint Edition 2014: Chaukamba surabharati Prakashan Varanasi, Chikitsa sthana 7/29-30 page no-436.
- Ibid, Chikitsa Sthana7/38 page no-438
- Acharya Sushruta, Sushruta samhita with Nibandha sangraha commentary of dalhanacharya and Nyaya Chandrika Panchika of Gayadasa on nidanasthana edited by Vaidya Jadavaji Trikamji Acharya Reprint Edition 2014: Chaukamba surabharati Prakashan Varanasi Sutra sthana 11/29 page no-50
