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Sushruta SamhitaShrira SthanaPratyeka marma nirdesa Sharira - Vital Parts of body - Sushrutasamhita Sharirasthana...

Pratyeka marma nirdesa Sharira – Vital Parts of body – Sushrutasamhita Sharirasthana Chapter 6

षष्ठोऽध्यायः अथातः प्रत्येकमर्मनिर्देशं शारीरं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः।।१।।

Now we shall discourse on the Sharira which specifically treats of the Marma or vital parts of the body. (Pratyeka-marma-nirdesa Sharira). 1

सप्तोत्तरं मर्मशतम् । तानि मर्माणि पञ्चात्मकानि भवन्ति । तद्यथा-मांसमर्माणि, सिरामर्माणि, स्नायुमर्माणि, अस्थिमर्माणि, सन्धिमर्माणि चेति। न खलु मांससिरास्नाय्वस्थिसन्धिव्यतिरेकेणान्यानि मर्माणि भवन्ति, यस्मान्नोपलभ्यन्ते । ॥ २॥

Classification of Marmas : There are one hundred and seven Marmas (in the human organism), which may be divided into five classes such as the Mansa-Marmas, Sira- Marmas, Snayu-Marmas, Asthi-Marmas and the Sandhi-Marmas. Indeed there are no other Marmas (vulnerable or vital parts) to be found in the body than the preceding ones. 2

तत्रैकादश मांसमर्माणि, एकचत्वारिंशत् सिरामर्माण, सप्तविंशतिः स्नायुमर्माणि, अष्टोवस्थिमर्माणि, विंशतिः सन्धिमर्माणि चेति । तदेतत् सप्तोत्तरं मर्मशतम् ॥ ३॥

1. Places where veins, arteries, ligaments, joints and muscles unite and an injury to which proves generally fatal.

Their different numbers: There are eleven Mansa-Marmas (vulnerable muscle-joints); forty-one Sira-Marmas ( similar veins, anastomosis); twenty-seven Snayu-Marmas (vital ligament-unions); eight Asthi-Marmas (bone-unions) and twenty Sandhi-Marmas (vulnerable joints). 3

तेषामेकादशैकस्मिन् सक्थिन भवन्ति । एतेनेतरसक्थि बाहू च व्याख्यातौ ।

उदरोरसोर्द्वादश, चतुर्दश पृष्ठे, ग्रीवां प्रत्यूर्ध्वं सप्तत्रिंशत् ।। ४ ।।

Their Locations: Of these, eleven are in one leg, thus making twenty-two in the two lower extremities. The same number counts in the two hands. There are twelve Marmas in the regions of the chest and the abdomen (Udara); fourteen in the back; and thirty-seven in the region of the neck (Griva) and above it. 4

तत्र सक्थिमर्माणि क्षिप्रतलहृदयकूर्चकूर्चशिरोगुल्फेन्द्रबस्तिजान्वाप्यूर्वीलोहिताक्षाणि विटपञ्चेति । एतेनेतरं सक्थि व्याख्यातम् ॥ ५॥

उदरोरसोस्तु गुदबस्तिनाभिहृदयस्तनमूलस्तनरोहितापलापान्यपस्तम्भौ चेति ।। ६ ।।

पृष्ठमर्माणि तु कटीकतरुणकुकुन्दरनितम्बपार्श्वसन्धिबृहत्यंसफलकान्यंसौ चेति ।। ७।।

बाहुमर्माणि तु क्षिप्रतलहृदयकूर्चकूर्चशिरोमणिबन्धेन्द्रबस्तिकू र्पराण्यूर्वीलोहिताक्षाणि कक्षधरञ्चेति । एतेनेतरो बाहुर्व्याख्यातः ।। ८॥

जत्रुण उर्ध्वं मर्माणि चतस्त्रो धमन्योऽष्टौ मातृका द्वे कृकाटिके द्वे विधुरे द्वे

फणे द्वावपाङ्गौ द्वावावर्ती द्वावुत्क्षेपौ द्वौ शङ्खावेका स्थपनी पञ्च सीमन्ताश्चत्वारि शृङ्गाटकान्येकोऽधिपतिरिति ।। ९ ।।

Names and distributions of Marmas : The Marmas which are situated in each leg are known as Ksipra, Tala- Hrdaya, Kurca, KurcaSira, Gulpha (ankle), Indrabasti, Janu (Knee), Ani, urvi, Lohitaksa and Vitapa. The twelve Marmas which are situated in the thorax and the abdomen (Udara) are Guda (anus), Basti (bladder), Nabhi (umbilicus), Hrdaya (heart), Stanamula (the roots of two breasts), the Stana-Rohita (muscles of the breasts), the two Apalapas and the two Apastambhas. The fourteen Marmas to be found in the back are the Katika-tarunas (Taruna-bones of the waist). the two Kukundaras, the two Nitambas (hips), Parsva-Sandhis (the two side-joints), the two Brhatis, the two Aisa-phalakas (shoulder-blades) and the two Ansas (shoulders). The eleven Marmas to be found in an arm are known as the Ksipra, Tala-Hrdya, Kurca, Kurca-Sirah, Manibandha, Indrabasti, Kurpara, Ani, Urvi, Lohitaksa and Kaksadhara. What is said of the one arm holds good of the other. The Marmas situated above the clavicle regions are known as the four Dhamanis, the eight Matrkas, the two Krkatikas, the two Vidhuras, the two Phanas, the two Apangas, the two avartas, the two Utksepas, the two Sankhas, one Sthapani five Simantas, four Srngatakas and one Adhipati. 5-9

तत्र तलहृदयेन्द्रबस्तिगुदस्तनरोहितानि मांसमर्माणि ।। १० ।।

नीलधमनीमातृकाशृङ्गाटकापाङ्गस्थपनीफणस्तनमूलापलापापस्तम्भहृदयनाभिपार्श्वसन्धिबृहतीलोहिताक्षोर्व्यः सिरामर्माणि ।। ११ ।।

स्नायुमर्माणि ।। १२ ।। आणीविटपकक्षधरकूर्च-कूर्चशिरो-बस्तिक्षिप्रांसविधुरोत्क्षेपाः

कटीकतरुणनितम्बांसफलकशङ्खास्त्वस्थिमर्माणि ।। १३ ।।

जानुकूर्परसीमन्ताधिपतिगुल्फमणिबन्धकुकुन्दरावर्त्तकृकाटिकाश्चेति सन्धिमर्माणि ।।१४।।

The different heads of Marmas : Of the aforesaid Marmas, those known as the Tala Hrdaya, Indrabasti, Guda and Stana-rohita. are Mansa-Marmas. Those known as Nila-dhamani, Matrka, Srigataka, Apanga, Sthapani, Phana, Stanamiila, Apalapa, Apastambha, Hrdaya (heart ), Nabhi (umbilicus ), Parsva – Sandhi, Brhati Lohitaksa and Urvi are Sira-Marmas. Those known as the Ani, Vitapa, Kaksadhara, Kurca, Kurca-Sirah. Basti, Ksipra, Anas ( shoulders), Vidhura and Utksepa are Snayu-Marmas. Those known as the Katika-taruna, Nitamba, Aisaphalaka, Sankha are Asthi- Marmas. The Janu, the Kurpara, the Simanta, the Adhipathi, the Gulpha, the Manibandha, the Kukundara, the avarta and the Krkatika are Sandhi-Marmas. 10-14

तान्येतानि पञ्चविकल्पानि सर्माणि भवन्ति । तद्यथा- सद्य:प्राणहराणि, कालान्तरप्राणहराणि, विशल्यघ्नानि, वैकल्यकराणि, रुजाकराणीति । तत्र सद्यः प्राणहराण्येकोनविंशतिः, कालान्तरप्राणहराणि त्रयस्त्रिंशत् त्रीणि विशल्यघ्नानि चतुश्चत्वारिंशद् वैकल्यकराणि, अष्टौ रुजाकराणीति ।। १५ ।।

Qualitative Classes : Again these Marmas (vital unions of the body ) are under five distinct heads, namely, Sadya-Pranahara (fatal within twenty-four hours ), Kalantara-Pranahara (fatal within a fortnight or a month), Visalyaghna (fatal as soon as a dart or any other imbeded foreign matter is extracted therefrom), Vaikalyakara (maiming or deforming) and Rujakar (painful) [ according as an injury respectively produces the aforesaid effects ]. Of these, nineteen Marmas belong to the Sadya-Pranahara group; thirty-three to the KalantaraPranahara group; three to the Visalyaghna group: forty-four to the Vaikalyakara group; and eight to the Rujakara group. 15

भवन्ति चात्र

शृङ्गाटकान्यधिपतिः शङ्खौ कण्ठसिरा गुदम् । हृदयं बस्तिनाभी च घ्नन्ति सद्यो हतानि तु ॥ १६ ॥

वक्षोमर्माणि सीमन्ततलक्षिप्रेन्द्रबस्तयः । कटीकतरुणे सन्धी पार्वजौ बृहती च या ।। १७ ।।

नितम्बाविति चैतानि कालान्तरहराणि तु । उत्क्षेपौ स्थपनी चैव विशल्यघ्नानि निर्दिशेत् ।। १८ ।।

लोहिताक्षाणिजानूर्वी – कूर्चविटपकूर्परा: कुकुन्दरे कक्षधरे विधुरे सकृकाटिके ।। १९ ।।

अंसांसफलकापाङ्गा नीले मन्ये फणौ तथा ।

वैकल्यकरणान्याहुरावर्ती द्वौ तथैव गुल्फो द्वौ मणिबन्धौ द्वौ द्वे द्वे कूर्चशिरांसि च । रुजाकराणि जानीयादष्टावेतानि बुद्धिमान् ॥ २१ ॥

क्षिप्राणि विद्धमात्राणि घ्नन्ति कालान्तरेण च ॥ २२ ॥ च ।। २० ।।

Memorable Verse: To the Sadya-Pranahara group (fatal in the course of a day if anyway hurt) belong the four Srigatakas, one Adhipati, the two Saikhas, the eight Kantha- Siras, the Guda, the Hrdaya, the Basti and the Nabhi. To the Kalantara-Pranahara group (fatal later on, if any way hurt) belong the eight Vaksa-Marmas. the five Simantas, the four Tala-Marmas, the four Ksipra-Marmas, the four Indra-bastis, the two Katika-tarunas, the two Parsva-Sandhis. the two Brhatis and the two Nitambas. To the Visalyaghna class belong the two Utksepas and the one Sthapani. To the Vaikalyakara (deforming) group belong the Marmas, known as the four Lohitaksas, the four Anis, the two Janus, the four urvis, the four Kurcas, the two Vitapas, the two Kurparas, the two Kukundaras, the two Kaksadharas, the two Vidhuras, the two Krkatikas, the two Ansas (shoulder), the two Ansa-phalakas ( shoulder-blades), the two Apangas ( tips of eyes), the two Nilas, the two Manyas the two Phanas and the two Avartas. A learned physician should know that the two Gulphas, the two Manibandhas and the four Kurca-Sirah (of the hands and legs) belong to the Rujakara group (painful if hurt ). A piercing of the Ksipra-Marma ends in an instantaneous death; or death may follow at a later time. 16-22

मर्माणि नाम: मांससिरास्नाय्वस्थिसन्धिसन्निपाताः ।

तेषु स्वभावत एव विशेषेण प्राणास्तिष्ठन्ति, तस्मान्मर्मस्वभिहतास्तांस्तान् भावानापद्यन्ते ।। २३ ।।

Firm unions of Mansa (muscles). Sira (veins), Snayu (ligaments), bones or bone-joints are called Marmas (or vital parts of the body) which naturally and specifically form the seats of life (Prana) and hence a hurt to any one of the Marmas invariably produces such symptoms as arise from the hurt of a certain Marma.¹ 23

तत्र सद्यः प्राणहराण्याग्नेयानि, अग्निगुणेष्वाशु क्षीणेषु क्षपयन्ति । कालान्तरप्राणहराणि सौम्याग्नेयानि, अग्निगुणेष्वाशु क्षीणेषु क्रमेण च सोमगुणेषु कालान्तरेण क्षपयन्ति । विशल्यप्राणहराणि वायव्यानि, शल्यमुखनिरुद्धो यावदन्तर्वायुस्तिष्ठति तावज्जीवति, उद्धृतमात्रे तु शल्ये मर्मस्थानाश्रितो वायुर्निष्क्रामति; तस्मात् सशल्यो जीवत्युद्धृतशल्यो म्रियते । वैकल्यकराणि सौम्यानि; सोमो हि स्थिरत्वाच्छेत्याच्च प्राणावलम्बनं करोति ! रुजाकराण्यग्निवायुगुणभूयिष्ठानि, विशेषतश्च तौ रुजाकरौ, पाञ्चभौतिकीञ्च रुजामाहुरेके ।। २४ ।।

The Marmas belonging to the Sady-Pranahara group are possessed of fiery virtues (thermogenric); as fiety virtues are easily enfeebled, so they prove fatal to life (in the event of being any way hurt); while those belonging to the Kalantara-Pranahara group are fiery and lunar (cool) in their properties. And as the fiery virtues are

1. Some are of opinion that hallucination, delirium, death, stupor and coma as described in the Sutrasthana are the result of injuries to these Marmas enfeebled easily and the cooling virtues take a considerable time in being so, the Marmas of this group prove fatal in the long run (in the event of being any way hurt, if not instantaneously like the preceding ones). The Visalyaghna Marmas are possessed of Vataja properties (that is, they arrest the escape of the vital Vayu); so long as the dart does not allow the Vayu to escape from their injured interior, the life prolongs; but as soon as the dart is extricated, the Vayu escapes from the inside of the hurt and necessarily proves fatal. The Vaikalyakaras are possessed of Saumya (lunar properties) and they retain the vital fluid owing to their steady and cooling virtues, and hence tend only to deform the organism in the event of their being hurt, instead of bringing on death. The Rujakara Marmas of fiery and Vataja properties become extremely painful inasmuch as both of them are pain-generating in their properties. Others, on the contrary, hold the pain to be the result of the properties of the five material components of the body (Panchabhautika). 24

केचिदाहुर्मांसादीनां पञ्चानामपि समस्तानां विवृद्धानाञ्च समवायात् सद्यः प्राणहराणि, एकहीनानामल्पानां वा कालान्तरप्राणहराणि, द्विहीनानां विशल्यप्राणहराणि, त्रिहीनानां वैकल्यकराणि, एकस्मिन्नेव रुजाकराणीति । नैवम्, यतश्चास्थिमर्मस्वप्यभिहतेषु शोणितागमनं भवति ।। २५-२६।।

Different Opinions on the Marmas: Some assert that Marmas, which are the firm union of the five bodily factors (of veins, ligaments, muscles, bones and joints), belong to the first group (Sadya-Pranahara); that those, which form the junction of four such, or in which there is one in smaller quantity, will prove fatal in the long run, in the event of their being hurt or injured (Kalantara- Pranahar).¹ Those, which are the junction of two such factors, belong to the Visalya-Pranahara² group; those of the three belong to the Vaikalyakara³ group; and those

1. The Marmas, such as Stana-mula, Apalupa, Apastambha, Simanta, KatikaTaruna, Parsva-Sandhi, Brhati and Nitamba belonging to the Kalantaramaraka group, are devoid of Mansa (muscles); and the “Marmas” known as Stanarohita, Talahrdaya, Ksipra and Indrabasti, belonging to the same class are devoid of Asthi (bones).

2. The Utksepa marma, belonging to the Visalya-pranahara group, is devoid of Mansa (muscles) and Sandhi (joint).

3. The Sthapani-Marma, belonging to the Vaikalyakara class, is devoid of Mansa in which only one of them exists belongs to the last or pain-generating type (Rujakara).¹

But the fore going theory is not a sound one, inasmuch as blood is found to exude from an injured joint which would be an impossibility in the absence of any vein, ligament (Snayu) and muscle being intimately connected with it. Hence every Marma should be understood as a junction or meeting place of the five organic principles of ligaments, veins, muscles, bones and joints. 25-26

भवन्ति चात्र । स्नाय्वनिस्थमांसानि तथैव सन्धीन् सन्तर्प्य देहं प्रतिपालयन्ति ॥ २७ ॥

ततः क्षते मर्मणि ताः प्रवृद्धः समन्ततो वायुरभिस्तृणोति । विवर्धमानस्तु स मातरिश्वा रुजः सुतीव्राः प्रतनोति काये ॥ २८ ॥

रुजाभिभूतन्तु पुनः शरीरं प्रलीयते नश्यति चास्य संज्ञा | अतो हि शल्यं विनिहर्त्तुमिच्छन् मर्माणि यनेन परीक्ष्य कर्णेत् || २९ ।।

एतेन शेषं व्याख्यातम् ।। ३० । ।

Metrical text: This is further corroborated by the fact that the four classes of Sira or vessels (which respectively carry the Vayu, Pitta, Kapha and the blood) are found to enter into the Marmas for the (muscle), Sira and Snayu; the Lohitaksa-marma (of the same group) is devoid of Snayu, Sandhi and Asthi (bones); the Janu-marma (of the same group) is devoid of Mansa, Sira and Snayu; the Urvi-marma (of the said group) is devoid of Asthi, Mansa and Snayu; the Vitapa-marma (of the said class) is devoid of Mansa, Sira and Asthi; the Kurpara-marama (of the same class) is devoid of Mansa, Sira and Snayu; the Kaksadhara marma (of the same class) is devoid of Sira, Asthi and Sandhi; the Vidhura-marma (of the said group) is devoid of Mansa, Sira and Sandhi; the Krkatika-marma is devoid of Mansa, Sira and Sandhi; the Ansa-marma; the Krkatika-mo 1-marma is devoid of Mansa, Sira and Sandhi; the Ansa-marma (of the same group) is devoid of Mansa, Snayu and Sandhi; the Ansa-phalaka-marma (of the said group) is devoid of Mansa, Snayu and Sandhi: the Nila, Manya and Phana Marmas (of the same group) are devoid of Mansa, Sandhi and Asthi; the Avarta-marma is devoid of Sira, Snayu and Mansa; the Apanga-marma (of the said class) is devoid of Mansa, Snayu and Sandhi.

1. The Gulpha, Manibandha and Kurca-sira Marmas, belonging to the Rujakara group are devoid of Mansa, Sira, Snayu and Asthi, i.e.. Sandhi alone is present in the purpose of keeping of maintaining the moisture of the local ligaments (Snayu), bones, muscles and joints thus sustain the organism.¹ The Vayu, aggravated by an injury to a Marma, blocks up (those four classes vessels)in their entire course throughout the organism and gives rise to great pain which extends all over the body. All the internal mechanism of a man (of which a Marma has been pierced into with a shaft or with any other piercing matter) becomes extremely painful and seems as if it were being constantly shaken or jerked and symptoms of syncope are found to set in. Hence a careful examination of the affected Marma should precede all the foregoing acts of extricating a Salya from its inside. From that similar symptoms as pain coma etc. due to Vata aggravated conditions and actions of the Pitta and Kapha should be presumed in the event of a Marma being any way injured or pierced into. 27-30

तत्र सद्यः प्राणहरमन्ते विद्धं कालान्तरेण मारयति । कालान्तरप्राणहरमन्ते विद्धं वैकल्यमापादयति, विशल्यप्राणहरं वैकल्यकरं च कालान्तरेण क्लेशयति रुजाञ्च करोति । रुजाकरमतीव्रवेदनं भवति ।। ३१ ।।

A Marma of the Sadyah-Pranahara type being perforated at its edge brings on death at a later time (within seven days), whereas a deformity of the organ follows from the piercing of a KalantaraMaraka² Marma at the side (instead of the centre). Similarly, an excruciating pain and distressful after-effects mark a similar perforation of a Marma of the Visalyaghna³ group. And a Marma of the Rujakaraª class produces an excruciating pain (instead of a sharp one) in the event of its being pierced at the fringe. 31

तत्र सद्यः प्राणहराणि सप्तरात्राभ्यन्तरान्मारयन्ति । कालान्तर

1. Hence the piercing of a bone is attended with bleeding.

2. If any of the Marmas of the Kalantara-Pranahara group be deeply perforated, then this perforation is sure to bring on death within a day (i.e. it will act like a slightly injured Marma or the Sadhyah-Pranahara group).

3. Any Marma of the Visalyaghna-group, being deeply perforated. brings on death within seven days (i.e. it will behave like a slightly injured Marma of the Kalantara-Pranahara class).

4. Any Marma of the Rujakara class, being deeply perforated (injured), is sure to bring excruciating pain etc. (i.e. it will act like a slightly injured Marma of the Visalyaghna group).

प्राणहराणि पक्षान्मासाद् वा । तेष्वपि तु क्षिप्राणि कदाचिदाशु मारयन्ति ।

विशल्यप्राणहराणि वैकल्यकराणि च कदाचिदत्यभिहतानि मारयन्ति ।। ३२ ।॥

An injured Marma of the Sadyah-Pranahara type terminates in death within seven days of the injury, while one of the Kalantara type, within a fortnight or a month from the date of hurt (according to circumstances). A case of injured Ksipra-marma seldom proves fatal before that time (seven days). An injured Marma of the Visalyaghna or Vaikayakara group may prove fatal in the event of its being severely injured. 32

अत ऊर्ध्वं प्रत्येकशो मर्मस्थानान्यनुव्याख्यास्यामः ।। ३३ ।।

तत्र पादाङ्गुष्ठाङ्गुल्योर्मध्ये क्षिप्रं नाम मर्म, तत्र विद्धस्याक्षेपकेण मरणम् ।। ३४ ॥

मध्यमाङ्गुलीमनुपूर्वेण मध्ये पादतलस्य तलहृदयं नाम, तत्रापि रुजाभिर्मरणम् ।। ३५ ।।

क्षिप्रस्योपरिष्टादुभयतः कूर्चो नाम; तत्र पादस्य भ्रमणवेपने भवतः ।। ३६।।

गुल्फसन्धेरध उभयतः कूर्चशिरो नाम; तत्र रुजाशोफौ ।। ३७ ।।

पादजङ्घयोः सन्धाने गुल्फो नाम; तत्र रुजः स्तब्धपादता खञ्जता वा ।। ३८ । ।

Marmas of the Extremities: Now we shall describe the situation of every Marma. The Marma, known as the Ksipra’, is situated in the region between the first and the second toes (Tarsal articulation), which being injured or pierced, brings on death from convulsions. The Marma, known as the Tala-Hrdaya, is situated in the middle of the sole of the foot in a straight line drawn from the root of the middle toe. An injury to this Marma gives rise to extreme pain which ends in death. The Marma, known as the Kurca 3, is situated two

1. It is a Snayu-Marma (ligament) to the width of half a finger and belongs to the Kalantara group.

2. It is a Mansa-Marma to the width of half a finger and belongs to the Kalantara group.

3. It is a Snayu-Marma to the length of four fingers width, and belongs to the Vaikalyakara group fingers width above from the Ksipra one on each side of the foot. An injury to this Marma results in shivering and bending in of the foot. The Marma called Kurca-Sirah is situated under the ankle-joints, one on each side of the foot (Gulpha-Sandhi); an injury to it gives rise to pain and swelling of the affected part. A perforation of the GulphaMarma², which is situated at the junction of the foot and the calfresults in pain, paralysis and maimedness of the affected leg. 33-38

पाणि प्रति जङ्घामध्ये इन्द्रबस्तिर्नाम; तत्र शोणितक्षयेण मरणम् ।। ३९ ।।

An injury to the Marma which is situated in the middle muscle of the calf to the distance of between twelve and thirteen fingers’ width from the ankle and known as the Indrabasti-Marma’, results in excessive haemorrhage which ends in death. 39

जङ्घोर्वोः सन्धाने जानु नाम; तत्र खञ्जता ।। ४० ।।

An injury to or piercing of the Janu-Marmaª, situated at the union of the thigh and the knee, results in lamenss of the patient. 40

जानुन ऊर्ध्वमुभयतस्त्र्यङ्गुलमाणी नाम; तत्र शोफाभिवृद्धिः स्तब्धसक्थिता च । । ४१ । ।

A piercing of the Ani-Marma³ situated on both the sides above three fingers width from the Janu (knee joint), brings on swelling and paralysis (numbness) of the leg. 41

ऊरुमध्ये उर्वी नाम; तत्र शोणितक्षयात् सक्थिशोषः ॥ ४२ ॥ उर्व्या ऊर्ध्वमधो वक्षणसन्धेरूरुमूले लोहिताक्षं नाम; तत्र लोहितक्षयेण मरणं पक्षाघातो वा ।। ४३ ।।

1. It is a Snayu-Marma, one finger in length and belongs to the Vaikalyakara group.

2. It is a Sandhi-Marma, to the length of two fingers, and belongs to the Vaikalyakara group.

3. Indravasti measures two finger in length according to Bhoja and Gayadasa, though half a finger in width according to others. It is a Mansa-Marma and belongs to the Kalantara group.

4. It is a joint-Marma, three fingers in length and belongs to the Vaikalyakara group.

5. It is a ligament-Marma, half a finger in length (three fingers according to Gayadasa) and is of the Vaikalyakara class.

A perforation of the Urvi-Marma¹ situated in the middle of the Uru (thigh), results in the atrophy of leg, owing to the incidental haemorrhage. An injury to the Lohitaksa-Marma, situated respectively a little above the Urvi Marma and below the Vanksana (hip joint) and placed near the base of the thigh, is attended with excessive haemorrahge and causes paralysis (of the leg ). 42-43

वङ्क्षणवृषणयोरन्तरे विटपं नाम; तत्र षाण्ढयमल्पशुक्रता वा भवति । एवमेतान्येकादश सक्थिमर्माणि व्याख्यातानि । एतेनेतरसक्थि बाहू च व्याख्यातौ ।। ४४-४५ ।।

विशेषतस्तु यानि सक्थिन गुल्फजानुविटपानि, तानि बाहौ मणिबन्धकूर्परकक्षधराणि । यथा वङ्क्षणवृषणयोरन्तरे विटपमेवं वक्षः कक्षयोर्मध्ये कक्षधरम्; तस्मिन् विद्धे त एवोपद्रवाः । विशेषतस्तु मणिबन्धे कुण्ठता । कूर्पराख्ये कुणिः । कक्षधरे पक्षाघातः ॥ ४६ ।। एवमेतानि चतुश्चत्वारिंशच्छाखासु मर्माणि व्याख्यातानि ।। ४७ ।।

An injury to the Vitapa-Marma³, situated between the Scrotum and the Vanksana (ingunial region), brings on loss of manhood or scantiness of semen. Thus the eleven Sakthi-Marmas of one leg have been described; those in the other being of an identical nature with the preceding ones. The Marmas in the hands are almost identical with those of the legs, with the exception that Manibandha, Kurpara and kaksadhara Marmas occur in the place of the Gulpha, Janu and Vitapa Marmas respectively. As the Vitapa-Marma is situated between the scrotum and the Vanksana (inguinal region), so the KaksadharMarma is situated between the Vaksa (chest) and the Kaksa ( armpit). An injury to these causes supervening symptoms. An injury to the Manibandha-Marma (wrist-marma) result specially in inoperativeness (Kuntha) of the affected hand; an injury to the Korpara-marma ends in dangling (Kuni) o the hand; and an injury to the Kaksadhara result in hemiplegia. Thus the forty-four Marmas of the upper and the lower extremities have been described. 46-47

अत ऊर्ध्वमुदरोरसोर्मर्मस्थानान्यनुव्याख्यास्यामः । तत्र वातवर्चोनिरसनं स्थूलान्त्रप्रतिबद्धं गुदं नाम मर्म; तत्र सद्योमरणम् ।। ४८-४९।।

1. It is a Sira-Marma, half a finger in length and of the Vaikalyakara group. It is a Sira- Marma, half a finger in length and of the Vaikalyakara group. 2. 3. It is a Snayu-Marma to the length of one finger and of the Vaikalyakara group.

अल्पमांसशोणितोऽभ्यन्तरतः कटयां मूत्राशयो बस्तिर्नाम; तत्रापि सद्योमरणमश्मरीव्रणादृते ।

तत्राप्युभयतो भिन्ने न जीवति, एकतो भिन्ने मूत्रस्त्रावी व्रणो भवति, स तु यत्नेनोपक्रान्तो रोहति । ॥ ५० ॥

पक्वामाशययोर्मध्ये सिराप्रभवा नाभिर्नाम; तत्रापि सद्य एव मरणम् ।। ५१ ।॥

Marmas on the Thorax etc. : Now we shall describe the Marmas, situated in the region of the thorax and the abdomen (trunk). A hurt to the Guda-Marma’, which is attached to the large intestine and serves as the passage of stool and flatus, ends fatally (within twentyfour hours of the hurt). An injury to the Basti-Marma² situated inside the cavity of the pelvic region and the blade and composed of small muscies and blood (and which serves as the receptacle of urine), proves fatal within the day, except in the cases of extracting the gravel, only when the injury to the organ is short of complete perforation of both of its walls. The urine oozes out through the aperture in the case where only one of its walls has been perforated and which may be closed and healed up with proper and judicious medical treatment. An injury to the Nabhi-Marma³, the root of all the Siras and situated between the amasaya (stomach) and the Pakvasaya (intestines) ends in death within the day. 48-51

स्तनयोर्मध्यमधिष्ठायोरस्यामाशयद्वारं सत्त्वरजस्तमसामधिष्ठानं हृदयं नाम; तत्रापि सद्य एव मरणम् ।। ५२ ॥

स्तनयोरधस्ताद् द्वयङ्गुलमुभयतः स्तनमूले नाम मर्मणी; तत्र कफपूर्णकोष्ठतया कासश्वासाभ्याञ्च म्रियते ।। ५३ ।।

स्तनचूचुकयोरूर्ध्वं द्वचङ्गुलमुभयतः स्तनरोहितौ नाम, तत्र लोहितपूर्णकोष्ठतया कासश्वासाभ्याञ्च म्रियते ।। ५४ ।।

अंसकूटयोरधस्तात् पार्श्वोपरिभागयोरपलापौ नाम; तत्र रक्तेन पूयभावं गतेन मरणम् ।। ५५ ।।

1. It is a Mansa-Marma to the length of four fingers’ width and belongs to the Sadyo-maraka class.

2. It is a ligament combination (Snayu-marna) to the length of four fingers, belonging to the Sadyah-Pranahara class.

3. It is a sira-Marma to the length of four fingers, belonging to the SadyahPranahara class.

A hurt of the Hrdaya-Marma, which is situated in the thorax between the two breasts and above the opening of the Amasaya and forms the seat of the qualities of Sattva, Rajas and Tamas, proves fatal within the day. An injury to the Stana-mula-Marmas2 situated immediately below each of the breasts and about two fingers in width fills the Kostha (throax) with deranged Kapha, brings on cough, difficult breathing (asthma) and proves fatal. An injury to any of the Stana-Rohita-Marmas³, situated above the nipples of the breasts about two fingers in width, fills the cavity of the Kostha (throax) with blood, producing symptoms of cough and asthma and ends fatally. An injury to the Apalapa-Marmas, situated below the Ansa-kuta (balls of the shoulders) and above the sides (meeting of the different branches of the sub-clavicle veins i.e. axilla), transforms the blood of the organism into pus and proves fatal thereby. 52-55

उभयत्रोरसो नाड्यौ वातवहे अपस्तम्भौ नाम; तत्र वातपूर्णकोष्ठतया कासश्वासाभ्याञ्च मरणम्।। ५६।।

एवमेतान्युदरोरसोर्द्वादश मर्माणि व्याख्यातानि ।। ५७।।

An injury to any of the Vayu-carrying vessels, known as the Apastambha-marma³ (meeting of the bifurcated branches of the bronchi lying on both the sides of the breast), fills and Kostha with the deranged Vayu (tympanitis) accompanied by cough and asthma, and terminate in death. Thus the twelve Marmas situated in the thorax and abdomen are described. 56-57

अत ऊर्ध्वं पृष्ठममण्यनुव्याख्यास्यामः- तत्र पृष्ठवंशमुभयतः प्रतिश्रोणीकाण्डमस्थिनी कटीकतरुणे नाम मर्मणी; तत्र शोणितक्षयात् पाण्डुर्विवर्णो हीनरूपश्च म्रियते ।। ५८-५९।।

1. It is a Sira-Marma to the length of four fingers and of the Sadyah-Pranahara class.

2. It is a Sira-Marma, two fingers in length and of the Kalantara class.

3. It is a Mansa-Marma about half a finger in length and of the Kalantara class (according to Vagabhata, of the Sadyo-Maraka class).

4. It is a Sira-Marma, half a finger in length and of the Kalantara class. 5. It is a Sira-Marma, half a finger in length and belongs to the Kalantara class.

पार्श्वयोर्जघनबहिर्भागे पृष्ठवंशमुभयतो नातिनिम्ने कुकुन्दरे नाम मर्मणी; तत्र स्पर्शाज्ञानमधः काये चेष्ट्रोपघातश्च ।। ६० ।।

श्रोणीकाण्डयोरुपर्याशयाच्छादनौ पार्श्वान्तरप्रतिबद्धौ नितम्बौ नाम ; तत्राध: कायशोषो दौर्बल्याच्च मरणम् ।। ६१ ।।

अधः पार्श्वान्तरप्रतिबद्धौ जघनपार्श्वमध्ययोस्तिर्ध्वगूर्ध्वंञ्च जघनात् पाश्र्वसन्धी नाम; तत्र लोहितपूर्णकोष्ठता म्रियते || ६२ ||

स्तनमूलादृजूभयतः पृष्ठवंशस्य बृहती नाम; तत्र शोणिताति प्रवृत्ति निमित्तैरुपद्रवैम्रियते ।। ६३ ।।

पृष्ठोपरि पृष्ठवंशमुभयतस्त्रिकसम्बद्धे अंसफलके नाम; तत्र बाह्वो: स्वापः शोषो वा ।। ६४ ॥

बाहुमूर्धग्रीवामध्येंऽसपीठस्कन्धनिबन्धनावंसौ नाम; तत्र स्तब्ध – बाहुता ।। ६५ ।।

एवमेतानि चतुर्दश पृष्ठमर्माणि व्याख्यातानि ।। ६६ ।।

Prstha Marmas : Now we shall discourse on the Marmas in back (of a man). An injury to any of the Katika-tarunas) ( sacro-iliac articulation), situated in the region of the Sroni (sacrum) on both sides of the spinal column, gives rise to an excessive haemorrhage and consequent pallor, worthless face and ends in death. A hurt to any of the Kukundara Marmas 2 (lit:-ahollow the great sacro-sciatic notch), situated on both sides of the spinal column and in the region slightly below the waist (inthe loins), results in complete anaesthesia and inoperativeness of the lower extremities. A hurt to the NitambaMarmas³, attached to the side above the Sroni (pelvis) and attached inside to the muscles of the waists, gives rise to Sosa (atrophy) in the lower extremities, weakness and ultimately brings on death. An injury to the Parsva-Sandhi-Marmams + (caelic axes) which are situated just at the middle below the extermities of the sides (Parsva) and which lies

1. It is an Asthi-Marma, half a finger in length and of the Kalantara-maraka class.

2. They are Joint-marmas (Sandhi), half a finger in length and of the Vaikalyakara group.

3. It is a bone Marma, half a finger in length, and of the Kalatara class.

4. It is a Sira- Marma to length of half a finger and belongs to the Kalantara class.

attached at the middle between the loins at their lower regions, fills the Kostha (abdomen) with the blood and results into death. A hurt to the Brhati-Marmas¹ which commencing from the roots of the breast course round both the sides of the spinal column (Prstha-vamsa), cause excessive bleeding, and the patient dies, as supervening symptoms arise from an excessive loss of blood. An injury to any of the two Amsa-phalaka Marmas² situated on either side of the vertebral column and connected with the scapula brings on anesthesia or atrophy (Sosa) of the arms. There are two Marmas known as Amsa-Marmas³ which are situated on either side midway between the neck and the head of the arms and connect the Amsa-pitha (glenoid cavity) and the Skandha (shoulder). An injury to any of these Marmas is attended with an incapacity of moving the hands. Thus the fourteen Marmas in the back have been described. 58-66

अत ऊर्ध्वमूर्ध्वजत्रुगतानि व्याख्यास्यामः ।

तत्र कण्ठनाडीमुभयतश्चतस्त्रो धमन्यः, द्वे नीले द्वे च मन्ये व्यत्यासेन; तत्र मूकता स्वरवैकृतमरसग्राहिता च ।। ६७-६८ ।।

ग्रीवायामुभयतश्चतस्त्र: सिरामातृकाः, तत्र सद्योमरणम् ।। ६९ ।।

The Jatrugata-Marmas : Now we shall describe the Marmas which are situated in the regions above the clavicles (Urdhva-Jatru). There are four Dhamani (arteries) about the two sides of the KanthaNadi (wind-pipe). Two of them are known as Nila, and the other two as Manya. One Nila and one Manya are situated on either side of the larynx, (i.e., anterior and posterior side of the larynx). An injury to any of them produces dumbness, and change of voice (hoarseness) and also the loss of the faculty of taste4. An injury to any of the eight Siras (arteries), four being on each side of the neck (Griva) and known as Sira-Matrka-Marmas) ends fatally within the day. 67-69

शिरोग्रीवयोः सन्याने कृकाटिके नाम; तत्र चलमूर्धता ।। ७० ।।

They are Sira-Marmas (arterial anestomsis) to the length of half a finger and belong to the Kalantara class.

2. It is an Asthi-Marma, half a finger in length and is Vaikalyakara.

3. They are Snayu-Marmas, half a finger in length and of the Vaikalyakara class.

4. They are Sira-Marmas, to the length of four fingers and of the Vaikalyakara class.

5. They are Sira-Marmas, four fingers in length and of the Sadyo-Marana class of pursing

कर्णपृष्ठतोऽधः संश्रिते विधुरे नाम; तत्र बाधिर्यम् ।। ७१ ।।

घ्राणमार्गमुभयतः स्त्रोतोमार्गप्रतिबद्धे अभ्यन्तरतः फणे नामः तत्र गन्धाज्ञानम्।। ७२।।

भ्रूपुच्छान्तयोरधोऽक्ष्णोर्बाह्यतोऽपाङ्गौ नाम; तत्रान्ध्यं दृष्टयुपघातो वा ।। ७३ ।।

भुवोरुपरि निम्नयोरावन्त नाम; तत्राप्यान्ध्यं दृष्ट्युप घातश्च ।। ७४।।

भ्रुवोरन्तयोरुपरि कर्णललाटयोर्मध्ये शखौ नाम; तत्र सद्योमरणम् ।। ७५ ।।

शङ्खयोरुपरि केशान्त उत्क्षेपौ नाम; तत्र सशल्यो जीवति पाकात् पतितशल्यो वा नोद्धृतशल्यः । ७६ ।।

An injury to any of the two Marmas lying at the junction of the head and neck (Griva) and known as Krkatika (transverse process of the arch of the atlas)results in a free movement of the head. A hurt to any of the Marmas attached to the lower end of an ear (posterior extrensic ligament) and known as the Vidhura² Marma results in the loss of hearing. An injury to the Phana-Marmas³, attached to the interior channels of both the nostrils, results in the loss of the faculty of smell. An injury to the Apanga-Marmas+ (Anastomosis of the infraorbital artery) situated below the tips of the eye-brows and about the external corners of the eyes, brings on blindness or defective vision. An injury to the Avarta-Marmas situated above and below the eyebrows, brings on blindness and impaired vision. An injury to the Sankha- Marmas’ ( meeting or suture of the temporal, frontal and sphenoid bones – Pterion), situated over the tips of the eye-brows and

1. They are Sandhi-Marmas, half a finger in length and of the Vaikalyakara group.

2. It is a Snayu-Marma and of the Vaikalyakara class.

3. They are Sira-Marmas to the length of half a finger and of the Vaikalyakara class.

4. They are Sira-Marmas to the length of half a finger and of the Vaikalyakara class.

5. They are Sandhi-Marmas, to the length of half a finger and of the Vaikalyakara class.

6. They are Asthi-Marmas of the length of half a finger.

between the ears and the forehead, results in death within the day. The Marmas situated over the two temples (Sankha) and at the border of the hair (sculp) are called Utksepa-Marma (meeting of the posterior and anterior temporal arteries)¹. An extraction of a shaft (Salya) or of any extraneous pointed thing lodged into these Marmas, results in the death of the patient, who, on the contrary, lives as long as the shaft is allowed to remain inside or if the shaft comes out itself (after putrefaction). 70-76

भ्रुवोर्मध्ये स्थपनी नाम; तत्रोत्क्षेपवत् ।। ७७।।

पञ्च सन्धयः शिरसि विभक्ताः (सीमन्ता नाम; तत्रोन्मादयचित्तनाशैर्मरणम् ।। ७८ ।।

घ्राणश्रोत्राक्षिजिह्वासन्तर्पणीनां सिराणां मध्ये सिरासन्निपातः श्रृङ्गाटकानि, तानि चत्वारि मर्माणि; तत्रापि सद्योमरणम् ।। ७९ ।।

मस्तकाभ्यन्तरोपरिष्टाच्छिरासन्धिसन्निपातो रोमावर्त्तोऽधिपतिः) तत्रापि सद्योमरणम् ।। ८० ।।

एवमेतानि सप्तत्रिंशदूर्ध्वजत्रुगतानि मर्माणि व्याख्यातानि ।। ८१ ।।

An injury to the Sthapani-Marma (nasal arch of the frontal veins), situated in the middle of the eye-brows, results in the manner of the preceding one. An injury to any of the five joints of the head which are known as the Simanta-Marmas³, results in fear, insensibility and madness of the patient and terminates in death. An injury to any of the four Srigataka-Marmas which forms the junction of the four Siras (nerves), (branches of the facial artery) and soothes the nose, the eyes, the ears and the tongue, proves fatal within the day. An injury to the Adhipati-Marmas (the vertical groove on the frontal bone) which is marked in the inner side of the roof of the cranium by the SiraSannipata (superior longitudinal sinus), and on the exterior side by the 1. They are Snayu-Marmas, half a finger in length and of the Visalyaghna class.

2. They are Sira-Marmas to the length of half a finger and of the Visalyaghna class.

3. They are Sandhi-Marmas to the length of four fingers and of the KalantaraPranahara class.

4. They are Sira-Marmas to the length of four fingers and of the SadyahPranahara class.

It is a Sandhi-Marma, half a finger in length and of the Sadyah-Pranahara class.

ringlet of the hair ( Romavarta) proves fatal within the day. Thus we have described the thirty-seven Marmas, situated in the region above the clavicles (Urdhva-Jatru). 77-81

भवन्ति चात्र ।

ऊर्व्यः शिरांसि विटपे च सकक्षपार्श्वे एकैकमङ्गुलमितं स्तनपूर्वमूलम् | विद्य्धङ्गुलद्वयमितं मणिबन्धगुल्फं त्रीण्येव जानु सपरं सह कूर्पराभ्याम् || ८२ ।। हृद्वस्तिकूर्चगुदनाभि वदन्ति मूर्ध्नि चत्वारि पञ्च च गले दश यानि च द्वे | तानि स्वपाणितलकुञ्चितसम्मितानि शेषाण्यवेहि परिविस्तरतोऽङ्गुलार्धम् ।। ८३ । । एतत् प्रमाणमभिवीक्ष्य वदन्ति तज्ज्ञाः शस्त्रेण कर्मकरणं परिहृत्य मर्म । पाश्र्वभिघातितमपीह निहन्ति मर्म तस्माद्धि मर्मसदनं परिवर्जनीयम् ॥ ८४ ।।

Memorable Verses: An incision should be made at the spot a finger’s width remote from the urvi, Kurca – Sira, Vitapa, Kalksa and a Parsva-Marma, whereas, a clear space of two-fingers should be avoided from its situation in making any incision about the Stanamula, Manibandha or Gulpha-Marma. Similarly a space of three fingers should be avoided from the Janu, Kurpar Hrdaya Basti Kurca, Guda and Nabhi Marma; and a space of four fingers should be avoided in respect of the four Srigatakas, five Simantas and ten Marmas in the neck (Nila etc.); a space of half a finger avoidance being the rule in respect of the remaining (fifty-six ). 1 Men versed in the science of surgery, have laid down the rule that, in a case of surgical operation, the situation and dimension of each local Marma should be first taken into account and the incision should be made in a way so as not to affect that particular Marma, in as much as an incision, even extending or affecting, in the least, the edge or the side of the Marma, may prove fatal. Hence all the Marma-Sthanas should be carefully avoided in a surgical operation. 82-84

छिन्नेषु पाणि चरणेषु सिरा नराणां सङ्कोचमीयुरसगल्पमतो निरेति । प्राप्यामितव्यसनमुग्रमतो मनुष्याः सञ्छिन्नशाखतरुवन्निधनं न यान्ति ।। ८५ ।।

1. Some are of opinion that a surgical operation (in the case of the remaining fifty six) should be made, leaving a space equal in measurement to the dimensions of a palm (from the affected part). Gayadasa, having learnt from Bhoja, explains that a space of two fingers should be left (from the affected part) in making surgical operations of the ten marmas, namely, the two Gulphas, the roots of the two breasts, the four Indrabastis, and the two Manibandhas.

क्षिप्रेषु तत्र सतलेषु हतेषु रक्तं गच्छत्यतीव पवनश्च रुजं करोति ।

एवं विनाशमुपयान्ति हि तत्र विद्धा वृक्षा इवायुधनिघातनिकृत्तमूलाः ।। ८६ ।।

तस्मात् तयोरभिहतस्य तु पाणिपादं छेत्तव्यमाशु मणिबन्धनगुल्फदेशे ।। ८७ ।।

The amputation of a hand or a leg may not prove fatal whereas a wound in any of the Marmas situated therein is sure to bring on death. The vessels become contracted in the case of a cut in the leg or in the hand of a man, and hence the incidental bleeding is comparatively scantier. Therefore it is that a cut in any of these parts of the body, however painful, does not necessarily prove fatal, like the lopping off of the branches of a tree. On the contrary, a man pierced into in any such Marmas, as the Ksipra or the Tala, suffers from excessive haemorrhage (from the affected part) and attended with an excruciating pain, owing to the derangement of the Vayu and meets his doom like a tree whose roots have been severed. Hence, in a case of piercing or of injury to any of these Marmas, the hand or the leg should be immediately amputated at the wrist or at the ankle (respectively). 85-87 मर्माणि शल्यविषयार्धमुदाहरन्ति यस्माच्च मर्मसु हता न भवन्ति सद्यः ।

जीवन्ति तत्र यदि वैद्यगुणेन केचित् ते प्राप्नुवन्ति विकलत्वमसंशयं हि ।। ८८ ॥

The medical authorities have described the Marmas to have covered half in the scope of Salya Tantra (Surgery), in as much as a person hurt in any of the Marmas dies presently (i.e. within seven days of the hurt). A deformity of the organ is sure to result from an injury to one of these Marmas, even if death be averted by a course of judicious and skillful medical treatment. 88

सम्भिन्नजर्जरितकोष्ठशिरः कपाला जीवन्ति शस्त्रनिहतैश्च शरीरदेशैः ।

छिन्नैश्च सक्थिभुजपादकरैरशैषैर्येषां न मर्मपतिता विविधाः प्रहाराः ।। ८९ ।।

The life of the patient is not to be despaired of even in the case of fracture or crushing of a bone of the Kostha, Sirah and Kapala or perforation of the intestines etc., if the local Marmas are found not to be in any way hurt or affected. Recovery the common in cases of cuts (pierce) in the Sakthi, Bhuja, Pada and Kara or in any other part of the body and even where a whole leg or hand is found to be severed and carried away if the Marmas are not in any way hurt or affected. 89

सोममारुततेजांसि रजः सत्त्वमांसि च । मर्मसु प्रायशः पुंसां भूतात्मा चावतिष्ठते । मर्मस्वभिहतास्तस्मान्न जीवन्ति शरीरिणः ।। ९० ।।

These Marmas form the primary seats of the Vayu, the Soma ) and Tejas (fiery principles of the organism), as well as of the fundamental qualities of Satva, Rajas and Tamas, and that is the why a man, hurt in any of the Marmas, does not live. 90

इन्द्रियार्थेष्वसम्प्राप्तिर्मनोबुद्धिविपर्ययः रुजश्च विविधास्तीव्राभवन्याशुहरे हते ।। ९१ ।।

हते कालान्तरघ्ने तु ध्रुवो धातुक्षयो नृणाम् । ततो धातुक्षयाज्जन्तुर्वेदनाभिश्च नश्यति ।। ९२ ॥

हते वैकल्यजनने केवलं वैद्यनैपुणात् । शरीरं क्रियया युक्तं विकलत्वमवाप्नुयात् ।। ९३ ।।

विशल्यघ्नेषु विज्ञेयं पूर्वोक्तं यच्च कारणम् । रुजाकराणि मर्माणि क्षतानि विविधा रुजः ।

कुर्वन्त्यन्ते च वैकल्यं कुवैद्यवशगो यदि ।। ९४ ।।

An injury to a Marma of the Sadyah-Pranahara class (in which death occurs within a day) is attended with the imperfection of the sense organs, loss of consciousness, bweilderment of Manah (mind) and Buddhi (intellect) and various kinds of pain. An injury to a Marma of the kalantara group (of a person) is sure to be attended with the loss of Dhatus (blood etc.) and various kinds of supervening symptoms (Upadrava) which end in death. The body of a person, hurt in any of the Vaikalyakara Marmas, may remain operative only under a skillful medical treatment, but a deformity of the affected organ is inevitable. An injury to any of the Visalyaghna Marmas ends in death for the reasons mentioned above. An injury to any of the Rujakara Marmas gives rise to various kinds of pain in the affected organ, which may ultimately bring about a deformity of the same, if placed under the treatment of an ignorant and unskillful Vaidya (surgeon). 91-94

छेदभेदाभिघातेभ्यो दहनाद् दारणादपि । उपघातं विजानीयान्मर्मणां तुल्यलक्षणम् ।। ९५ ।।

मर्माभिघातस्तु न कश्चिदस्ति योऽल्पात्ययो वाऽपि निरत्ययो वा । प्रायेण मर्मस्वभिताडितास्तु वैकल्यमृच्छन्त्यथ वा म्रियन्ते । ९६ ।।

An injury to the adjacent part of a Marma, whether incidental to a cut, incision, blow (Abhighata), burn, puncture, or to any other cause exhibits the same series of symptoms as an actually affected one. An injury to a Marma, whether it be severe or slight, is sure to bring deformity or death. 1

मर्माण्यधिष्ठाय हि ये विकारा मूर्च्छन्ति काये विविधा नराणाम् । प्रायेण ते कृच्छ्रतमा भवन्ति नरस्य यत्नैरपि साध्यमानाः ।। ९७।।

The diseases which are seated in the Marmas, are generally serious, but they may be made to prove amenable with the greatest care and difficulty. 97

इति सुश्रुतसंहितायां शारीरस्थाने प्रत्येकमर्मनिर्देशशारीरं नाम षष्ठोऽध्यायः ।। ६ ।।

Thus ends the sixth Chapter of the Sharira Sthana in the Susruta Samhita, which treats of Marmas.

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