Marma and Marma Therapy: A Review

Abstract

Ayurveda is a science of life which believes in treating mind, body and soul for ensuring a complete state of health and this ancient wisdom is well reflected in the unique concept and composition of marma also. Marma are not only anatomical landmarks but they are also the sites where tridosha are present with their subtle forms Prana, Ojusa (soma) and Tejas (agni). They also contain 3 gunas namely sattva, raja, tamas (manas contents) and soul or life force (bhutatma). Detailed description on marma and marma chikitsa is available in Sushruta Samhita and Siddha respectively. Manipulating or stimulating Marma in the management of various diseases is called Marma Chikitsa/ Therapy. Through stimulation of marma by various methods the Prana (vital energy) existing in marmas 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. This article aims to provide an overview on marma and marma therapy. Details are collected from ancient science texts, Ayush physicians/surgeons, internet and personal experience.

Full text

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MARMA AND MARMA THERAPY: A REVIEW
1*Negi Vineeta Kumari, 2Parvat Susheela, 3Vyas Anju, 4Sharma Om. and 5Sharma S. K.
1Research Officer Regional Ayurveda Research Institute for Nutritional Disorders, CCRAS,
Ministry of Ayush, Jaral Pandoh Mandi, Himachal Pradesh, India.
2Lecturer CDL College of Ayurveda Jagadhari Haryana, India.
3Lecturer Bundelkhand Govt. Ayurvedic College Jhansi UP, India.
4Consultant Regional Ayurveda Research Institute for Nutritional Disorders, CCRAS,
Ministry of Ayush, Jaral Pandoh Mandi, Himachal Pradesh, India.
5Assistant Director Regional Ayurveda Research Institute for Nutritional Disorders, CCRAS,
Ministry of Ayush, Jaral Pandoh Mandi, Himachal Pradesh, India.
ABSTRACT
Ayurveda is a science of life which believes in treating mind, body and
soul for ensuring a complete state of health and this ancient wisdom is
well reflected in the unique concept and composition of marma also.
Marma are not only anatomical landmarks but they are also the sites
where tridosha are present with their subtle forms Prana, Ojusa (soma)
and Tejas (agni). They also contain 3 gunas namely sattva, raja, tamas
(manas contents) and soul or life force (bhutatma). Detailed description
on marma and marma chikitsa is available in Sushruta Samhita and
Siddha respectively. Manipulating or stimulating Marma in the
management of various diseases is called Marma Chikitsa/ Therapy.
Through stimulation of marma by various methods the Prana (vital
energy) existing in marmas 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. This article aims to provide an overview on marma and marma
therapy. Details are collected from ancient science texts, Ayush physicians/surgeons, internet
and personal experience.
KEYWORDS: Marma, Varmam point, Prana, Siddhar.
World Journal of Pharmaceutical Research
SJIF Impact Factor 8.074
Volume 7, Issue 15, 258-271. Review Article ISSN 2277– 7105
Article Received on
06 June 2018,
Revised on 26 June 2018,
Accepted on 16 July 2018
DOI: 10.20959/wjpr201815-12973
*Corresponding Author
Dr. Negi Vineeta Kumari
Research Officer Regional
Ayurveda Research Institute
for Nutritional Disorders,
CCRAS, Ministry of Ayush,
Jaral Pandoh Mandi,
Himachal Pradesh, India.

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INTRODUCTION
Marma is defined as anatomical site where muscles, veins, ligaments, bones and joints meet
together.[1] There are one hundred and seven (107) marmas (vital spots) out of which eleven
are present in each limbs, twenty six in trunk (three in abdomen, nine in thorax, fourteen in
the back) and thirty seven in head neck region.[2,3,4] They are also the sites where not only
tridosha are present but their subtle forms prana, ojus and tejas are also present with sattva,
raja and tama.[5] Vagbhata defines that marma is the meeting point of mamsa, asthi, sira,
snayu, damni and sandhi and is where the prana is present.[6] However it is also opined that
marma can be constituted by the one or more of the above. This is very much similar with
that of Chinese meridian concept in which the points appear either on single meridian line or
at the meeting points of different meridians.[7] Vagbhata also states that marma is a place
where unusual pulsations (visham spandana) can be felt and where shall be the tenderness on
pressure (peeditae ruka).[8] In Charaka Samhita, though marma are referred and stated but
their details are not available.[9,10] Sushruta defined marma as the collective point of meeting
of above mentioned dhatu except dhamani. He has used the term marma both for diseases of
vital organ system as well as the topographical cure points, therefore the marma in the system
should be saved by stimulating topographical cure points.[11] According to Siddhar varmam
points are the places in the body where the subtle varmam energy is found.[12] Marma is the
point on the body where the blockage of energy is felt.[13] It is the junction between
physiology and consciousness, and by touching it changes the body’s biochemistry and can
unfold radical and alchemical change in one’s make up.[14] Stimulation of these inner
pharmacy pathways signals the body to produce exactly what it needs including hormones
and neurochemicals that heal the body, mind and consciousness.[14] Marma points are specific
areas on the body, which has relation through pranic channels to various internal organs,
doshas and srotas. These points are being used during abhyanga along with the application of
different kinds of medicated and aromatic oils to stimulate internal organs.[15]
According to Siddar Varmam is a subtle energy which helps in the proper functioning of the
body and life force. Marmas are invisible but could be traced at a point where body, mind and
psychic energies are concentrated together. These points are located at nadis, nerves, blood
vessels, junction of bones, muscles and tissues and are spread throughout the body. Though
varmam texts mention the existence 8000 varmam points in the body but there is general
notation that there are 108 varmam points which serve as the basis for the art of varmam.
They are classified in to 12 paduvarmam (points which are connected with the nerves of the

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brain directly or indirectly and these points aid in alleviating brain related disorders) and 96
thoduvarmam.[16] Ayurveda is a science of life which believes in treating mind, body and soul
for ensuring a complete state of health. Manipulating or stimulating marma points in the
management of diseases is called marma chikitsa and it is an inherent power of human 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 diseased body parts) where as their improper manipulation may
cause severe pain, disability, deformity and even death.
MATERIAL AND METHODS
Data was gathered from ancient science texts, Ayush physicians/surgeons, internet and
personal experience.
History
Marma science is part of Vedic science. Naturally it has influenced all other sciences which
we find in Veda (400BC) like Ayurveda, Yoga, Martial arts, Sidha system of medicine etc.
the first reference is found in Rig Veda that there is reference of words like Varman or drapi,
which is some kind of body armour or corselet to protect the body from the assault of enemy
weapons. In Atharva-Veda also we find the reference of the term kavacha or corselet or
breast plate for protection.[17] In Mahabharata the great epic also we find many references for
Marma or Varma. Martial art became effective and popular for self defense because the
monks were able to protect themselves against weapons due to knowledge of marma. As non
violence was taught by this religion, they were not allowed to use weapons even for their self
protection, hence the art of marma was taught to all monks for unarmed self protection. This
art was kept as secret for centuries, as it was taught only to certain disciples. As the monks
started travelling to various countries like Japan, China, Indonesia etc. this art also spread to
these countries. It is therefore very certain that the traditional Chinese medicine had adopted
this science from Ayurveda.
Synonyms
Marma, Varmam (Sidda), Praanasakthi (sage Patanjali), Vethasatthi (Thriumoolar), Kaalam,
Puravi, Yogam, Saram, Pranam, Swaasam, Kalai, Sivam, Vassi.

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Etymology of Marma
The word marma comes from Sanskrit origin word ‘mri’ meaning death. Marma are the vital
areas of the body. Its importance is explained by the Sanskrit phrase ‘Maryanti iti marmani’
which means that any harm to these points is hazardous or any injury to these parts may lead
to severe pain, disability, loss of function, loss of sensation and death.[18] Acharya Sushruta
(revered as father of surgery) also mentioned in Sushruta Samhita that these points should be
protected from any injury during surgery. Marma also means secret or latent power.[19]
Classification of Marma[20]
In Ayurveda there are total 107 marma (upper and lower limbs 44, back-14, chest and
abdomen-12, udarvajatrugata-37) in the body. These are divided into different groups
according to the physical matrices and also on the basis of their special features. The
classification according to Sushruta is only five but according to Vagabhata are six with
inclusion of Dhamani marma.

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SN
Classification
Marmas
1
Physical
component
Mamsa marma
Sira marma
Snayu marma
Asthi marma
Sandhi marma
Number
11
41
27
8
20
Names
Talhridya-4
Indrabasti-4
Stanarohita-2
Guda-1
Urvi-4
Lohitaksha-4
Nabhi-1
Hridaya-1
Stanamoola-2 Aplap-2
Apstambha-2
Parshavasandhi-2
Vrihati- 2
Manya,Neela-2,2
Matrika-8
Fana-2
Apanga-2
Shringataka-4
Sthapani-1
Kshipra-4
Kurcha-4
Kurchashira-4
Ani-4
Vitap-2
Kaksharadhara -2
Ansa -2
Basti-1
Utkshepa-2 Vidur-2
Katikataruna-2 Nitamba-2
Amsaphalaka-2 Shankha -2
Kukundara-2
Gulpha-2, Janu-2
Kurpar-2,
Manibanda-2
Krikatika-2
Aavarta-2
Adipati-1
Simanta-5
2
Special
features
Sadhya Pranahar
(agni)
Kalantar
Pranhara
(agni+soma)
Vishalyaghan
(vayu)
Vaikalyakara
(somaya)
Rujakara
(agni+vayu)
Numbers and
prognosis
19
Death within 7 days
of injury
33
Death within 15 days to
month
3
Death being the
foreign body
removed
44
Causes deformity
8
Causes
excruciating pain
Name
Hridya,
Nabi,
Basti,
Guda,
Matrika,
Shringataka,
Shankha, Adhipati
Kshipra, Talhridya,
Indrabasti, Katikataruna,
Parsharvasandhi, Vrihati,
Nitamba, Stanamool,
Stanarohita, Aplap,
Apstamba,
Simanta
Utksepa
Sthapani
Lohitaksha, Sthapani, Janu,
Ani, Urvi, Vitapa, Kurpara,
Kukundara, Kakshadara
Vidura, Krikatika, Amsa,
Amsaphalaka, Neela,
Manya, Fana, Avarta,
Apanga.
Gulpha-2
Manibandha-2
Kurchashira-4

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Marma pramana
SN
Pramana
Marma
1
1 angula
Urvi, Kurchashira, Vitapa, Kakshadhara, Stanamoola.
2
2 angula
Manibandha, Gulpha.
3
3 angula
Janu, Kurpara
4
Swapanital
Hridya, Basti, Nabhi, Guda, Kurcha, Shringataka, Simant, Matrika, Neela, Manya.
5
½ angula
Rest of all marma
Marmabhighata lakshan[21]
Shakha
marma (44)
Marma
Location of marma
Marmabhighat lakshan
1
Kshipra
Angusta anguli madhaya
Aakashepaen maranam
2
Talhridya
Madyamaangulim anupurvaena
talasaya madyae
Rujabhi marnam
3
Kurcha
Kshiprasayoparistat ubhayatah
Bhramana, vaepanae
4
Kurchasira
Gulpha sandhaeraadha ubhyatah
Ruja, shofa
5
Gulfa (manibandha
upper limb)
Paadjangyo sandhanae
Ruja, stabda padata, khanjata
6
Inderavasti
Janga madhyae
Shonit kshyae maranam
7
Janu (kurpar)
Jangourvu sandhanae
Khanjata
8
Aani
Jaanunurdavamubyat trayangulam
Shophabhivridhi, stabdha sakthi
9
Urvi
Urumadhyae
Shonitkshyata sakthishosh
10
Lohitaksha
Urvyourdavamadhovankshan
sandhaer moolae
Lohikshyan pakshaghata
11
Vitap (kakshadhar)
Vankashana vrishanyor antarae
Shandaya, alpasukarata
Udarar-ura
marma (12)
1
Guda
Vatavarchonirsnam, sthulantra
pratibadham
Sadyomarnam
2
Vasti
Alpamansashonito abhyantartah
katyam mutrashayo
Sadyomarnam
3
Nabhi
Pakvaamashayormadhyae shira
prabhava
Sadyomarnam
4
Hridya
Stanyormadhyam, satvarajatama
adhisthanam
Sadyamamarnam
5
Stanamool (2)
Stanyoradastad dwayangulam
ubayataha
Kaphapuran kostataya kasa
swasabhyam mriyatae
6
Stana rohit(2)
Stanachuchakayorurdhavam
dwayangulam ubayatah
Lohitapuranakostaya kasa
swasabhyam mriyatae
7
Aplap (2)
Ansakutyo adastad pasharvo upari
bhag
Raktaenpuyabhavam marnam
8
Apstambha(2)
urso ubhya, nadyo vatavahae
vatapurankostaya
kasaswasabyam marnam

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Prista marma(14)
1
Kukunder
Parsharvajaghanbahirbagae
pristavanshamubyatah natinimnae
Saparshagyanam, adhakayae
chesto upgatah
2
Nitamba
Sronikandyauparyaashayaaachadanae
parshavaantar pratibadho
Adhakayashoso
daurbalyanch cha marnam
3
Parshava
sandhi
Jagahan parsharvamadhyo tiryak udharvam
cha jaghanat
Lohitapurnakostaya mriyatae
4
Katikaturuna
Pristavanshamubayatah pratishronikandam
asthini
Shonitakshayat,
panduvivrano, heenaroopa
mriyatae.
5
Vrihati
Stanmoolatubayata pristavanshasya
Shonit atipravriti nimitair
updravye mriyatae
6
Ansaphalaka
Presto upari pristavansham ubyata
trikasambdhae ansapalakae
Bahvo swapa shosho
7
Ansa
Bahumurdha
grivamadhyae nibandhanansapeethaskandha
Stabadha bahuta
Udarvajatrugat
marma(37)
1
Dhamaninela
manya – 4
Kanthanadimaubayatochatsro damnayo
Mookta, swaravaikritam, ras
agrahita
2
Siramatrika -8
Grivayam ubayatah
Sadhyo marnam
3
Krikatika – 2
Shiro grivyo sandhanae
Chalmurdhvata
4
Vidura – 2
Karnapristto adhah
Badhirta
5
Fana – 2
Ghranamargaubayatah
srotomargapratibadhae abyantartah
Gandhaagyanam
6
Apanga – 2
Brupuchantayo akshanobahyato
Aandhya, dristiupghata
7
Aavarta – 2
Bruvoupari nimnayor
Aandhayam, dristiupghato
8
Shankha – 2
Bruvoantryoupari karnlalatmadhayae
Sadhyomarnam
9
Utkshep - 2
Shankhyo upari keshanta
Sashalyojivetpakatpatita
shalyova, na udrit shalya
10
Sthapani - 1
Bruvo madhyae
Like utkshep marma
11
Simanta -5
Pancha sandhyah shirsi vibhakta
Unmad, bhaya, chitanasha
12
Shringataka -
4
Ghranashrotakshijihva santarpaninama
Sadhyomarnam
13
Adhipati – 1
Mastakabyantaratuparistata
sirasandhisannipato romavartavata
Sadhyomarnam
Indications of Marma Chikitsa[22]
1. Musculoskeletal disorder
2. Alimentary tract diseases
3. Respiratory tract diseases
4. Cardiovascular diseases
5. Neurological diseases
6. Genitourinary tract diseases
7. Metabolic disorders

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8. Eye and Ear related disorders
9. Cerebral palsy, down syndrome, mental retardation, autism, speech disorders etc.
Methods of Application of Marma Therapy[23]
While stimulating marma few questions arise in mind like – How to stimulate the marma
point? How much should be the pressure during stimulation? How long should be the contact
period during application of pressure? How many times stimulation should be applied in one
sitting? How many times it should be repeated? There are different schools practicing in
different ways. Dr Sunil Joshi says the pressure (while stimulating marma) should be optimal
with contact time for .8 seconds (one cardiac cycle) and it should be repeated for 12-20 times
(normal respiration rate per minute) in one sitting while others say 6 time stimulation in one
sitting is sufficient.
Medical varmalogy affirms 12 stimulation methods for each varmam point to alleviate 48
different diseases. The uniqueness of the art of varmam is in abating 48 different diseases by
stimulating a single varmam point.
The following are the general rules to be followed while administering varmam treatment:
1. Finger nails should be cut in both the hands and varmam points in the body should not be
touched by the finger nails.
2. Don’t talk to others while rendering varmam treatment and make the patient to sit or lie
down during procedure.
3. It is sufficient to cure the diseases by rendering varmam treatment twice a week. But
depending on the need of the patient and the intensity of the ailment, it can also be
administered daily.
4. For indoor patients, the treatment can be administered once in six hours daily (4 times
daily).
5. After rendering varmam treatment to each patient, it is necessary to touch the wall or any
wooden objects before treating the next patient. This is to avoid the transfer of the body
heat from one patient to another.
6. There are not many dietary restrictions for this treatment but it is better to avoid the
consumption of curd and greens at night.
7. The pressure applied should be based on the age and the body condition of the patients.
8. Don’t administer this treatment to patients who come with complaints of snake bite,
scorpion bite and poisoning cases.

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9. Make sure that patient is neither fasting nor full stomach.
10. Preferable times is morning hours after rising from the bed and attended morning
toilette.[24]
There are 12 methods of varmam application as following
1. Gentle movement
2. Mild movements
3. Clenching the varmam point along with the muscle
4. Slippery pinches
5. Mild tapping
6. Gentle stroking with fingers
7. Pressing point with a single finger
8. Balancing the energy of the points in the bone and joints
9. Placing the energy on the varmam point
10. Transferring energy from one point to another
11. Strengthening one nerve as that of the other
12. Touching and lifting the varmam point
All these 12 method can be executed on varmam point. The siddhars had propounded that the
application of these 12 techniques on single point is capable of curing 48 different diseases.
Measurement and pressure
A profound knowledge of the finger measurement and the amount of pressure to be applied is
essential for rendering varmam treatment. Maathrai means the method of touching the
varmam point by the fingers and can be considered as a measure. If the varmam point is
touched either with the interphalangial joint of the thumb or the side tip of the thumb, it is
considered as ¼ maathirai. If a point is stimulated with the soft pulp portion of the middle
finger that is from the tip of middle finger to the distal interphalangial joint then it is 1
maathirai. Similarly it is ¾ measures when the varmam point is stimulated with ¾ portion of
this region and when ½ of this portion is used then it is ½ maathirai. In the art of varmam the
pressure that has to be applied for treatment is the same as the pressure that is applied in the
snapping of a finger. One snap of a finger is divided in to four stages:
1. Placing – ¼ maathirai pressure
2. Pressing – ½ maathirai pressure
3. Twisting – ¾ maathirai pressure

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4. Releasing – 1 maathirai pressure
Using above stated four different maathirai along with the 12 application methods will enable
48 types of applications on a single vaarmam point. When ¼ maathirai pressure is applied,
the energy traverses through the bone marrow to cure the ailment. Similarly, for ½ maathirai
pressure the energy traverses through the nerve, for ¾ maathirai pressure the energy traverses
through the bones and for I matrai pressure the energy flows through the bone marrow, nerve
and the bones to cure the disease. Marma points are a double edged sword, whose results
primarily depend upon the nature and extent of their stimulation. Therefore in Siddha system
of medicine one fourth and half matra pressure is indicated for therapeutic purpose for
beginners.
Role of Marma Therapy[25]
1. Removes blocks in energy channels (srotas).
2. Pacifies doshas bringing it to normal path (especially vyanvayu which controls autonomic
nervous system).
3 Creates physical, mental and emotional flexibility.
4 Creates an opportunity to experience powerful and dynamic transformation at physical,
mental, emotional and spiritual level by building a positive link with the unconscious mind.
Disadvantages of Marma Chikitsa
During ancient times, knowledge of marma was known to kings and warriors. It was applied
in battle fields to hit and achieve maximum lethal effect on enemies. This science was used
both in warfare, surgery and later on martial arts too. Therefore if not used judiciously it can
cause minor pain and disability to death of a patient or person.
Research Findings On & Related To Marma Therapy
According to Mishra DP et al. sadhyapranahara marma may be used to treat disorders related
with pita dosha imbalance, vaikalyakar marma for kapha imbalance, vishalyghana and
rujakar marma for vata imbalances.[26]
Kshipra marma is related to head, brain, pituitary, pineal, hypothalamus, neck, throat, thyroid
and parathyroid in acupressure where as in acupuncture stimulates lymphatic system.[27]
Marry Fox et al. suggest that Marma therapy as an adjunct to conventional western
multidisciplinary stroke rehabilitation should be feasible and safe.[28]

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Prasad Shishir et al. concludes that marma therapy is a promising, fast acting, cost effective,
less time consuming, easy to use and non invasive alternative method for treatment of
Avabahuka (adhesive capsulitis).[29]
According to Wen Ching Liu et al. the Hoku point (L#4; large intestine #4), located at the
dorsal surface of the web between the thumb and the index finger (kshipra marma) is a
recognized acupoint for the induction of the analgesic effects of acupuncture. They concluded
that PAG and somatosensory cortex respond to acupuncture with two distinct activity
patterns. Stimulation of the acupoint, as opposed to the non-acupoint, increases the level of
activity in both areas without altering their basic activity patterns.[30]
DISCUSSION
From above and according to our experience we can conclude that Kshipra marma should be
stimulated in every type of pain for its analgesia effect. Nearby marma of affected areas
should be stimulated (Siddhars) with kshipra marma. Every marma points have their
measures so in our opinion marma points should be stimulated according to their measure.
It has promising results in musculoskeletal disorders, cost effective, feasible, can be applied
any time, with no side effects if applied properly and almost no special infrastructure is
required. This is a universally sustainable type of medical system which can be used for
theurapeutic and preventive aspect of health.
CONCLUSION
A mechanism may be explored through functional magnetic resonance imaging (FMRI) and
pharmacological studies.
ACKNOWLEDGMENT
We wish to thank Vaid KS Dhiman DG CCRAS Ministery of Ayudh Govt. of India for their
valuable guidance and support.
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