An Anatomical Study of Traumatic Injuries of Rujakar Marma
As it is well known thing that Ayurveda is the science of life.it has peculiar part like Marmas which shows similar value ability now a days also in modern surgery. Marmas are said to be half part of surgery (Shalya-vishyardh) by Acharya Sushruta. Marmas are the vital points in our body which possesses Mansh (muscle), Shira (vessels), Snayu (liga-ments, tendons and connective tissue), Asthi (bony tissue) and Sandhi (joints) combinly. Marmas are the places where the aliveness (prana) is present naturally and specially according to acharya sushruta. Sushruta belongs to the group of surgery predominantly, when surgery is performed, Marma points have to be saved that’s why Marma is described in detail by the father of surgery Acharya Sushruta. Characteristics of injury on marma points (Marma Viddha lakshana) are also described in detail by acharya sushruta along with the exact location of Marma points. Up to what extant Marmas are spreads (Parinam), that area of body should be avoided for the surgery. Similarly according to time period of death marmas are classified by Sushruta so that it can be distinguish that most intensity of aliveness (Prana) are cause of sudden death (Sadhya-pranhar). Marma chikitsa is a new concept in Ayurveda where Marma points are gently pressed to cure the localize or generalize pain like acupuncture. As marmas are the “Doorways†into the body‘s inner pathways for consciousness and energy healing.
Introduction
Marma points are the high energy level vital points of our body .transmission of the energy from one points to other point is by gently pressure applying on marma points any trauma to the marma point may cause of death or the painful condition .according to trauma on marma points the rujakar marma are painful after the trauma due to the plenty of agni & vayu mahabhut [1] recepters which are responsible for the pain sensations are found richly on these sites. Presence of structure on the sites of rujakar marma only one of structure is found from mams, sira, snayu, asthi, sandhi.
Marma sthan are the places where the prana are found specially. Rujakar marma are the marma where the rujakaratva is the peculiar feature. Rujakar marma is having only one component at vulnerable out of six and rest of the components are in less vulnerable condition. According to acharya vagbhatt marma points are the point where abnormal pain and pulsation are found on pressure marma points are tender points [2].
Marma points are the energy points and according to ayurved prana [3] are situated on the marma points some other system of medicine are based on the marma points like acupressure, acupuncture etc. fundamental of these system of medicine to stimulate the energy or the pran by message or by acupressure or by acupuncture. According to south indian marma are two type, padu marmas and thodu marmas which are one hundred and eight in number [4]. On the basis of their injury effect, this description of marmas is known as 'munnula' munnula sastra is written by Bhoj in the form of poems. marma chikitsa was developed by pressing and counter striking on marma points to give relief to the patient of marmabhighata.
Material and Methods
Ancient Texts-Shushrut sharir sthan (dalhan commentary, charak sharir sthan, astang hridaya sharir sthan, astang sangraha sharir sthan. Modern texts-Gray's Anatomy, Netters Atlas, BD Chaurasiya, Cunningham manual anatomy.
- Cadaveric dissection: By the cadaveric dissection done according to Cunningham manual anatomy.
- Internet Sources: GOOGLE Search engine & other internet sources.
Discussion
Rujakar marma are eight in number, two in each extremity. In upper limb Manibandh (2) and kurchshira (2), in lower limb Gulpha (2) and kurchshira (2). Nature of these rujakar marma is producing pain after injury on the sight of marama all six components are found on the marma site along with prana which are found naturally and spefically [5].
Gulpha Marma
Location-junction between leg & foot [6]
- Number: Two (one in each lower extremity).
- According to location (sthan): Lower extremity (adho shakhagat marma).
- According to the result of trauma (abhighat parinam): Continuous painful (rujakar).
- According to structure (sanrachana): Ankle joint (sandhi marma).
- According to measurement (praman): Two anguli (finger breadth).
The components which are found on gulpha marma may be consider as
- Mansa: Peroneus longus, peroneus brevis, peroneus treaties.
- Sira: Malleolar branches of anterior tibial, posterior tibial and fibular arteries.
- Snayu: Anterior talofibular, posterior talofibular and calcaneofibular ligament, interosseous tibiofibular ligament, deltoid ligament, fibrous capsule.
- Asthi: Medial malleolus of tibia, lateral malleolus of fibula, upper-lateral-medial aspects of talus.
- Sandhi- Ankle joint (joint between lower end of tibia and fibula with the talus).
- Viddh lakshana (traumatic symptoms): Ruja (continuous pain), stabdpadata (restricted movements), and khanjata (functional deformity).
Manibandh Marma
Location: at the junction between forearm and hand.
- Number: Two (one in each upper extremity).
- According to location (sthan): Upper extremity (urdhva shakhagat marma).
- According to result of trauma (abhighat parinam): Continuous painful (rujakar).
- According to structure (sanrachana): Wrist joint (sandhi marma).
- According to measurement (praman): Two anguli (two finger breadth).
The components which are found on manibandh marma may be consider as
- Mansa: abductor pollicis brevis, flaxor pollicis brevis, adductor pollicis, abductor digiti minimi, palmeris brevis, flaxor digiti minimus brevis.
- Sira: branches of palmer arch (superficial and deep), radial & ulner arteries and their branches. Tributaries of Venus arch.
- Snayu: palmer and dorsal radial-carpal & ulner carpel ligament, lateral ulner & radial carpel ligament.
- Asthi: lower end of radius & ulna & carpel bones (proximal row).
- Sandhi: lower radio-ulnar & radio carpal joint.
- Viddh lakshana: kunthata (restriction in the wrist joint movements and become less powerful.
Kurchshira
Location- both sides blow the ankle joint and wrist joint.
- Total =04
- Urdhva sakha (upper extamity) =02
- Adho sakha (lower extremity) =02
Journal of Natural & Ayurvedic Medicine
- According to result of trauma (abhighat parinam): Continuous painful (rujakar)
- According to structure (sanrachana): Snayu marma
- According to measurement (praman): One angul (one fingers breadth)
Components which are found on kurchashir marma as are
- Mansa: Tibialis anterior, extensor digitorum brevis, adductor pollicis, opponens pollicis, opponens digiti minimi.
- Sira: Branches of radial & ulnar artery, branches of superficial & deep palmer arch, branches of medial & lateral planter arch.
- Snayu: Deltoid ligament, talocalcaneal ligament, calcaneo fibular ligament. Dorsal radio carpal & dorsal intercarpal ligament.
- Asthi: carpal bone of distal row, metacarpals, calcaneus, talus.
- Sandhi: carpometacarpal joint, calcano-cuboid, calcano navicular joints.
- Viddha lakshana: Ruja (pain), sofa (swelling).
Conclusion
Marma points are the pranasthana where especially prana resides agni, vayu, satva, rajah, tamah, five senses with prana resides at marma. Prana leads the life forward. The vital organ is consisted with soma, vayu, teja, satva, tamah and atma and that is why healthy marma is a symbol of healthy life. The prana means the energy, which sustains or keeps the life. Tri-marma (hridaya, basti, shira) described by ch araka is the vital most part of our body. Apart from these charaka has also described oja & sukra as most vital dhatu to save the life.
References
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Ghanekar BG (1997) Shushrut sharir sthan, ayurved sandipika hindi vyakhya, 3rd (Edn.), meharchandra lachmandas publications new delhi, shusrut sharir 6/23, pp: 186.
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Chakrapani (1997) ayurved dipika vyakhya, charak samhita 9th (Edn.), chaukhamba publications, chapter 7/9, pp: 338.
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Thatte DG (1998) Acupuncture marma & other Asian therapeutic thechniques, 2nd (Edn.), chaukhamba orientalia Varanasi, pp: 22.
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Ghanekar BG (1997) Shushrut sharir sthan, ayurved sandipika hindi vyakhya, 3rd (Edn.), meharchandra lachmandas publications new delhi, shusrut sharir 6/22, pp: 186.
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Ghanekar BG (1997) Shushrut sharir sthan, ayurved sandipika hindi vyakhya, 3rd (Edn.), meharchandra lachmandas publications new delhi, shusrut sharir 6/31, pp: 190.
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Ghanekar BG (1997) Shushrut sharir sthan, ayurved sandipika hindi vyakhya, 3rd (Edn.), meharchandra lachmandas publications new delhi, shusrut sharir 6/32, pp: 192.
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