The previous chapter explained flesh, sirAs, and other bodily structures, and marmas are situated in those structures; therefore their description follows. The commentary supplies an omitted word after 'each,' understanding the title as a detailed account of each marma belonging to flesh, sirA, and the other categories.
Key terms
marma
A vulnerable vital point or region in the classical anatomical system.
pratyeka
Each individually, understood with the omitted tissue categories.
There are one hundred and seven marmas. They are of five kinds: marmas of flesh, sirA, snAyu, bone, and joint. No marmas apart from these five structural bases are recognized, because none are observed separately from them.
The commentary glosses fivefold as five kinds. It considers the objection that injury to srotases can also be fatal. Its reply is that injury to a channel is not inevitably fatal, as another passage permits cautious treatment after declaring the prognosis. Although some marmas cause pain or disability rather than death, injury there still destroys one of the life-sustaining principles. Alternatively, srotases and other structures exist within flesh and the other four bases rather than independently; therefore only these five marma categories are needed.
Key terms
saptottara marmashata
The total of one hundred and seven marmas.
mAMsamarma (mamsamarma)
A marma classified primarily by flesh.
sirAmarma (siramarma)
A marma classified primarily by a vessel or channel.
snAyumarma (snayumarma)
A marma classified primarily by a binding structure.
Of the one hundred and seven marmas, eleven are classified as flesh marmas, forty-one as sirA marmas, twenty-seven as snAyu marmas, eight as bone marmas, and twenty as joint marmas.
The commentary enumerates each subtotal. The eleven flesh marmas are four talahRdayas, four indrabastis, the anus, and two stanarohitas. The forty-one sirA marmas comprise four dhamanIs, eight mAtRkAs, four shR~ggATakas, paired apA~ggas, one sthapanI, paired phaNas, stanamUlas, apastambhas and apalApas, the heart, navel, paired pArshvasandhis and bRhatIs, four lohitAkShas, and four UrvIs. The twenty-seven snAyu marmas comprise four ANIs, paired viTapas and kakShadharas, four kUrcas and four kUrcashiras, the bladder, four kShipras, paired aMsas, vidhuras and utkShepas. The eight bone marmas are paired kaTIkataruNas, nitambas, aMsaphalakas, and temples. The twenty joint marmas are paired knees and elbows, five sImantas, one adhipati, paired ankles, wrists, kukundaras, Avartas, and kRkATikAs. Repeating the grand total closes the enumeration rather than needlessly duplicating it.
Key terms
talahRdaya (talahridaya)
A named marma in each palm and sole.
mAtRkA (matrika)
One of eight named neck sirA marmas.
shR~ggATaka (shringataka)
One of four named craniofacial marma junctions.
kShipra (kshipra)
One of four distal limb marmas.
adhipati
A single superior cranial marma in the enumeration.
Eleven marmas occur in one lower limb; the other lower limb and both upper limbs follow the same pattern. Twelve are in the abdomen and chest, fourteen in the back, and thirty-seven from the neck upward.
The eleven marmas in one lower limb are kShipra, talahRdaya, kUrca, kUrcashiras, gulpha, indrabasti, jAnu, ANI, UrvI, lohitAkSha, and viTapa; the other limb is the same. In the abdomen and chest are guda, basti, nAbhi, hRdaya, paired stanamUlas, stanarohitas, apalApas, and apastambhas. The back contains paired kaTIkataruNas, kukundaras, nitambas, pArshvasandhis, bRhatIs, aMsaphalakas, and aMsas. Each upper limb contains kShipra, talahRdaya, kUrca, kUrcashiras, maNibandha, indrabasti, kUrpara, ANI, UrvI, lohitAkSha, and kakShadhara. Above the jatru are four dhamanIs, eight mAtRkAs, paired kRkATikAs, vidhuras, phaNas, apA~ggas, Avartas, utkShepas, and temples, one sthapanI, five sImantas, four shR~ggATakas, and one adhipati.
The commentary says each lower-limb name is counted once to make eleven, and their defining locations will be given later. In the trunk, guda through hRdaya are single while the remaining named chest marmas are paired, making twelve. All seven back names are paired, making fourteen. The upper-limb items are likewise counted individually for each side.
The commentary says these are the names belonging to the five tissue-based marma classes introduced earlier. Their numerical totals were already explained, so it does not repeat the counting here.
Key terms
nIlA-manyA (nila-manya)
Named neck sirA marmas included in the vascular class.
viTapa (vitapa)
A paired groin-region marma classified as snAyu.
kaTIkataruNa (katikataruna)
A paired lower-back or pelvic bone marma.
Avarta (avarta)
A paired head-region marma classified as a joint marma.
The marmas are grouped into five outcome classes: immediately life-taking, life-taking after an interval, fatal when an embedded object is removed, disability-producing, and pain-producing. Their counts are nineteen, thirty-three, three, forty-four, and eight respectively. The immediately fatal group includes four shR~ggATakas, adhipati, two temples, eight neck sirAs, guda, hRdaya, basti, and nAbhi. The delayed-fatal group includes the eight chest marmas, five sImantas, four talahRdayas, four kShipras, four indrabastis, two kaTIkataruNas, two pArshvasandhis, two bRhatIs, and two nitambas. The three vishalyaghna points are two utkShepas and sthapanI. The disability-producing group includes lohitAkShas, ANIs, knees, UrvIs, kUrcas, viTapas, elbows, kukundaras, kakShadharas, vidhuras, kRkATikAs, aMsas, aMsaphalakas, apA~ggas, nIlAs, manyAs, phaNas, and Avartas. The pain-producing group consists of two ankles, two wrists, and four kUrcashiras. KShipras are also said to cause death after a delay when pierced.
The commentary expands every subtotal: nineteen immediately fatal, thirty-three delayed fatal, three vishalyaghna, forty-four disability-producing, and eight pain-producing. The eight chest marmas are paired stanamUlas, stanarohitas, apalApas, and apastambhas. It notes a possible tension: the fivefold outcome scheme is later compressed into two categories, fatal and disability-producing. The commentator says this is not a fault because the twofold statement is intended to intensify physicians' caution rather than erase the useful fivefold teaching.
Key terms
sadyaHprANahara (sadyahpranahara)
Classified as causing death immediately when severely injured.
kAlAntaraprANahara (kalantarapranahara)
Classified as causing death after an interval.
vishalyaghna
Classified as fatal when an embedded foreign object is removed.
Marmas are junctions where flesh, sirAs, snAyus, bones, and joints come together. Life-sustaining principles are naturally and especially situated there; therefore injury to a marma produces the corresponding grave effects.
SannipAta means close conjunction or thorough intermixture. All five structures are joined at every marma, but a point is called a flesh, sirA, snAyu, bone, or joint marma according to which structure predominates, as substances are named earthy or otherwise by elemental predominance. 'Naturally' means without needing another cause, and the prANas are the life principles beginning with agni. The resulting effects may refer to loss of sensory contact and disturbance of mind and intellect described in this chapter, while other commentators connect them to dizziness, delirium, falling, and loss of awareness described elsewhere.
Key terms
sannipAta (sannipata)
Close conjunction or intermixture of the five structural bases.
prANa (prana)
A life-sustaining principle said to be especially located at marmas.
Adhikya (adhikya)
Predominance that determines a marma's tissue-based name.
manobuddhiviparyaya
Disturbance or reversal of mental and intellectual function after injury.
Adhikarana 9 (16) · Śloka 16
tatra sadyaḥprāṇaharāṇyāgnēyāni, agniguṇēṣvāśu kṣīṇēṣu kṣapayanti; kālāntaraprāṇaharāṇi saumyāgnēyāni, agniguṇēṣvāśu kṣīṇēṣu kramēṇa ca sōmaguṇēṣu kālāntarēṇa kṣapayanti; viśalyaprāṇaharāṇi vāyavyāni, śalyamukhāvaruddhō yāvadantarvāyustiṣṭhati tāvajjīvati, uddhr̥tamātrē tu śalyē marmasthānāśritō vāyurniṣkrāmati, tasmāt saśalyō jīvatyuddhr̥taśalyō mriyatē (pākātpatitaśalyō vā jīvati); vaikalyakarāṇi saumyāni, sōmō hi sthiratvācchaityācca prāṇāvalambanaṁ karōti; rujākarāṇyagnivāyuguṇabhūyiṣṭhāni, viśēṣataśca tau rujākarau; pāñcabhautikīṁ ca rujāmāhurēkē ||16||
Immediately fatal marmas are predominantly Agneya and destroy life quickly when qualities of agni are rapidly lost. Delayed-fatal marmas are both saumya and Agneya: rapid loss of agni qualities and gradual loss of Soma qualities cause decline over time. Vishalyaghna marmas are vAyavya; life continues while an embedded object's opening confines internal vAyu, but removal allows vAyu at the marma to escape, so the person is said to die after extraction. A variant adds that one may live if the object falls out after suppuration. Disability-producing marmas are saumya, because Soma's stability and coolness support life. Pain-producing marmas are rich in agni and vAyu, which especially cause pain, though some authorities say pain is produced by all five elements.
The commentary explains that every marma contains Soma, vAyu, tejas, rajas, sattva, tamas, and the elemental self, but one principle predominates in each class. Agni acts rapidly, explaining immediate decline; Soma declines more gradually. Agni and vAyu are especially pain-producing, although Soma can also contribute, since kapha-type wounds can hurt. The five-element account of pain is explicitly a second opinion.
Key terms
Agneya (agneya)
Predominantly characterized by agni in this prognostic theory.
saumya
Predominantly characterized by Soma and its stabilizing, cooling qualities.
vAyavya (vayavya)
Predominantly characterized by vAyu.
shalya
An embedded foreign object or projectile.
pA~jcabhautika rujA (panchabhautika ruja)
The alternative opinion that pain derives from all five elements.
Some authorities explain the outcome classes by how many of the five structural components are fully present: all five in immediately fatal marmas, four in delayed-fatal marmas, three in vishalyaghna marmas, two in disability-producing marmas, and only one in pain-producing marmas. The text rejects this explanation because blood is observed even when a bone marma is injured.
The commentary details this second theory. 'Absent' means completely lacking, not merely reduced. It assigns named marmas to groups supposedly lacking one, two, or three structural components, and says the pain-producing ankles, wrists, and kUrcashiras retain only one. The commentator's preferred view rejects this because every marma is a junction of flesh, sirA, snAyu, bone, and joint. Even where bone is not visibly evident in certain immediately fatal points, its power is held to be present. Conversely, visible bleeding after bone injury is offered as direct evidence that blood-bearing structure is present there, so none of the five is wholly absent.
Key terms
samavAya (samavaya)
The conjunction or co-presence of structural components.
hIna (hina)
Completely absent in the rejected theory, rather than merely diminished.
dvitIyadarshana (dvitiyadarshana)
A second doctrinal view explaining the prognostic differences.
pratyakSha pramANa (pratyaksha pramana)
Direct observation, here the sight of blood after bone injury.
The four kinds of siras in the body are situated chiefly at marmas. By nourishing the snayus, bones, muscles, and joints, they sustain the body and restore its functioning.
The four kinds are vessels carrying vata, pitta, kapha, and blood. Their presence within snayus, bones, muscles, and joints explains, in the commentary's view, why blood may emerge even when a bone is pierced.
Key terms
sirA (sira)
A vessel in the classical system, classified by what it carries.
marma
A vulnerable vital point where important structures converge.
When a marma is wounded, increased vayu spreads through the surrounding vessels and produces extremely severe pain throughout the body. Overcome by pain, the body breaks down and awareness is lost. Therefore, a person intending to remove a foreign body must examine the marmas carefully and withdraw it with great caution.
The commentary describes a sequence in which a local wound allows doshic disturbance, especially vayu, to spread throughout the body; severe pain then separates the conscious principle from the bodily system. Some read 'vayu increased in those vessels' instead of 'those vessels and increased vayu,' but both interpretations describe vayu enveloping the whole body. The warning about removal follows from the risk of disturbing a marma.
Key terms
marmakShata (marma-kshata)
Wounding of a vital point.
mAtarishvan (matarishvan)
Vayu, described here as spreading through the body.
sa~jj~jAnAsha (sanjna-nasha)
Loss of awareness or consciousness.
shalya
A lodged foreign body.
Adhikarana 13 (21) · Śloka 21
ētēna śēṣaṁ vyākhyātam ||21||
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एतेन शेषं व्याख्यातम् ||२१||
Meaning of the śloka
By this explanation, the remaining effects are also understood.
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ētēnēti rugādirūpēṇa vāyōrlakṣaṇēna, śēṣamiti dāhādi srōtōnirōdhādi ca pittaślēṣmaṇōrlakṣaṇaṁ vyākhyātamēvētyarthaḥ||21||
Meaning of the commentary
The signs of vayu were illustrated by pain and related features. By extension, the effects of pitta and kapha at an injured marma—such as burning and obstruction of channels—are said to have been explained as well.
Key terms
rujA (ruja)
Pain, used as a characteristic sign of vayu disturbance.
dAha (daha)
Burning, given as a sign associated with pitta.
srotonirodha (sroto-nirodha)
Obstruction of channels, associated here with kapha.
sheSha (shesha)
The remaining effects inferred from the preceding explanation.
Adhikarana 14 (22) · Śloka 22
tatra sadyaḥprāṇaharamantē viddhaṁ kālāntarēṇa mārayati, kālāntaraprāṇaharamantē viddhaṁ vaikalyamāpādayati, viśalyaghnaṁ vaikalyakaraṁ ca bhavati, vaikalyakaraṁ kālāntarēṇa klēśayati rujāṁ ca karōti, rujākaramatīvravēdanaṁ bhavati ||22||
A wound near the margin of a marma normally classed as immediately fatal may instead cause death later. A marginal wound of a delayed-fatal marma may cause disability. A vishalyaghna marma may behave as disability-producing, a disability-producing marma may cause prolonged distress and pain, and a pain-producing marma may cause exceptionally intense pain.
The commentary explains anta as the region near rather than at the center of a marma. Variation in the site and severity of injury can make one category produce the usual result of the next less immediately grave category. Conversely, very severe injury to a later category may produce the effect of an earlier, graver one. Thus the prognostic categories are tendencies rather than mechanically fixed outcomes.
Key terms
sadyaHprANahara (sadyah-pranahara)
A marma category traditionally expected to cause death rapidly.
kAlAntaraprANahara (kalantara-pranahara)
A marma category associated with death after an interval.
vishalyaghna
A marma where removal of an embedded object is traditionally considered fatal.
vaikalyakara
A marma associated with lasting functional impairment.
rujAkara (rujakara)
A marma associated chiefly with pain.
Adhikarana 15 (23) · Śloka 23
tatra sadyaḥprāṇaharāṇi saptarātrābhyantarānmārayanti, kālāntaraprāṇaharāṇi pakṣānmāsādvā, tēṣvapi tu kṣiprāṇi kadācidāśu mārayanti, viśalyaprāṇaharāṇi vaikalyakarāṇi ca kadācidatyabhihatāni mārayanti ||23||
Immediately fatal marmas are said to cause death within seven nights, while delayed-fatal marmas do so within a fortnight or a month. Even among the latter, severe injury may sometimes kill rapidly. Vishalyaprāṇahara and disability-producing marmas may also be fatal when injured with exceptional force.
Although sadyas ordinarily means 'at once,' here it is defined as within seven nights. Delayed-fatal points kill rapidly when severely injured but otherwise follow their stated interval. The commentary treats these categories as variable: pain-producing injuries may cause disability, and disability-producing or other types may depart from their usual outcome depending on the force and character of injury.
Key terms
saptarAtra (sapta-ratra)
Seven nights, the outer limit assigned here to rapid fatality.
pakSha (paksha)
A fortnight.
atyabhihata
Injured with exceptional severity.
niyatakarma (niyata-karma)
The normally assigned outcome of a marma category.
Adhikarana 16 (24) · Śloka 24
ata ūrdhvaṁ sakthimarmāṇi vyākhyāsyāmaḥ- tatra pādasyāṅguṣṭhāṅgulyōrmadhyē kṣipraṁ nāma marma, tatra viddhasyākṣēpakēṇa maraṇaṁ; madhyamāṅgulīmanupūrvēṇa madhyē pādatalasya talahr̥dayaṁ nāma , tatra rujābhirmaraṇaṁ; kṣiprasyōpariṣṭādubhayataḥ kūrcō nāma, tatra pādasya bhramaṇavēpanē bhavataḥ; gulphasandhēradha ubhayataḥ kūrcaśiraḥ, tatra rujāśōphau; pādajaṅghayōḥ sandhānē gulphaḥ, tatra rujaḥ stabdhapādatā khañjatā vā; pārṣṇiṁ prati jaṅghāmadhyē indrabastiḥ, tatra śōṇitakṣayēṇa maraṇaṁ; jaṅghōrvōḥ sandhānē jānu, tatra khañjatā; jānuna ūrdhvamubhayatastryaṅgulamāṇī , tatra śōphābhivr̥ddhiḥ stabdhasakthitā ca; ūrumadhyē urvī, tatra śōṇitakṣayāt sakthiśōṣaḥ; urvyā ūrdhvamadhō vaṅkṣaṇasandhērūrumūlē lōhitākṣaṁ, tatra lōhitakṣayēṇa maraṇaṁ pakṣāghātō vā; vaṅkṣaṇavr̥ṣaṇayōrantarē viṭapaṁ, tatra ṣāṇḍhyamalpaśukratā vā bhavati; ēvamētānyēkādaśa sakthimarmāṇi vyākhyātāni |
ētēnētarasakthi bāhū ca vyākhyātau |
viśēṣatastu yāni sakthni gulphajānuviṭapāni, tāni bāhau maṇibandhakūrparakakṣadharāṇi ; yathā vaṅkṣaṇavr̥ṣaṇayōrantarē viṭapamēvaṁ vakṣaḥkakṣayōrmadhyē kakṣadharaṁ, tasmin viddhē ta ēvōpadravāḥ; viśēṣatastu maṇibandhē kuṇṭhatā, kūrparākhyē kuṇiḥ, kakṣadharē pakṣāghātaḥ |
ēvamētāni catuścatvāriṁśacchākhāsu marmāṇi vyākhyātāni ||24||
Eleven marmas are described in each lower limb. Kshipra lies between the great and second toes; injury is linked with convulsions and death. Talahṛdaya is in the middle of the sole along the line of the middle toe; injury causes fatal pain. Kurcha lies above kshipra and injury causes abnormal turning and trembling of the foot; kurchashiras beside the ankle causes pain and swelling. Injury to the ankle joint causes pain, stiffness, or lameness. Indrabasti in the middle of the calf toward the heel is linked with fatal blood loss. Knee injury causes lameness; ani above the knee causes swelling and a stiff limb; urvi in the middle of the thigh causes wasting from blood loss; lohitaksha at the thigh root is linked with fatal hemorrhage or paralysis; and vitapa between groin and testis with impotence or reduced shukra. The upper limbs follow the same pattern, with wrist, elbow, and kakshadhara corresponding to ankle, knee, and vitapa; their distinctive effects include loss of hand function, a contracted elbow, and paralysis. Forty-four limb marmas are counted.
The commentary supplies the marma type, size, and prognostic class for each site. It describes kshipra and talahridaya as half an angula and delayed-fatal; kurcha as a four-angula disability-producing snayu marma; kurchashiras as a one-angula disability-producing snayu marma; ankle as a two-angula disability-producing joint marma; and indrabrasti as a delayed-fatal muscle marma, primarily half an angula and located thirteen angulas toward the heel. Bhoja and Gayi instead give indrabrasti a size of two angulas. Knee is a three-angula disability-producing joint marma; ani is primarily half an angula, though Gayi calls it three angulas; urvi is a one-angula vessel marma; and lohitaksha a one-angula snayu marma. Wrist, elbow, and kakshadhara inherit the corresponding lower-limb effects with the stated functional distinctions.
Key terms
kShipra (kshipra)
A marma between the great and second digits.
talahRudaya (tala-hridaya)
A marma in the central sole or palm.
indrabasti
A calf or forearm marma associated with major blood loss.
lohitAkSha (lohitaksha)
A marma near the root of the thigh or corresponding upper-limb region.
viTapa (vitapa)
A marma between the groin and testis.
kakShadhara (kakshadhara)
The corresponding marma between chest and axilla.
Adhikarana 17 (25) · Śloka 25
ata ūrdhvamudarōrasōrmarmāṇyanuvyākhyāsyāmaḥ - tatra vātavarcōnirasanaṁ sthūlāntrapratibaddhaṁ gudaṁ nāma marma, tatra sadyōmaraṇaṁ; alpamāṁsaśōṇitō'bhyantarataḥ kaṭyāṁ mūtrāśayō bastiḥ, tatrāpi sadyōmaraṇamaśmarīvraṇādr̥tē, tatrāpyubhayatō bhinnē na jīvati, ēkatō bhinnē mūtrasrāvī vraṇō bhavati, sa tu yatnēnōpakrāntō rōhati; pakvāmāśayayōrmadhyē sirāprabhavā nābhiḥ, tatrāpi sadyō maraṇaṁ; stanayōrmadhyamadhiṣṭhāyōrasyāmāśayadvāraṁ sattvarajastamasāmadhiṣṭhānaṁ hr̥dayaṁ, tatrāpi sadya ēva maraṇaṁ; stanayōradhastād dvyaṅgulamubhayataḥ stanamūlē, tatra kaphapūrṇakōṣṭhatayā (kāsaśvāsābhyāṁ ) mriyatē; stanacūcukayōrūrdhvaṁ dvyaṅgulamubhayataḥ stanarōhitau , tatra lōhitapūrṇakōṣṭhatayā kāsaśvāsābhyāṁ ca mriyatē; aṁsakūṭayōradhastāt pārśvōparibhāgayōrapalāpau nāma, tatra raktēna pūyabhāvaṁ gatēna maraṇaṁ; ubhayatrōrasō nāḍyau vātavahē apastambhau nāma, tatra vātapūrṇakōṣṭhatayā kāsaśvāsābhyāṁ ca maraṇam; ēvamētānyudarōrasōrdvādaśa marmāṇi vyākhyātāni ||25||
Twelve marmas are described in the abdomen and chest. Guda, connected with the large intestine and expelling wind and stool, and basti, the urine reservoir within the pelvis, are classed as immediately fatal when severely injured; the text makes a special exception for a stone-related bladder wound and says a one-sided wound may heal with careful treatment, whereas bilateral rupture is fatal. Nabhi lies between the stomach and large bowel and is the source of vessels; the heart lies between the breasts above the stomach opening and is the seat of sattva, rajas, and tamas—injury to either is said to kill immediately. Paired stanamula points below the breasts are linked with kapha filling the trunk and fatal cough or breathlessness; paired stanarohita points above the nipples with blood filling the trunk and the same symptoms. Apalapa below the shoulder prominences is linked with blood becoming pus, and apastambha on both sides of the chest with vayu filling the trunk, cough, breathlessness, and death.
Guda is a four-angula, immediately fatal muscle marma. Basti is described as a thin-walled, downward-facing, single-opening structure related to the navel, back, pelvis, testes, anus, groin, and penis; it is a four-angula snayu marma. The exception concerns a bladder wound caused by a stone. Nabhi is a four-angula vessel marma, and the lotus-bud-shaped downward-facing heart is also treated as a four-angula vessel marma. Each stanamula lies separately two angulas below its breast and is a delayed-fatal vessel marma. Each stanarohita lies two angulas above a nipple; the commentary cites a half-angula measure and reports differing prognostic classification, including a Vriddha Vagbhata reading. Apalapa and apastambha are paired half-angula vessel marmas associated with death after an interval.
Key terms
guda
The anorectal vital point connected with expulsion of stool and wind.
basti
The bladder or urinary reservoir in this context.
nAbhi (nabhi)
The navel marma, described as a source of vessels.
hRudaya (hridaya)
The heart marma and classical seat of the three gunas.
stanamUla / stanarohita (stanamula / stanarohita)
Paired vital points below the breast and above the nipple.
apastambha
A paired lateral chest marma associated with breathlessness after injury.
Adhikarana 18 (26) · Śloka 26
ata ūrdhvaṁ pr̥ṣṭhamarmāṇi vyākhyāsyāmaḥ - tatra pr̥ṣṭhavaṁśamubhayataḥ pratiśrōṇikāṇḍamasthinī kaṭīkataruṇē, tatra śōṇitakṣayāt pāṇḍurvivarṇō hīnarūpaśca mriyatē; pārśvayōrjaghanabahirbhāgē pr̥ṣṭhavaṁśamubhayatō kukundarē, tatra sparśājñānamadhaḥkāyē cēṣṭōpaghātaśca; śrōṇīkāṇḍayōruparyāśayācchādanau pārśvāntarapratibaddhau nitambau, tatrādhaḥkāyaśōṣō daurbalyācca maraṇaṁ; adhaḥpārśvāntarapratibaddhau jaghanapārśvamadhyayōstiryagūrdhvaṁ ca jaghanāt pārśvasandhī, tatra lōhitapūrṇakōṣṭhatayā mriyatē; stanamūlādr̥jūbhayataḥ pr̥ṣṭhavaṁśasya br̥hatī, tatra śōṇitātipravr̥ttinimittairupadravairmriyatē; pr̥ṣṭhōpari pr̥ṣṭhavaṁśamubhayatastrikasambaddhē aṁsaphalakē, tatra bāhvōḥ svāpaśōṣau ; bāhumūrdhagrīvāmadhyēṁ'sapīṭhaskandhabandhanāvaṁsau, tatra stabdhabāhutā; ēvamētāni caturdaśa pr̥ṣṭhamarmāṇi vyākhyātāni ||26||
Fourteen marmas are described on the back. Katikataruna near the posterior pelvic structures is linked with fatal blood loss, pallor, and loss of complexion. Kukundara beside the lower spine is linked with loss of sensation and movement below. Nitamba above the pelvic plates is linked with wasting and fatal weakness; parshvasandhi at the junction of back and sides with internal accumulation of blood; and brihati opposite the breast roots with complications from excessive bleeding. Injury to the shoulder blades causes numbness and wasting of the arms, while injury to amsa between the upper arm and neck causes stiffness of the arm.
Some read 'toward the pelvic ears' instead of 'toward the pelvic mass' for katikataruna; these are paired half-angula bone marmas and delayed-fatal. Gayi reads and locates kukundara somewhat differently, in a depression near the lower buttock-side region; they are half-angula disability-producing joint marmas. Nitamba are paired half-angula delayed-fatal bone marmas covering internal receptacles. Parshvasandhi and brihati are paired half-angula vessel marmas associated with death after an interval. The upper-back qualifier locates the shoulder blades at the trika formed by the neck-shoulder junction; they are disability-producing bone marmas. Amsa binds the shoulder blade and upper arm and is a disability-producing snayu marma.
Key terms
kaTIkataruNa (kati-taruna)
Paired vulnerable points near the posterior pelvic region.
kukundara
Paired lower-back or pelvic-side marmas with variant localization.
nitamba
Paired marmas above the pelvic plates.
pArshvasandhi (parshva-sandhi)
Paired junctional points between the back and sides.
bRuhatI (brihati)
Paired back points opposite the roots of the breasts.
aMsaphalaka (amsaphalaka)
The shoulder-blade marma.
Adhikarana 19 (27) · Śloka 27
ata ūrdhvamūrdhvajatrugatāni vyākhyāsyāmaḥ- tatra kaṇṭhanāḍīmubhayataścatasrō dhamanyō dvē nīlē dvē ca manyē vyatyāsēna , tatra mūkatā svaravaikr̥tamarasagrāhitā ca; grīvāyāmubhayataścatasraḥ sirā mātr̥kāḥ, tatra sadyōmaraṇaṁ; śirōgrīvayōḥ sandhānē kr̥kāṭikē, tatra calamūrdhatā; karṇapr̥ṣṭhatō'dhaḥsaṁśritē vidhurē, tatra bādhiryaṁ; ghrāṇamārgamubhayataḥ srōtōmārgapratibaddhē abhyantarataḥ phaṇē, tatra gandhājñānaṁ; bhrūpucchāntayōradhō'kṣṇōrbāhyatō'pāṅgau, tatrāndhyaṁ dr̥ṣṭayupaghātō vā; bhruvōrupari nimnayōrāvartau nāma, tatrāpyāndhyaṁ dr̥ṣṭayupaghātō vā; bhruvōrantayōrupari karṇalalāṭayōrmadhyē śaṅkhau, tatra sadyōmaraṇaṁ; śaṅkhayōrupari kēśānta utkṣēpau, tatra saśalyō jīvēt pākāt patitaśalyō vā nōddhr̥taśalyaḥ; bhruvōrmadhyē sthapanī, tatrōtkṣēpavat; pañca sandhayaḥ śirasi vibhaktāḥ sīmantā nāma, tatrōnmādabhayacittanāśairmaraṇaṁ; ghrāṇaśrōtrākṣijihvāsantarpaṇīnāṁ sirāṇāṁ madhyē sirāsannipātaḥ śr̥ṅgāṭakāni , tāni catvāri marmāṇi, tatrāpi sadyōmaraṇaṁ ; mastakābhyantarōpariṣṭhāt sirāsandhisannipātō rōmāvartō'dhipatiḥ, tatrāpi sadya ēva |
ēvamētāni saptatriṁśadūrdhvajatrugatāni marmāṇi vyākhyātāni ||27||
Thirty-seven marmas are described above the clavicles. Nila and manya are paired vessels beside the throat; injury causes muteness, altered voice, or loss of taste. The eight matrikas at both sides of the neck are classed as immediately fatal. Injury to krikatika at the head-neck junction causes an unstable head; vidhura behind and below the ear causes deafness; phana inside both nasal passages causes loss of smell; apanga beside the eyes and avarta above the brows cause blindness or impaired sight; and the temples are classed as immediately fatal. At utkṣepa above the temples and sthapani between the brows, a person is said to survive while an embedded object remains or falls out after suppuration, but die if it is extracted. Injury to the five cranial simantas is linked with mental disturbance, fear, loss of awareness, and death. Four shrungatakas are junctions of vessels nourishing smell, hearing, sight, and taste and are classed as immediately fatal. Adhipati is the vessel-and-joint convergence beneath the crown hair whorl and is also immediately fatal.
The commentary locates one nila and one manya on each side and classifies them as four-angula, disability-producing vessel marmas. There are four matrikas on each side of the neck. Krikatika is a half-angula joint marma; vidhura a slightly depressed disability-producing snayu marma; phana, apanga, and avarta are paired half-angula vessel or joint marmas. The temples are half-angula bone marmas. Utkṣepa and sthapani are half-angula vishalyaghna marmas: the traditional claim is survival if the foreign body remains or falls after suppuration and death if removed. The five four-angula simantas are delayed-fatal joint marmas. Four shrungatakas arise because the nourishing vessel junction divides according to the four senses. Adhipati is a half-angula joint marma marked externally by a hair whorl.
Key terms
nIlA / manyA (nila / manya)
Paired throat-side vessel marmas.
mAtRukA (matrika)
Eight vital vessels on the two sides of the neck.
vidhura
A point behind and below the ear associated with hearing.
utkShepa / sthapanI (utkshepa / sthapani)
Head marmas traditionally classed as fatal upon foreign-body removal.
shRu~ggATaka (shrungataka)
A junction of vessels said to nourish four sense faculties.
adhipati
The crown marma beneath a hair whorl.
Adhikarana 20 (28-29) · Śloka 29
bhavanti cātra ślōkāḥ- urvyaḥ śirāṁsi viṭapē ca sakakṣapārśvē ēkaikamaṅgulamitaṁ stanapūrvamūlam |
viddhyaṅguladvayamitaṁ maṇibandhagulphaṁ trīṇyēva jānu saparaṁ saha kūrparābhyām ||28||
hr̥dbastikūrcagudanābhi vadanti mūrdhni catvāri pañca ca galē daśa yāni ca dvē |
tāni svapāṇitalakuñcitasammitāni śēṣāṇyavēhi parivistaratō'ṅgulārdham ||29||
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भवन्ति चात्र श्लोकाः- उर्व्यः शिरांसि विटपे च सकक्षपार्श्वे एकैकमङ्गुलमितं स्तनपूर्वमूलम् |
विद्ध्यङ्गुलद्वयमितं मणिबन्धगुल्फं त्रीण्येव जानु सपरं सह कूर्पराभ्याम् ||२८||
हृद्बस्तिकूर्चगुदनाभि वदन्ति मूर्ध्नि चत्वारि पञ्च च गले दश यानि च द्वे |
तानि स्वपाणितलकुञ्चितसम्मितानि शेषाण्यवेहि परिविस्तरतोऽङ्गुलार्धम् ||२९||
Meaning of the śloka
The verses summarize marma dimensions. Urvi, kurchashiras, vitapa, kakshadhara, and the earlier breast-related root points are each one angula; wrist, ankle, and breast-root points are two angulas; each knee together with its counterpart and the elbows is three angulas. Heart, bladder, kurcha, anus, navel, four shrungatakas, five cranial simantas, and the twelve throat points are measured by the person's cupped palm, interpreted as four angulas. The remaining marmas are half an angula across.
The commentary resolves several compressed expressions: shiras means kurchashiras and kakshaparshva means kakshadhara. Wrist, ankle, and stanamula are two angulas; paired knees and elbows are three. The four shrungatakas, five simantas, eight matrikas, two nilas, and two manyas belong to the four-angula group measured by the person's own cupped palm. Fifty-six remaining marmas are primarily taken as half an angula, though some authorities call them palm-sized. Gayi, following Bhoja, reads a different mnemonic: the two stanamulas, two ankles, four indrabrastis, and two wrists—ten marmas—are two angulas; and he interprets the three-angula group as two knees, four anis, and two elbows. The rest agrees.
Key terms
a~ggula (angula)
A traditional proportional finger-width measure.
svapANitalaku~jcita (sva-pani-tala-kunchita)
The measure of the person's own cupped palm, interpreted as four angulas.
Those knowledgeable in marma advise first considering the stated measurements and keeping operative instruments away from these sites. Even a blow beside a marma may be fatal; therefore injury to a marma region should be carefully avoided.
The commentary says that the purpose of stating marma measurements is to guide avoidance during operative work. It explains marmasadana as the site or region of a marma.
Key terms
marma
A classically defined vital or vulnerable bodily site.
pramANa (pramana)
The stated measurement or extent of a marma.
shastra
A cutting or operative instrument.
pArshvAbhighAta (parshvabhighata)
A blow or injury beside the marma itself.
marmasadana
The marma site or region, according to the commentary.
Adhikarana 22 (31-32) · Śloka 33
chinnēṣu pāṇicaraṇēṣu sirā narāṇāṁ saṅkōcamīyurasr̥galpamatō nirēti |
prāpyāmitavyasanamugramatō manuṣyāḥ sañcchinnaśākhataruvannidhanaṁ na yānti ||31||
kṣiprēṣu tatra satalēṣu hatēṣu raktaṁ gacchatyatīva pavanaśca rujaṁ karōti |
ēvaṁ vināśamupayānti hi tatra viddhā vr̥kṣā ivāyudhanipātanikr̥ttamūlāḥ ||32||
tasmāttayōrabhihatasya tu pāṇipādaṁ chēttavyamāśu maṇibandhanagulphadēśē |33|
The text contrasts complete severance of a hand or foot with injury to the kshipra and tala marmas. After a limb is cut off, the siras contract and relatively little blood is said to escape, so a person may survive severe loss like a tree with branches cut away. When the kshipra and tala sites of a hand or foot are struck, however, profuse bleeding and severe pain from vata are said to lead to death, like a tree cut at its root. The beginning of the next verse historically directs rapid amputation at the wrist or ankle after such injury.
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karacaraṇacchēdē jīvanti tadavayavabhūtamarmacchēdē tu na jīvantīti viśēṣaṁ darśayannāha- chinnēṣvityādi| saṅkōcamīyuḥ saṅkōcaṁ jagmuratō'lpaṁ rudhiraṁ pravartatē| kṣiprēṣvityādi tatra pāṇyōścaraṇayōrvā| gayī tu, vr̥kṣā ivāyudhanipātētyādisthānē ‘kiñjalkapatramathanādiva paṅkajāni’ iti paṭhati||31-32||-
Meaning of the commentary
The commentary explains the claimed distinction: severance of an extremity may be survived, whereas severance of a marma within it is considered fatal. Samkocham iyuh means the vessels contract, leading in this model to less blood flow. In the kshipra passage, 'there' refers to either hands or feet. Gayi reads the simile differently: instead of trees whose roots are cut by a weapon, he compares the victims to lotuses whose filaments and petals are crushed.
Key terms
kShipra (kshipra)
A marma in the hand or foot associated here with severe hemorrhage and pain when injured.
tala
A vital region of the palm or sole in this context.
sirAsa~gkoca (sira-samkocha)
Contraction of vessels after severance in the text's explanation.
maNibandha (manibandha)
The wrist region.
gulpha
The ankle region.
Adhikarana 23 (33) · Śloka 34
marmāṇi śalyaviṣayārdhamudāharanti yasmācca marmasu hatā na bhavanti sadyaḥ ||33||
jīvanti tatra yadi vaidyaguṇēna kēcittē prāpnuvanti vikalatvamasaṁśayaṁ hi |34|
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मर्माणि शल्यविषयार्धमुदाहरन्ति यस्माच्च मर्मसु हता न भवन्ति सद्यः ||३३||
जीवन्ति तत्र यदि वैद्यगुणेन केचित्ते प्राप्नुवन्ति विकलत्वमसंशयं हि |३४|
Meaning of the śloka
Marmas are said to constitute half of the domain of shalya because injury to them does not always cause immediate death. Some injured people may survive through a physician's skill, but the text says they will nevertheless develop impairment.
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marmamānakathanaprayōjanaṁ pūrvataravākyē pratipādya marmasthānaviṣayaṁ nirdiśannāha- marmāṇītyādi| śalyasya manaḥśarīrābādhakarasya viṣayaḥ śalyaviṣayaḥ; sa ca śastrādipraṇidhānānmaraṇāmaraṇakārakatvēna dvividhaḥ; tatra maraṇakārakaḥ śalyaviṣayō marmākhyaḥ śarīradēśaḥ, yasmāttatra hatāḥ sadya ēva na bhavanti saptāhābhyantara ēva mriyanta ityarthaḥ, tasmānmaraṇakārakatvēna marmāṇi śalyaviṣayārdhamudāharanti, ‘pūrvācāryāḥ’ iti śēṣaḥ| nanu, kēcinmarmahatā api jīvantō dr̥śyantē tat kathaṁ maraṇakārakatvēna marmāṇi śalyaviṣayārdhamityāśaṅkyāha- jīvantītyādi||33||-
Meaning of the commentary
The commentary defines shalya's domain as injuries of mind or body caused by an embedded or injuring object and divides it into those that cause death and those that do not. A marma is the bodily region within the fatal division. It interprets 'not immediately' as death occurring within seven days. Anticipating the objection that some people survive marma injury, the following line attributes survival to medical skill but predicts lasting impairment.
Key terms
shalyaviShaya (shalya-vishaya)
The field or domain of injuring objects and surgical conditions.
marma
A vital bodily site classified here within potentially fatal injury.
sadyaH (sadyah)
Immediately; interpreted by the commentary in relation to death within seven days.
The text says that people may survive a penetrated or shattered trunk or skull, wounds from weapons in other parts of the body, or even severance of thighs, arms, feet, and hands, provided that the varied blows have not struck marmas.
To describe the other half of shalya's domain, the commentary states that even severe cutting, splitting, and related wounds outside marmas are not necessarily fatal.
Key terms
koShTha (koshtha)
The trunk or internal body cavity in this injury description.
Soma, maruta, tejas, rajas, sattva, tamas, and the embodied self are said to reside especially in the marmas. Therefore, according to the text, beings struck in a marma do not survive.
The commentary treats marmas as seats of both bodily and mental principles. When injury at a marma disturbs the bodily and mental doshas, mind and body are destroyed; because these support the embodied self, the self's embodied presence is also said to cease.
Key terms
soma
A cooling or nourishing principle said to reside in marmas.
mAruta (maruta)
The moving principle or vata said to reside in marmas.
tejas
The fiery or illuminating principle said to reside in marmas.
sattva-rajas-tamas
The three gunas of mind said to be concentrated at marmas.
bhUtAtman (bhutatman)
The embodied self supported by mind and body in the commentary's account.
When an immediately life-taking marma is struck, the text describes loss of contact between the senses and their objects, disturbance of mind and understanding, and many intense pains. Injury to a delayed-fatal marma is said to cause definite depletion of dhatus, followed by death from depletion and pain. With an impairment-producing marma, skilled treatment may preserve the body but leave disability. For a vishalyaghna marma, the previously stated mechanism applies. Injured pain-producing marmas cause varied pains and may ultimately cause impairment when managed by an unskilled practitioner.
The commentary says these are the defining signs of the five marma classes, beginning with sadyah-pranahara. For vishalyaghna it recalls the earlier explanation that life continues only while the opening of the wound is blocked by the embedded object and internal vayu remains contained.
Key terms
sadyaHprANahara (sadyah-pranahara)
A marma class believed to cause rapid death when injured.
kAlAntaraghna (kalantaraghna)
A marma class believed to cause death after an interval.
vaikalyajanana
A marma class associated with lasting functional impairment.
vishalyaghna
A marma class in which removal of an embedded object is historically said to precipitate death.
rujAkara (rujakara)
A marma class chiefly associated with severe pain.
dhAtukShaya (dhatu-kshaya)
Depletion of bodily constituents in the historical prognosis.
The commentary emphasizes that injury to a region close to a marma can also cause severe consequences. It defines upaghata here as injury in the vicinity.
Key terms
cheda
Cutting injury.
bheda
Splitting or penetrating injury.
abhighAta (abhighata)
A blow or blunt injury.
dahana
Burning injury.
dAraNa (darana)
Tearing or laceration.
upaghAta (upaghata)
Injury close to a marma, according to the commentary.
The commentary says this warning is intended to make the physician especially diligent in marma injury. It explains alpatyaya as involving little complication and niratyaya as free from complication. Gayi does not include this statement in his reading.
The commentary extends the warning from trauma to bodily disorders affecting a marma or its neighboring region. It explains murchhanti as rising or becoming strongly manifest and implies that the physician should therefore take special care.
Key terms
marma
A vital or vulnerable bodily site in the classical system.
vikAra (vikara)
A disorder or pathological change.
mUrcchanti (murchhanti)
Become elevated, intensified, or strongly manifest.
This marks the end of the sixth chapter of the Sharirasthana in Dalhana's commentary on Sushruta entitled Nibandhasangraha. The transmitted spelling of Dalhana's name is shown with a textual variation.
Key terms
pratyeka
Each individually or one by one.
marmanirdesha (marma-nirdesha)
Description or specification of the marma sites.
shArIrasthAna (Sharirasthana)
The division concerned with embodiment and anatomy.