E-ISSN:2456-3110

Review Article

Marma Chikitsa

Journal of Ayurveda and Integrated Medical Sciences

2022 Volume 7 Number 2 March
Publisherwww.maharshicharaka.in

Pain management through Marma Chikitsa

Yadav A.1*, Marwaha R.2, Bhalerao N.3, Chourasia S.4
DOI:

1* Arvind Kumar Yadav, Post Graduate Scholar, P.G. Dept. of Rachna Sharir, Pt. Khushilal Sharma Govt. Auto. Ayurveda College & Institute, Bhopal, M.P, India.

2 Rita Marwaha, Professor and HOD, P.G. Dept. of Rachna Sharir, Pt. Khushilal Sharma Govt. Auto. Ayurveda College & Institute, Bhopal, M.P, India.

3 Nisha Bhalerao, Associate Professor, P.G. Dept. of Rachna Sharir, Pt. Khushilal Sharma Govt. Auto. Ayurveda College & Institute, Bhopal, M.P, India.

4 Swatantra Kumar Chourasia, Assistant Professor, P.G. Dept. of Rachna Sharir, Pt. Khushilal Sharma Govt. Auto. Ayurveda College & Institute, Bhopal, M.P, India.

Pain is an extraordinary sensation that could range from slight to intense ache. Ache has both physical and emotional components. The physical part of ache effects from nerve stimulation In Ayurveda pain is correlated with Vedana / Shula. Said feeling is maximally expressed by Vedana in Ayurveda literature.[1] Different texts of Ayurveda mentioned 107 Marma points based on anatomical positions and different structures around them. Marma are those places in the body where Prana exist, they have various effects on individual such as physical, mental and social health. Marma point or Prana essential energy in the body continues exclusive physiological, mental and if the waft of Prana or essential energy gets obstructed or blocked, the body structure is disturbed and pathology start growing. Marma points are stimulated via unique strategies or methods, so via stimulations, Marma may be directed to eliminate blockages and stimulate Prana or electricity drift for this reason ensuing in a country of healthy body, mind and spirit. Marma points are stimulated by different techniques or methods, so by stimulations, Marma may be directed to remove blockages and stimulate Prana or energy flow thus resulting in a state of healthy body, mind and spirit. In present scenario Marma Chikitsa is very popular in various part of india for its instant, permanent, natural and non-invasive way of treatment. Marma Chikitsa had emerged as new dimensions in non-pharmacological treatment of Ayurveda. If properly stimulate, Marma Chikitsa help in maintaining the vitality of the body and treatment of disease/pain by Prana or natural healing agents such as prostaglandin

Keywords: Marma, Pain, Shula, Vedna, Marma Chikitsa, Ayurveda

Corresponding Author How to Cite this Article To Browse
Arvind Kumar Yadav, Post Graduate Scholar, P.G. Dept. of Rachna Sharir, Pt. Khushilal Sharma Govt. Auto. Ayurveda College & Institute, Bhopal, M.P, India.
Email: 		Arvind Kumar Yadav, Rita Marwaha, Nisha Bhalerao, Swatantra Kumar Chourasia, Pain management through Marma Chikitsa. J Ayu Int Med Sci. 2022;7(2):69-76.
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https://jaims.in/jaims/article/view/1762

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2022-01-27 2022-01-29 2022-02-05 2022-02-12 2022-02-19
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 17%

© 2022by Arvind Kumar Yadav, Rita Marwaha, Nisha Bhalerao, Swatantra Kumar Chourasiaand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Introduction

The word “Marma’’ comes from Sanskrit starting place “Mra’’ manner area of Prana (vital power).[1] Any trauma to these sites may be fatal or can result in disability of the person. These Marmas point harmonize the apprehensive and endocrine glands and normalize exclusive pathology in the frame through crucial energy itself, with right stimulations/Manipulation. This approach is called Marma Chikitsa. Marma Chikitsa is an ancient Indian exercise whose purpose is stimulations / manipulation of crucial strength (Prana) in the body for enhancing the restoration procedure. Marma Chikitsa is based on the movement of 107 Marma points inside the body to get admission to the frame and mind. Marma’s knowledge allows the clinicians to regulate the glide of Prana through the coarse and diffused bodies in order to restore the patient’s health and serenity. Marma Chikitsa is the oldest treasure of Indian surgical treatment from the Vedic duration. For the duration of the Vedic generation the expertise of Marma was regarded to the emperors and warriors. The concept and practice of Marma was very famous in those days to reap the maximum effect when contending with the enemies.[1]

Classification of Marma: In Ayurveda there are total 107 Marma 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 types but according to Vagabhata are six with inclusion of Dhamani Marma.  Acharya Sushruta categorizes

  1. According to anatomical structure (Rachna Bheda)
  2. According to region (Sadanga Bheda)
  3. According to injury result (Parinaama Bheda)
  4. According to measurement (Pramana Bheda)

Table 1: According to anatomical structure (Rachana Bheda) [1-2]

Types of Marma As per Sushrut As per Vagbhatta
Mamsa Marma 11 10
Sira Marma 41 37
Snayu Marma 27 23
Asthi Marma 08 08
Sandhi Marma 20 20
Dhamani Marma - 09
Total 107 107

Table 2: Marma classification according to region (Shadang Bheda)[1-2]

Types of Marma Number of Marma
Shakha (Bahu and Sakthi) 44
Udara 03
Urha 09
Prishtha 14
Jatroordhva 37
Total 107

Table 3: Marma classification according to injury result (Parinaama Bheda)[1]

Types of Marma Number of Marma Mahabhootadhikya
Sadhyapranahara 19 Agni
Kalantarapranahara 33 Agni-soma
Vishalyaghna 04 Vayu
Vaikalyakara 44 Soma
Rujakara 08 Agni- vayu
Total 107  

Table 4: Marma classification according to measurement (Pramana Bheda)[1]

Types of Marma Number of Marma
One Angula 12
Two Angula 06
Three Angula 04
Four Angula(Swapanitala) 29
Half Angula 56
Total 107

Marmabhighata Lakshana
Table 5: Shakhamarma (11 x 4 = 44)[2]

No. Marma Location of Marma Marmabhighat Lakshan
1. Kshipra First intermetacarpal ligament Loss of function
2 . Talhridya Palmer apponeurosis Severe Pain
3. Kurcha Carpo-metacarpal and intercarpal ligament Disfigurement of hand
4. Kurchasira Lateral ligament of the wrist joint Pain with inflammation of wrist
5. Gulfa(Manibandha upper limb) Ankle joint Impairment of function with swelling, difficulty in walking
6. Inderavasti Calf muscles Death due to severe bleeding
7. Janu(Kurpar) Knee joint Gait deformity at knee
8. Aani Tendon of biceps muscles Swelling and paralysis of forearm
9. Urvi Brachial artery and brachial vein Paralysis due to excessive bleeding
10. Lohitaksha Axillary vessels Paralysis due to excessive bleeding and nerve damage
11. Vitap (Kakshadhar) Inguinal canal / ligament Infertility and oligospermia

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Table 6: Udara Urha Marma (12)[3]

1. Guda Anal canal and Anus Sudden death
2. Vasti Urinary bladder Sudden death
3. Nabhi Umbilicus Sudden death
4. Hridya Heart Sudden death
5. Stanamool (2) Internal mammary vessels Death due to pneumothorax after some time
6. Stanarohit (2) Lower portion of pectoralis major muscles Death due to haemothorax after some time
7. Aplapa (2) Lateral thoracic and subscapular vessels Severe haemorrhage in thorax region and death
8. Apstambha (2) Two bronchii Death due to haemorrhage

Table 7: Prishta Marma (14)

1. Kukunder Sacroiliac joint Loss of sensation and paralysis of lower limb
2. Nitamba Ala of the ileum / ischial tuberosity Loss of function due to Wasting muscles of lower limb
3. Parshava sandhi Common iliac vessels / renal angle Severe hemorrhage
4. Katikaturuna Sciatica notch Haemorrhage and anaemia.
5. Vrihati Subscapular and transverse cervical arteries Death due to excessive bleeding
6. Ansaphalaka Spine of the scapula Deformality due to muscle wasting
7. Amsa Coraco-humoral Gleno-humoral ligaments and Trapezius muscle Loss of function of shoulder joint or frozen shoulder

Table 8: Urdhva Jatrugat Marma (37)[4]

1. Dhamani Neela, Manya – 4 Blood vessels of the neck Aphakia, disturbed voice due injury of blood vessels
2. Siramatrika-8 Blood vessels of the neck Sudden death
3. Krikatika–2 Atlanto occipital articulation Uncontrolled head movement
4. Vidura–2 Posterior auricular vessels or ligament Deafness
5. Phana–2 Olfactory region of the nose Loss of smell
6. Apanga–2 Zygomaticotemporal vessels Blindness and disturbed vision
7. Aavarta–2 Junction of the frontal, molar and sphenoid bone Blindness and disturbed vision
8. Shankha–2 Temporal region Sudden death
9. Utkshep-2 Temporal muscles and facial renival Severe bleeding
10. Sthapani-1 Nasal arch of the frontal vein Like above
11. Simanta-5 Cranial sutures Loss of conciousness
12. Shringataka-4 Cavernous, intracavernous sinus Sudden death
13. Adhipati–1 Torcular herophilia Sudden death

Table 9: Marmabhighata (According to Vagbhatta)[5]

SN Marma Name Marmabhighata Lakshan
1. Mamsa Marma When Mamsa Marma is injured, there will be continuous bleeding, viscosity of blood is reduced, blood resembles like fleshy dilute water, pallor of the skin, loss of function of sense organs and quick death of the person.
2. Snayu Marma When Snayu Marma, are injured, there will be bending of the body, convulsions, very severe pain, inability for riding, sitting etc. distortions of Anga or even death of a person.
3. Sira Marma When Sira Marma are injured, blood which is thick flows out of Sira continuously in large quantity, due to blood loss symptoms like thirst, giddiness, dyspnoea, delusion, unconsciousness and hiccup arise and proceed to death of a person.
4. Asthi Marma When Asthi Marma is injured, there is discharge of thin fluid mixed with bone marrow intermittently and severe pain continuously.
5. Sandhi Marma When Sandhi Marma are injured, the site of injury feels as full of spicules, even after healing of the wound there is shortening of the arm, lameness, loss of strength and movement of joint, emaciation of body and swelling of joints occurs.
6. Dhamani Marma When Dhamani Marma is injured, the frothy and warm blood flows out with sound and the person becomes unconscious.

Pain: Pain is indispensable for survival. It serves a protective function by signaling the presence of noxious, tissue-damaging conditions.

From a medical standpoint, the subjective description and indication of the location of pain may help pinpoint the underlying cause of the disease.[6]

Nociceptors: The receptors for pain are free nerve ending which are present in all parts of body except mind. Intense thermal, mechanical, or chemical stimuli can activate the receptors. Irritation or damage at tissue or cellular level releases chemical compounds which consist of prostaglandins and potassium ions (k+) that stimulate nociceptors. Pain may also persist even after absence of stimulus, due to this fact ache-mediating chemical substances linger and due to this effect nociceptors show-off very small amount of adaptation. Conditions that elicit the ache include excessive distention (stretching) of a structure, prolonged muscular con-tractions, muscle spasms or ischemia (insufficient blood flow to an organ).[7]


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Role of Vayu in Marma: The entire galaxy is made up of Panchamahabhuta, the general sustenance is maintained by Shita and, Snigdha Guna. The basic nature of the body is Kapha, the transformation process is mainly due to Pitta and Vata, Vayu is held in Agni, which in turn is supported by Shitatva of Jala. The bodies, even though Panchabhautika in nature, has in it certain vital points where Agni and Vayu are predominant.

Such Vata points on body that are Agneya in nature are called Marmas. This predominance of Agni and Vayu over these area marks them vital and more prone to injuries that leads to diseases or death. Marma Chikitsa is basically Vatapittahara Chikitsa, it comes under Madhyama Rogamarga.

Marma and Shula: Pain is one of the most common features of traumatic lesions and understanding its nature and properties is important for the successful management of pain. In Ayurvedic medicinal therapy, this is the only lacuna, that is, the immediate management of pain. Marma Science and Chikitsa have an answer to this and hence, if we incorporate Marma science in the broad field of Ayurvedic therapy, we can overcome this lacuna. Marma science also draws its basic premises from the same body of texts as the other disciplines of Ayurvedic practice.[8] Marmas are considered as half of the surgery subject as any injury to Marmas Can proves to be fatal so if the patient is promptly treated by the skilled doctor even though the patient will suffer from excessive pain.[9] In Susruta Samhita, Maharshi Susrutahas mentioned that the commonest cause of pain is Vata.[10]

Wound and pain are both coexisting features of trauma. Pain is a feeling of uneasiness. In Ayurveda, Vedana (pain), Dukha (unhappy), Pida (ache) , Sula (pain), Ruk (pain), Ruja (mental pain), Bheda (cutting pain ), Sadana (unhappy), Avasada (depressed)), are words used for pain. According to Susruta Samhita, the main causative factor of pain is Vata. The seat of pain is Mana(psyche) and Sharira(body).[11]In all cases of Vatika pre dominance, the chances of pain are quite common along with other clinical presentations of Vatika anomalies. In a normal state, the Vatais responsible for the activation of several functions of different systems.[12] According to the Astanga Hridaya, Sutrasthana12/49-50, derange-ment, displacement, dilatation, piercing pain, anaesthesia, lethargy, pricking and incising pain, constricting pain,

breaking pain, twisting pain, excitation of the hair follicle and thirst due to severe pain, tremor, hardening, porosity, dryness, stimulation, spasm, distaste of mouth, black and reddish black discolouration are due to the Vata.

Types of Pain in Wound[13],[14]

Vatika Vedana: Todana (pricking pain), Bhedana (cutting/ incising pain), Tadana (pain due to blunt in-jury), Chedana (cutting/ excising pain), Ayamana (stretching pain), Manthana (gripping pain), Viksepana (pulling pain), Chumcumayana (tingling sensation), Nirdahana (burning pain), Avabhanjana (breaking pain), Sphotana (bursting pain), Vidarana (perforating pain), Utpatana (tearing pain), Kampana (tremoring pain), Vislesana (dislocating pain), Vikirana (radiating pain), Purana (distending pain), Stambhana (stiffness/ ankylosing pain), Swapana / Swapa (anaesthesia), Akuncana (spasmodic pain), Ankusika (anchoring/ hanging pain), Atimatra Vedana (sudden excessive pain), Vividha Shoola (different pain).

Paittika Vedana: Osa (burning pain), Chosa (scalding pain), Paridaha (burning sensation all around), Dhumayana (sensation of hot smoke), Gatrangarava-kirnamivapacyate (sensation of touch by burning coal), Usmabhivriddhi (increased temperature), Kshateksharavasiktavaccha Vedana (caustic application overwound like pain).

Kaphaja Vedana: Alpavedanama (mild pain), Suptatvama (numbness), Avedanam /Aruja (analgesia), Parsvasubheda (pain in flanks)

Tridosaja / Sannipataja Vedana: Vividha Vedana (different kinds of pain), Sarva Vedana (all kinds of pain).

The Sites of Pain[15]

The sites of pain are the precordial region, flanks, back, sacral and suprapubic regions.


  • The Vatika Sula is characterized by being spasmodic having periods of exacerbations and remissions repeatedly with the retention of urine, flatus and faeces. It can be identified as a pricking or tearing type of pain.
  • The Paittika Sula is very severe and sudden in on-set. The colicky pain is associated with thirst, fainting, burning sensation and pain in the umbilical region. Excessive perspiration, vertigo is also accompanied by the Paittika Sula.

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  • The Kaphaja Sula is low-intensity colicky pain in the abdomen. It is associated with nausea, cough, malaise, anorexia, excessive salivation, and heaviness of the abdomen. The colicky pain is aggravated after meals and in the early morning. In Sannipataja Sula all three Dosas get vitiated. The clinical presentation may be varied accordingly. All the symptoms may be in an aggravated state.

Management of Pain: The management of pain comprises a multifold approach. It can be categorized into local management and systemic management. The pain caused by traumatic lesions can be managed by local fomentation, irrigation, application of local medicament and bandaging. In Ayurveda, the term Vedana is more or less used for the feeling. It may be the feeling of wellbeing or the feeling of illness (Sukhatamaka and Dukhatmaka).[16] In Ayurveda, there is no particular uniform medicine for any kind of pain. Management of pain depends upon the causative factor or Doshika predominance responsible for the pain. In conventional (allopathic) pain treatment several analgesics, anti-inflammatory, antipyretic drugs, chemo trypsin and serratiopeptidase like chemicals and opioids are used, but there is no universal drug for all kinds of pain to date.[17] Every individual response to pain in a different way. In the same way, every analgesic chemical acts pharmacologically in a different way. Only one analgesic preparation cannot solve the problem of pain. So, the management of pain is not so simple and satisfactory with the aforesaid drugs. Instant pain relief is the motive of Marma therapy. Stimulation of Marma cans produce analgesia by secreting several prostaglandin inhibitors, endorphins, interferon and other opioid like substances which are a hundred times more potent than opium. Instant pain relief by Marma therapy is possible within no time.[18]

Following Marma points are responsible for the relief of pain in different organs.

1. Shoulder pain - Kshipra Marma and Kurpara Marma.

2. Pain in abdomen – Kurpara and Urvi Marma.

3. Chest Pain - Kurpara, Urvi and

4. Cervical (neck) pain - Kshipra, Kurpara, Ani Marma

5. Leg and knee pain - Kshipra, Gulpha

6. Sciatic pain - Kshipra, Gulpha

Pain management aims at minimizing distress, feeling of unrest, and improving the quality of life. A cardinal point in the management of pain is that it should be holistic and patient centered in its application. This can be fulfilled in the Ayurvedic approach only in terms of Marma Chikitsa.[19]

Technique of Marma Therapy: Marma therapy is an uncomplicated and easy-to-learn technique of regaining the vital energy.

Posture: For successful practice of self-Marma therapy, posture is important. The practitioner must remain steady, quiet and mentally alert during this practice. A sitting posture is most convenient for the practitioners. Usually one should assume a posture of cross-legged position, keeping the spine erect. Keep the hands on the knees in upward position or one can adopt the Dhyana Mudra.

The most common postures for the practice of self-Marma therapy are;

1. Simple cross-legged posture (Sukhasana)

2. Lotus posture (Padmasana)

3. Half lotus posture (Ardha Padmasana)

4. Diamond posture (Vajrasana)

5. Sitting posture on chair

6. Standing posture

In exceptional circumstance, lying down position (recumbent posture) may also be adopted.

The practitioner can adopt any one of these postures during the self-Marma therapy practice. If one cannot adopt some specific posture he can do practices in any posture anytime and anywhere. During the practice one should try to keep the vertebral column erect and achieve the relaxation of the body musculature. In sitting and standing postures keep the neck and spine in straight line without stiffness or tilting towards any direction. In standing posture, the feet should be parallel to each other. The arms should hang down loosely from the shoulder joints near to the body with open palms facing inwards with straightened fingers.

Pre therapy exercises: It comprises of the following steps

1. Total relaxation of body.


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2. Deep breathing exercise.

3. Perception of body as whole.

4. Perception of psychic centers.

5. Perception of Marma

Gentle massage with thumb and fingers over the Marma

Then comes the actual therapy consisting of application of pressure with thumb or fingers over the Marma points.

Pressure: depend upon the nature of the Marma

Stimulation time: 0.8sec/ stimuli

Time: 3 times per day

Repetition: 15 to 18 times in single sitting.[20]

Discussion

Marma Chikitsa is an important aspect of Ayurvedic treatment where the application of pressure or stimulation on these Marmas points induces the flow of Prana (vital energy) along a complete system of subtle channels called Nadis. Message is widely applied in the treatment of Marma.

Marma Chikitsa is used to treat the disease of nervous system with brain. Marma Chikitsa is beneficial to treat traumatic neurological or neurosurgical lesion, traumatic paraplegia, hemiplegia and monoplegia etc. In orthopedic lesions especially prolapsed intervertebral disc etc. it is helpful to reduce the pain of nerves, muscles, ligaments, bones and joints. It is also useful to improve the function of body organs achieving homeostasis. 

Marma Chikitsa works on the neuro-endocrine system. Actually, due to pressure or stimulation over these points, certain chemical substance and neurotransmitters are release like endorphins and enkephalin which send nerve impulse to brain causing the desired effect. Another theory state that the very small electrical changes that occur at Marma points is found to capable of producing effect for in responsible for triggering the desired effect. The gate control theory of brain is state that nerve and bear are large bundles of various of various size some of them are thick & some are thin transmit the sensation of pain while the thick carry the tactile sensation, thus if the

thick impulse is increased the selectively block of the conduction of thin fibers, this is called the gate control theory.

In Ayurveda, the term Vedana / Shula is unpleasant feeling. It may be the feeling of well-being or the feeling of illness. The governance of all kinds of body sensations is the subject of the Vata. But during the vitiation of Vata, all these functions get disturbed and the excessive activity of vitiated Vata may cause pain sensation. From the above and according to the literature we can conclude that Marmas should be stimulated in every type of pain for its analgesic effect. Every Marma points have their measures, so Marmas points should be stimulated to their measures.

Conclusion

Marmas are vital points that regulates our body functions. Marmas are considered as centers for the Prana. They can be used specifically for the diagnosis and treatment of disease or generally for promoting health and longevity. Marmas were applicable for all Ayurvedic therapies; it is applicable for simple self-treatments to complex clinical procedures. Marmas were considered as main pillars of Ayurvedic clinical procedure. Marma therapy can be used along with all Ayurvedic Chikitsa like Panchakarma and Yoga. Marma Chikitsa is the best technique to attain the effects of Yoga and Pranayama. Marma Chikitsa is advance technique of Ayurveda related to diagnosis, treatment of particular disease and reduce pain. The present article shows the mode of action of Marma Chikitsa, as suggested in the literature, which has been discussed. The special capability of Marma Chikitsa in Treating any kind of pain disorders, Thus, it can be concluded that Marma science, which is an extremely ancient field of Facts, holds significant promise in being used to maintain the vitality of the body and treatment of diseases.

Reference

1. Shastri Ambika Dutta. Sushrut Samhita, Ayurveda Tattva Sandipika. Varanasi, Chaukhambha Sanskrit Sansthan Varanasi. Volume-1, 2012, Sharir Sthana, chapter 6/29-30, page-76.

2. Shastri Ambika Dutta. Sushrut Samhita, Ayurveda Tattva Sandipika. Varanasi, Chaukhambha Sanskrit Sansthan Varanasi. Volume-1, 2012, Sharir Sthana, chapter 6/25, page-72.


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3. Shastri Ambika Dutta. Sushrut Samhita, Ayurveda Tattva Sandipika. Varanasi, Chaukhambha Sanskrit Sansthan Varanasi. Volume-1, 2012, Sharir Sthana, chapter 6/26 page-73.

4. Shastri Ambika Dutta. Sushrut Samhita, Ayurveda Tattva Sandipika. Varanasi, Chaukhambha Sanskrit Sansthan Varanasi. Volume-1, 2012, Sharir Sthana, chapter 6/28 page-75.

5. Brahmanand Tripathi. Ashtang Hrudaya, Nirmala Hindi Vyakhya. Chaukhambha Sanskrit Pratishthan, Delhi. 2015, Sharirsthan, chapter 4/47-51 page- 397.

6. Tortora, Gerard J. Principal of Anatomy and Physiology. Hoboken, NJ: J Wiley. 2006, 13th edition, Page 612.

7. Tortora, Gerard J. Principal of Anatomy and Physiology, Hoboken, NJ: J Wiley. 2006, 13th edition, Page 613.

8. Joshi Sunil Kumar. Marma Science and Principles of Marma Therapy. New Delhi, Vani Publications. 2019, page-51.

9. Shastri Ambika Dutta. Sushrut Samhita, Ayurveda Tattva Sanddipika. Varanasi, Chaukhamba Sanskrit Sansthan, Varanasi. 2012, Sharirasthana 6/33, page-74.

10. Shastri Ambika Dutta. Sushrut Samhita, Ayurveda Tattva Sanddipika. Varanasi, Chaukhamba Sanskrit Sansthan, Varanasi, 2012, Sutrasthana 17/12, page-94.

11. Joshi Sunil Kumar. Marma Science and Principles of Marma Therapy. New Delhi, Vani Publications. 2019, page-52.

12. Sharangdhra. Sharangdhara Samhita. Choukhamba Surbharti Prakashan, Varanasi. reprint 2012, Purvakhanda 5/25, page 22.

13. Sukla Acharya Vidyadhara. Charak Samhita of Agnivesha. Choukhamba Sanskrit Prakashan, Delhi. 2013, Sutrasthana 18/1-4, page 275-276.

14. Shastri Ambika Dutta. Sushrut Samhita, Ayurveda Tattva Sanddipika. Varanasi, Chaukhamba Sanskrit Sansthan, Varanasi. 2012, Sutrasthana 17/5, page-92.

15. Joshi Sunil Kumar. Marma Science and Principles of Marma Therapy. New Delhi, Vani Publications. 2019, page-53.

16. Joshi Sunil Kumar. Marma Science and Principles of Marma Therapy. New Delhi, Vani Publications. 2019, page-54.

17. Joshi Sunil Kumar. Marma Science and Principles of Marma Therapy. New Delhi, Vani Publications. 2019, page-55.

18. Joshi Sunil Kumar. Marma Science and Principles of Marma Therapy. New Delhi, Vani Publications. 2019, page-55.

19. Joshi Sunil Kumar. Marma Science and Principles of Marma Therapy. New Delhi, Vani Publications. 2019, page-55.

20. Sunil Kumar Joshi. Marma Science and Principles of Marma Therapy. New Delhi, Vani Publications. 2019, page-71.


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