Vous êtes sur la page 1sur 48

(In Ayurvedic Diagnosis and Treatment)

Dr. Srinivas Hejmadi Acharya


B.S.A.M., M.D. (Ayu), Ph.D

SCIENCE OF MARMA

Program Officer & Head, International enter for Ayur!edic Studie"# Head of Pancha$arma De%artment &u'arat Ayur!ed (ni!er"ity )amnagar

Abadhavarjanam Nityam Svasthavrittanuvartanam Utpannartivighatascha Marmanam Paripalanam. ~aibiidviji^nio *nityio svisWiviVttiini#viti^nio utpinnii*ti^*viGiitiSci mimi^Niiopi*rpiilinio~
To defy from dangers to Marma, to follow the hygienic measures e ery day and to treat the affliction, are the means to care Marma!

Science of Marma
(In India and Abroad)
"! #nowledge of Marma related to martial art $ warfare medicine! %! #nowledge of Marma with surgical im&ortance! '! #nowledge of Marma with medical im&ortance a! Marma Chi(itsa ) mani&ulating $ treating Marma in the management of diseases!

*! Marma Nidana ) utili+ing Marma ,ari(sha in diagnosis of illnesses!

CONTE-T OF ,RANA )"


Prana though prevailing ubiquitously in entire body, it per orms the unctions according to the organs situated in the local regions. !n the local regions also, Prana gets more centralised in speci ic parts "hich can be called as its seat or chie centre. #part rom this, there are lesser centres belonging to that local region "here Prana keeps moving to aid (Sanchara Sthana) the unctions o those body parts. Such movements by currents o $rana may also have speci ic directions. %his is elucidated in ad&oining picture.

CONTE-T OF ,RANA )%
'hen Prana gets disturbed in localised regions only, then the disturbed unction o that related region shall be e(hibited. %his may happen as a consequence to many causes (etiological actors) that hamper the local regional path"ays o Prana. %his is true "ith the sense that certain local packets o Prana (Marma) are also a ected during such event. !t may be hypothesised, that by tact ul stimulation o local centres o Prana, the paths or movement o Prana become cleared and normal unctioning ensues. %his hypothesis is urther discussed in the orth coming chapters.

CONTE-T OF ,RANA )'

CONTE-T OF ,RANA ).

CONTE-T OF ,RANA )/

Marma 0astu 1Matri23


The site of Marma constitutes some physica substances of the body. These are five in number vi!. ".Mamsa (muscle) 2.Sira (vessels conveying body fluids & impulses). 3.Snayu (flat tapering substances like tendons) 4.Ast i (bone) and #.Sand i (articulative points especially bone !oints).

Marma 0astu 1Matri23


%he #gni, Soma and )ayu are seemingly important basis through "hich the multiple unctions o $rana (li e energy) in the body is made possible. %hus *arma )astu is also considered by the predominence o #gni, Soma, and )ayu.

Marma 0astu 1Matri23

Marma

Ty&es of Marma
4 a3 Su&erficial 15ttana3 Marma 4 *3 6ee& 17am*heera3 Marma 4 c3 Neither su&erficial nor dee& 15*haya3 Marma (such opinions are not prompted in classical books of Ayurveda.)

Ty&es of Marma
$hysica Matri%
Mamasa Marma Sira Marma Snayu Marma Asthi Marma Sandhi Marma #hamani Marma Eleven in number F urty ne in number !"enty Seven in number Eight in number !"enty in number Nine in number (as per $agbhata)

Ty&es of Marma
Specia &eatures Sadhya Pranahara &alantara Pranahara $ishalyaghna $ai(alya(ara )uja(ara #eath by % days #eath by ' rtnight r m nth #eath as s n ' reign b dy rem ved #e' rming Sever pain

Ayurveda Sthapani Shankha #panga *atrika )asti !ndrabasti /ridaya

Some com&arison of Martial Marma with the classical ones!


Kulabhyasa Sirasayam +annunthi +a-huthukochi .alpandum ,adypathy %hilakusy Tamil %hrikoodhyakam %hilaskkla Chivukkutty ,aksatram )ilanku *oothiram ,adupautha ,eeramarma

(!nvestigation to pathognomy o *arma)


Examination of Marma (marma pareeksha)

Marma Nidana

Signs of Affliction to Marma Understanding the relation of Marma with


mind

Clinical application of Marma

$a pation of Marma
%he method or palpating speci ic *arma are described in the previous chapter. %he patient must lie in a rela(ed posture be ore physician starts palpating. !t is al"ays pre erable to e(amine 0*arma1 in the morning hours a ter raising rom the bed. $hysician must make sure that the patient is not asting neither o ull stomach and he has attended morning toilette.

$a pation of Marma
%he doctor has to look or *arma points care ully one by one making sure that he is palpating the *arma place and not any other in&ured tender part near by. Charaka says *arma are the sites o Chetana nibaddha i.e., speci ic places o Chetana (consciousness) and hence they are comparatively tender in nature. %he pain originating in these *arma places (on a liction2) are sever in comparison to the other places o body (Charaka Samhita. Siddhi Sthana. 9th chapter 3rd Sloka). %hus eeling o pain on slight pressure is the only reliable inde( to identi y as "ell to assess the vitiation o *arma. %he physician must be attentive enough to assess the degree o tenderness. %his one has to acquire only by constant practice and e(pertise. %he tenderness being a varying actor related to the constitution o the patient and also illness. %his phenomenon is similar to that o e(amining and grading bodily re le(es o the patient in neurological practice "here "ithout proper practice re le(es can not elicited. )agbhata adds to above in ormation that the *arma are the places "here pulsations (Spandanam) are ound along "ith some degree o tenderness.

4(amination o #msakoota

4(amination o #msapalaka

4(amination o Sphik *arma

4(amination o kukundara

4(amination o $arshvasandhi

4(amination o !ndrabasti in legs

4(amination o #ani *arma

4(amination o +oorchashira in legs

4(amination o !ndrabasti in hands

4(amination o +rikatika

4(amination o #dhipati

Sel $alpation o Shankha

General signs of Injuries to Marma


Bhrama Pralapa Patanam Pramoha "i heshtanam Samlayanam !shnata Srasthangata Mur ha !rdhva "ata Teevra #uja Mamsoda$a Srava Sarvaindriyartha !parama

Signs of affliction to 8ridaya Marma


'hen /ridaya gets a licted (#bhihate) "ith the vitiated 5osha in the body the ollo"ing eatures supervene 6 cough and dyspnoea, reduced strength o the body (strength or e(ertion), dryness in the throat, peculiar e(tracting pain in lungs (+lomakarshana), protrusion o the tongue, dryness o buccal cavity (*ukhatalu Shosha), convulsions (#pasmara), psychosis (7nmada), delirium ($ralapa), disorientation (Cittanasha). Signs 8 symptoms sho"n above simulate cardiac arrest, shock, and also sever respiratory crisis, leading to neuro psychological disturbances. !t "ill be a deviation rom the main topic to consider the pathophysiological discussions here. /o"ever, an intelligent physician can grasp the underlying clinical picture by the above quotations.

Signs of aff iction to Shiro Marma


%he name o Shiro *arma is not used in the list o 109 *arma. !t possibly re er collectively the important *arma ound on the head (Shiras). Shiro *arma does not re er to the organs on the head like eyes, nose, ear etc. :ut more truly to the brain. %he ollo"ing eatures supervene "hen shiro *arma is vitiated by 5osha (intrinsic actors) 6 torsion o the neck like that o torticolis (*anyastambha), acial paralysis ; transient paresis o hal side o body (#rdita), visual disturbances (Cakshuvibhrama), delusion (*oha) binding ache in head ()eshtanam), loss o unction in body parts (Chestanasha), cough, dyspnoea (<adgada), drooping o eye lids, tics (<anda Spandanam), e(cessive ya"ning (.rambhanam), dribbling o saliva rom mouth, loss o pitch o the voice i.e. monotonous (Svarahani), torsion or spastic acial muscles ()adana .ihmatva) etc. %here is no need to point out that above eatures indicate various kinds o organic neurological problems.

Signs of affliction to 9asti Marma


'hen the vitiated Dosha in the body aff ict the (asti Marma the fo o)ing features appear. *etention of f atus+ retention of urine , faeca matter+ pain in the regions of groin genita s , b adder+ rotating , constricting pain as that of obstructive uropathy due to prostatitis (-unda a)+ group of signs occurring due to Avarana of Apana (udavarta)+ tumor.hyperp asia of /ata origin (Ashtee a)+ sti ness in b adder (0pastambha)+ restrictive pain (1raha) in umbi icus abdomen+ rectum , pe vis etc. The above sings , symptoms are indicative of anoma ies in b adder and obstructive uropathic conditions associated )ith conse2uences.

*e ation of Marma )ith Mind


In majority of the psychosomatic i ness +the invo vement of different Marma in the body is invariab y found. The mind e%hibits pro%ima re ations )ith the Marma !ones. Ayurvedic c assics state that mind prevai s throughout the body and its seat is Hridaya (Marma). The channe s of mind in the body are ubi2uitous , cannot be specified as in case of Tridosha too. $rana has intricate re ation )ith mind and /ata is the so e cause for motivating , contro ing the mind (3hara4a Samhita. Sutra Sthana. "5th chapter. 6th S o4a). 'e have discussed enough in ear ier chapters regarding $rana . /ata in re ation to the Marma. Therefore it is not astonishing that the state of mind inf uence upon Marma points in the body. It is a so true that the three 2ua ities such as Sattva+ *ajas+ and Tamas are a so found in the Marma )hich are three contents of the mind itse f. This ma4es an easy e%p anation that )hy the status of mind , its disturbances are ref ected upon Marma. More the mind is susceptib e , sensitive+ so is the state of Marma. &o o)ing are the e%amp es of certain psychosomatic and neurotic condition )here the Marma are genera y noted affected in our hospita .

The Clinical A&&lications of Marma


7nder this title author "ishes to emphasise on the utilisation o *arma $areeksha in clinical e(amination and assessment o the patients. 'e have discussed that morbidity at the site o *arma has direct relation "ith the vitiated 5osha 8 5hatu o the body. %here ore, the vitiated *arma is desirably related to the pathogenesis o particular diseases. *any a time *arma $areeksha becomes a valuable tool or di erential diagnosis. %he subtitle running belo" incorporates clinical details as e(perienced by the author 8 clinical datas are used "herever needed.

"elation of Marma #it some $iseses


=umbar 5egenerative 5iseases and Sciatica 666 !ndrabasti,+atikataruna,+ukundara,,itamba !n lammatory conditions 8 #ma > +shipra,%alahridaya, +urchashira, !ndrabsti. 5i erent /eadaches 666 Shankha,+rikatika,7tkshepa,#varta,Sthapani Cervial pain (spondylosis)666 +rikatika,#msapalaka,#msakoota. 4pilepsy, psychosis 666 +rikatika, 7tkshepa,Sthapani etc.

Marma Chi(itsa 1The Care of Marma3


Abadhavarjanam Nityam Svasthavrittanuvartanam Utpannartivighatascha Marmanam Paripalanam. ~aibiidviji^nio *nityio svisWiviVttiini#viti^nio utpinnii*ti^*viGiitiSci mimi^Niiopi*rpiilinio~
1. #badavar&anam ($reventive #spect) ?. Svasthavrittanuvartanam (%o"ards $ositive /ealth)

<eneral line o %reatment


4 ,rinci&ally, the treatment should in ol e the re&lenishment of *asic &hysical matri2 16hatu3 of Marma, the control of 0ata 6osha $ &acifying the ,itta 6osha, which in turn su&&lement the loss of ,rana too! In case of traumatic conditions, healing drugs $ *lood coagulants are to *e used! Thus the medicines ha ing the &ro&erties of Snigdha, Madhura, Ti(ta, :ee aneeya, 9alya, 9rimhana, 0ata Shama(a, ,itta Shama(a , are utilised in the treatment! Only if s&ecified, tactful remo al of #a&ha is &erformed!

Treatment of Marma
The treatment to the prob ems of Marma can be superficia y understood under the fo o)ing categories+ I. The interna treatment given by ora and other routes. II. The treatments given oca y at the site of Marma III. Ho)ever+ third y the psycho ogica component shou d be remembered by the physician.

I. The interna treatment


4 In general, while &rescri*ing drug regimen for Marma 0i(ara the ,hysician shall ha e to ta(e into account following &oints ; a! The general state of 6osha the *ody

itiation in

*! The su*stance <uality of Marma relating to itiation 1which include the 6hatu of Marma3 c! The Srotas or Ashaya 1system3 to which the s&ecific Marma *elongs d! ,refera*ly, the s&ecific ty&e of 0ata 1out of the fi e3 which resides in that Marma!

I. The interna treatment


Some !mporatant /erbs
@ :ala (#bitulum indicum) @ Aasna ()anda Ao(bhurgi) @ #malaki (4mbelica o icianalis) @ #r&una (%erminalia ar&una) @ #sh"agandha ('ithenia somni era) @ .eevanti (=eptadena reticulata) @ %aila (Sesum oil) ; 4randa (Castor Bil) @ *ilk and <hee

Some *ineral 8 herbo6mineral $reparations


@ #&asthi :hasma

(<oat bone :hasma) @ +acchapaprishta :hasma (%ortoise shell :hasma ) @ $eranda :hasma @ +apardhika :hasma @ *uktashukti :hasma ($earl shell :hasma) @ .aharmohar $ishti @ Aa&ata :hasma (Silver :hasma) @ Suvarna :hasma (<old :hasma) @ ,ava&eevana Aasa *arma <utika

II. The treatments given oca y


The Marma are also treated locally at the site! This suites more &refera*ly for the su&erficial Marma largely e2isting on e2tremities, *ac( and some on face! 9ut for the dee&er Marma also, in some instances treatments are gi en locally u&on the su&erficially referring anatomical area a*o e them! Such treatments include oil a&&lications, A*hyanga 1massage3, heat a&&lications=Agni(arma 1cautery3 in the surrounding area, u&anaha 1hot &oultice3, 6hara, >e&a, 5d artana etc!

4 ,al&ation of Marma locally, howe er, counts first in the treatment of Marma e2isting su&erficially! A&&lying comforta*le &ressure and stro(ing with fingers and &alms u&on the Marma sites is a *est way to treat them! The (nowledge of accu&ressure may *e hel&ful for the &ractitioners willing to use the (nowledge of Marma!

Some 5seful local remedies


7 Marma epam 7 1hee+ Mi 4+ 3oo )ater+ Mud+ Mahanarayana Tai a+ -sheeraba a Tai am etc. Some usefu Therapies under $ancha4arma 7 Abhyanga (particu ar y over Marma) 7 0nmardana 7 Dhara 3hi4itsa (inc uding $is!hichi ) 7 $inda Sveda 7 Shirodhara 7 Shirobasti 7 0robasti 7 -atibasti 7 $ichu Dharana 7 A epa (pou tice) etc. Marma -shobe 8epa This is a compound herba mi%ture recommended especia y for Marma e%terna app ication mentioned in the boo4 of Sahasrayoga (5nd chapter under 1uti4a $ra4arana).

9enefits of Treating E2ternally


4stablish proper nutrients to marma sites "hich are basically made o 5hatu (metabolic discete) /elp in cleaning the channels (Srotas) or Aasavahini situated at the site , "hich convey the 5osha. %he qualities o the medicaments used in %aila shall also counteract the morbid actors vitiating the *arma.

The $sycho ogica 3omponent


4 Thirdly, the intricate relation of Marma with mind has to *e considered in treatment as&ect also! ,hysician should o*ser e for the source of mental stress *y counselling with &atient! The &atient must *e a&&raised of the gra ity=or the role of mental grief, tension etc! in the &hysical distur*ances! ,sychosomatic illnesses for instance &ro ide enough material to understand the relation of Marma with mind! O* iously certain Medhya Rasayana 1*rain re?u enators3 drugs and treatments li(e Shirodhara are note worthy at this conte2t! These assist in *ringing the mind to rela2ed state!

4 The re&lenishment of &hysical content of Marma is a *eneficial &oint *y @ogasana! 8owe er, the effect of @ogasana and ,ranayama are not limited to the &hysical e2ercises! They are closely related with mo ement of ,rana in different Nadi of the *ody! 4 The relati e terms li(e ,rana! Nadi and 0ata in res&ect of Marma are already discussed, there is no need to highlight ,rana $ Nadi Shudhi in the care of Marma! ,reser ation of ,rana through the control o er mental acti ities $ rela2ed state of *ody $ mind is an im&ortant as&ect, in the treatment of Marma too! 4 There are s&ecific Mudra which hel& in &urifying s&ecific Cha(ra in the *ody,so that the ,rana mo es freely in channels 1Nadi3 uno*structed!

9oga : in treating Marma

Vous aimerez peut-être aussi