Sushruta Samhita Sharirasthana Chapter 6 Pratyeka Marma Nirdeśa Shariram (Description of Fatal Spots)

The sixth bankruptcy of Sharirasthana of Sushruta Samhita is known as as Pratyeka Marma Nirdeśa Shariram Adhyaya. This bankruptcy offers with Description of deadly spots.

अथातःप्रत्येकमर्मनिर्देशंशारीरंव्याख्याख्यामः॥१॥
यथोवाचभगवान्धन्वन्तरिः॥२॥

We will now expound the bankruptcy by means of title Pratyeka Marma Nirdeśa Sārīra — description of each and every deadly spot one after the other as published by means of the venerable Dhañvañtari.

Marma sañkhyā and bheda – quantity and sorts of deadly spots 

सप्तोत्तरंमर्मशतम्।तानिमर्माणिपञ्चात्मकानिभवन्तितद्यथा – मांसमर्माणि,स्नायुमर्माणि, अस्थिमर्माणिसन्धिमर्माणिचेति। नखलुमांससिरास्नाय्वस्थिसन्धिव्यतिरेकेणान्यानिमर्माणिभवन्ति, यस्मानोपलभ्यन्ते॥३॥ 

Marmas are the necessary or deadly spots / spaces within the frame. They are 100 and 7 in quantity. These are categorised into 5 classes. They are –

Name of the Marma in response to its composition	Located in or made up of / composed of
Mamsa Marma	Muscles
Sira Marma	Veins
Snayu Marma	Ligaments
Asthi Marma	Bones
Sandhi Marma	Bony joints

Apart from the discussed forms of marmas i.e. necessary spots composed of muscle tissue, veins, ligaments, bones and joints discussed above, there aren’t any different sorts of marmas, since no different other form of deadly spots rather than those are discovered.

Classification of Marma in response to content material (make up) of marma

तत्रैकादशमांसमर्माणि, एकचत्वारिंशत्‌सिरामर्माणि,सप्तविंशतिः स्नायुमर्माणी,  अष्टावस्थिमर्माणि, विंशतिःसन्धिमर्माणिचेतितदेतत्‌सप्तोत्तरंमर्मशतम् ॥४॥

Name / Category of Marma	Number
Mamsa Marma	11
Sira Marma	41
Snayu Marma	27
Asthi Marma	08
Sandhi Marma	20
Total Marmas	107

Thus, there are all in combination, 100 and 7 Marmas.

Marma Vyahana – distribution of deadly spots within the frame

तेषामेकादशैकस्मिन्‌सक्थ्निभवन्ति, एतेनेतरसक्थिबाहूचव्याख्यातौ, उदरोरसोर्द्वादश, चतुर्दशपृष्ठे, ग्रीवांप्रत्यूर्ध्वंसप्तत्रिंशत् ॥५॥

Below discussed is the distribution of those 107 Marmas in numerous portions of the frame –

Location of Marmas within the frame	Number
Limbs – 11 in each and every limb	11×4 = 44 Marmas
Abdomen and Chest in combination	12 Marmas
Back	14 Marmas
Neck and head	37 Marmas
Total No of Marmas	107 Marmas

Marma Nama – names of deadly spots: –

तत्रसक्थिमर्माणि क्षिप्रतलहृदयकुर्चकूर्चशिरोगुल्फेन्द्रबस्तिजान्वाण्युर्विलोहिताक्षाणि विटपंचेति,एतेनेतरत्सक्थिव्याख्यातम् ।उदरोरसोस्तुगुदबस्तिनाभिहृदयस्तनमूलस्तनरोहितापलापान्यापस्तम्भौचेति। पृष्ठमर्माणितु कटीकतरुणकुकुन्दरनितम्बपार्श्वसन्धिबृहत्यंसफलकान्यंसौ चेति। बाहुमर्माणितु क्षिप्रतलहृदयकूर्चकूर्चशिरोमणिबन्धेन्द्रबस्तिकूर्पराण्युर्वीलोहिताक्षाणि कक्षधरंचेति; एतेनेतरोबाहुर्व्याख्यातः। जत्रुण‌ऊर्ध्वं चतस्त्रोधमन्योऽष्टौ मातृका द्वे कृकाटिके द्वे फणे द्वावपाङ्गौ द्वावुत्क्षेपौ  द्वौ शङ्खावेकास्थपनीपञ्चसीमन्ताश्चत्वारिशूङ्गाटकान्येकोऽधिपतिरिति ॥६॥

Sakti marma-Below discussed are the names of the Marmas of Sakthi i.e. one leg / decrease limb –

–       Kshipra

–       Talahrdaya

–       Kurca

–       Kurcasira

–       Gulpha

–       Indrabasti

–       Janu

–       Ani

–       Urvi

–       Lohitaksha and

–       Vitapa

The similar are the names of Marmas of the opposite decrease limb additionally. The collection of Marmas also are the similar – 11 in quantity.

Udara-uras Marma–Below discussed are the names of the Marmas provide within the stomach and chest –

–       Guda

–       Basti

–       Nabhi

–       Hrdaya

–       Stanamula

–       Stanarohita

–       Apalapa and

–       Apastambha

Prstha marma – Below discussed are the names of the Marmas provide within the again – each and every 2 in quantity –

–       Katikataruna

–       Kukundara

–       Nitamba

–       Parsvasandhi

–       Brhati

–       Amsaphalaka

–       Amsa

Bahu marma :- Below discussed are the names of the Marmas provide within the arm –

–       Kshipra

–       Talahrdaya

–       Kurcha

–       Kurchasira

–       Manibandha

–       Indrabasti

–       Kurpara

–       Ani

–       Urvi

–       Lohitaksha

–       Kaksadhara

The similar are the names of Marmas of the opposite higher limb additionally. The collection of Marmas also are the similar – 11 in quantity.

Jatrūrdhva Marma— Below discussed are the names of the Marmas provide above the extent of shoulders i.e. within the head and neck –

–       Dhamanis – 4

–       Matrka – 8

–       Krkatika – 2

–       Vidhura – 2

–       Phana – 2

–       Apanga – 2

–       Avarta – 2

–       Utkshepa – 2

–       Shanka – 2

–       Sthapani – 1

–       Simanta – 5

–       Srngataka – 4

–       Adhipati – 1

Names of Mamsa and many others Marmas

तलहृदयेन्द्रबस्तिगुदस्तनरोहितानिमांसमर्माणि,नीलधमनीमातृकाशृङ्गाटकापाङ्गस्थपनीफणस्तनमूलापलापापस्तम्भहृदयनाभिपार्श्वसन्धिबृहतीलोहिताक्षोर्व्यःमर्माणि,आणीविटपकक्षधरकूर्चकूर्चशिरोबस्तिक्षिप्रांसविधुरोत्क्षेपा :स्नायुमर्माणि,कटीकतरुण सिरानितम्बांसफलकशङ्खास्त्वस्थिमर्माणि,जानुकूर्परसीमन्ताधिपतिगुल्फमणिबन्धकुकुन्दरावर्तकृकाटिकाश्चेतिसन्धिमर्माणि॥७॥ 

Mamsa Marma – Below discussed are the Mamsa Marmas –

–       Talahrdaya,

–       Indrabasti,

–       Guda,

–       Stanarohita

Sira Marma – Below discussed are the Sira Marmas –

–       Nīladhamanī,

–       Mātrka,

–       Srñgāțaka,

–       Apāñga,

–       Sthapanī,

–       Phaņā,

–       Stanamūla,

–       Apasthambha,

–       Hrdaya,

–       Nabhi,

–       Parsvasandhi,

–       Brhati,

–       Lohitaksa and

–       Urvi 

Snayu Marma – Below discussed are the Snayu Marmas –

–       Ani,

–       Vitapa,

–       Kaksadhara,

–       Kurca,

–       Kurcasira,

–       Basti,

–       Ksipra,

–       Amsa,

–       Vidhura and

–       Utksepa

Asthi Marma – Below discussed are the Asthi Marmas –

–       Katīkataruna,

–       Nitamba,

–       Amsaphalaka and

–       Sankhā

Sandhi Marma – Below discussed are the Sandhi Marmas –

–       Janu,

–       Kurpara,

–       Simanta,

–       Adhipati,

–       Gulpha,

–       Manibandha,

–       Kukundara,

–       Avarta and

–       Krkatika

Classification of Marmas, effect-wise

तान्येतानिपञ्चविकल्पानिभवन्तितद्यथा – सद्यःप्राणहराणि,कालान्तरप्राण हराणि,विशल्यघ्नानि,वैकल्यकराणि,रुजाकराणिचेति।तत्रसद्य :प्राणहराण्येकोनविंशतिः,कालान्तरप्राणहराणित्रयस्त्रिंशत्,त्रीणिविशल्यनानि,चतुश्चत्वारिंशद्वैकल्यकराणि,अष्टौ रुजाकराणीति॥८॥ 

Based at the impact they motive once they get injured, Marmas are once more of 5 sorts. They are –

Category / Name of the Marmas	Effect of harm	Number
Sadyah prānahara marmas	motive loss of life briefly once they get injured	19
Kalantara prānahara marmas	motive loss of life regularly, after a while, once they get injured,	30
Visalyaghna marmas	motive loss of life when the overseas frame embedded in them is got rid of,	03
Vaikalyakara marmas	motive deformity once they get injured	44
Rujākara marmas	motive serious ache once they get injured	08

Names of Sadhyo pranahara and many others Marmas

भवन्तिचात्र
शृङ्गाटकान्यधिपतिःशङ्खौकण्ठसिरागुदम्॥
हृदयंबस्तिनाभ्यौचघ्नन्तिसद्योहतानितु॥९॥
वक्षोमर्माणिसीमन्ततलक्षिप्रेन्द्रबस्तयः॥
कटीकतरुणेसन्धीपार्श्वजौबृहतीचया॥१०॥
नितम्बावितिचैतानिकालान्तरहराणितु॥
उत्क्षेपौस्थपनीचैवविशल्यघ्नानिनिर्दिशेत्॥११॥
लोहिताक्षाणिजानूर्वीकूर्चविटपकूर्पराः॥
कुकुन्दरेकक्षधरेविधुरेसकृकाटिके॥१२॥
अंसांसफलकापाङ्गानीलेमन्येफणौतथा॥
वैकल्यकरणान्याहुरावर्तीद्वौतथैवच॥१३॥
गुल्फोद्वौमणिबन्धौद्वौद्वेद्वेकूर्चशिरांसिच।
रुजाकराणिजानीयादष्टावेतानिबुद्धिमान्॥
क्षिप्राणिविद्धमात्राणिघ्नन्तिकालान्तरेणच॥ ॥१४॥

Some verses right here 

Sadhya Pranahara Marmas –

Number – 19

Effect of harm – they kill the individual briefly once they get injured.

Name of Sadhya / Sadyo Pranahara Marma	Number
Srngataka	4
Adhipati	1
Sankha	2
Kanthasira / Matrika	8
Guda	1
Hrdaya	1
Basti / Vasti	1
Nabhi	1
Total	19

Kalantara Pranahara Marmas –

Number – 33

Effect of harm – they kill the individual regularly, after a while, once they get injured.

Name of Kalantara Pranahara Marma	Number
Vaksa Marma – necessary / deadly spots within the chest Stanamula – 2 Stanarohita – 2 Apalapa – 2 Apastambha – 2	08
Simanta	05
Tala (Talahrdaya) Hasta – in hand – 2 Sakti – in leg / foot – 2	04
Kshipra In Hasta – 2 In Sakti – 2	04
Indrabasti In Hasta – 2 In sakti – 2	04
Katikataruna	02
Parsva Sandhi	02
Brhati	02
Nitamba	02
Total	33

Vishalyaghna Marmas –

Number – 03

Effect of harm – they kill the individual when the salya – overseas frame embedded in them is got rid of.

Name of Visalyaghna Marma	Number
Utkshepa	02
Sthapani	01
Total	03

Vaikalyakara Marmas –

Number – 44

Effect of harm – they’re going to motive deformity once they get injured.

Name of Vaikalyakara Marma	Number
Lohitaksa	04
Ani	04
Janu	02
Urvi	04
Kurca	04
Vitapa	02
Kurpara	02
Kukundara	02
Kaksadhara	02
Vidhura	02
Krkatika	02
Amsa	02
Amsaphalaka	02
Apanga	02
Nila	02
Manya	02
Phana	02
Avarta	02
Total	44

Rujakara Marmas –

Number – 308

Effect of harm – those marmas would produce serious ache once they get injured.

Name of the Rujakara Marma	Number
Gulpha	02
Manibandha	02
Kurcasira	04
Total	08

Kșipra marma reasons loss of life both briefly or after a while, when injured / punctured.

Marma – Prāņa sthāna – seats of existence 

मर्माणिमांससिरास्नाय्वस्थिसन्धिसन्निपाताःतेषुस्वभावत‌एवविशेषेणप्राणास्तिष्ठन्तितस्मान्मर्मस्वभिहतास्तांस्तान्भावानापद्यन्ते॥१५॥ 

Marmas are confluence of the under discussed buildings (which additionally make up the marmas) –

–       Mamsa – muscle tissue

–       Sira – veins

–       Snayu – ligaments

–       Asthi – bones and

–       Sandhi – joints

Prana – the existence entity or existence power is claimed to are living in such confluence of those buildings by means of nature. Therefore, when those marmas are injured, they produce their respective results (enumerated above).

Marma svabhāva – nature of deadly spots 

तत्रसद्य : प्राणहराण्याग्नेयानि, अग्निगुणेष्वाशुक्षीणेषुक्षपयन्तिकालान्तरप्राणहराणिसौम्याग्नेयानि, अग्निगुणेष्वाशुक्षीणेषुक्रमेणचसोमगुणेषुकालान्तरेणक्षपयन्तिविशल्यप्राणहराणिवायव्यानि, शल्यमुखावरुद्धोयावदन्तर्वायुस्तिष्ठतितावज्जीवति, उद्धृतमात्रेतुशल्येमर्मस्थानाश्रितोवायुर्निष्क्रामति, तस्मात्सशल्योजीवत्युद्धतशल्योम्रियते (पाका.त्पतितशल्योवाजीवति) वैकल्यकराणिसौम्यानि,सोमोहिस्थिरत्वाच्छैत्याच्चप्राणावलम्बनं करोतिरुजाकराण्यग्निवायुगुणभूयिष्ठानि, विशेषतश्चतौरुजाकरौपाञ्चभौतिकीचरुजामाहुरेके॥१६॥ 

Sadyah prāṇahara marma– These marmas are agneya in nature i.e. they’re important in fiery qualities. Due to this fiery nature best, those marmas kill the debilitated individuals briefly.

Kālāñtara prāņahara marma – These marmas are Saumya-agneya in nature. They are important with qualities of each water and fireplace. Due to the agneya or fiery nature – scorching high quality, those marmas kill the debilitated individuals in fast time. Also, because of their watery nature – chilly qualities, they kill different individuals regularly, after a while.

Višalya prāņahara marma – These marmas are Vayavya in nature i.e. they’re important with qualities of air. When the salya – overseas frame like arrow enters the frame of the individual at those marmas, they block the air within those spaces and save you it from escaping out. The particular person survives so long as the air stays within, obstructed from popping out by means of the overseas frame. But as quickly because the overseas frame is got rid of by means of pulling it out, the air which were blocked by means of it within the necessary spot will get launched and springs out and that is when the individual dies. So, the individual survives when the overseas frame is provide within and dies when it’s pulled out. (the individual survives if the salya comes out because of suppuration at that marma).

Vaikalyakara marma – These marmas are Saumya in nature i.e. they’re important in qualities of water or moon. These marmas will motive deformities when injured however because of their balance and chilly nature, the moon / water would lend a hand in sustenance of existence.

Rujākara marma – These marmas are agneya and vayavya in nature i.e. they have got predominance of each fireplace and air components. Both those have capability of manufacturing ache and therefore when injured, those marmas motive serious ache. According to a few government, ache is Panchabhautika i.e. brought about by means of all of the 5 bhutas – components in combination.

Anya mata – other opinion 

केचिदाहुर्मासादीनांपञ्चानामपिसमस्तानांविवृद्धानांसमवायात्सद्य :प्राणहराणि,एकहीनानामल्यानांवाकालान्तरप्राणहराणि,द्विहीनानांविशल्यप्राणहराणि,त्रिहीनानां वैकल्यकराणि,एकस्मिन्नेवरुजाकराणीति।नैवं,यतोऽस्थिमर्मस्वप्यभिहतेषुशोणितागमनं भवति॥१७॥ 

Below discussed are the evaluations of a few students / mavens

–       Sadyah Pranahara Marmas – In those marmas, there may be presence of all of the 5 elements i.e. mamsa, sira, snayu, asthi and sandhi in nice proportions and they’re in detail combined in combination.

–       Kalantara Pranahara Marmas – In those marmas, best 4 of the 5 elements will probably be provide with deficit of any certainly one of them or they’re going to be found in much less amount.

–       Visalyaghna Marmas – In those marmas any two elements might not be provide and they’re going to be made up of best 3 elements.

–       Vaikalyakara Marmas – In those marmas, best two elements out of 5 will probably be provide, with the absence of 3 elements.

–       Rujakara Marmas – These marmas are made up of any one amongst the 5 elements and the opposite 4 elements will probably be absent.

This view isn’t proper since we see that there’s bleeding even if the asthi marma is injured.

Marma mahatva – significance of deadly spots 

चतुर्विधायास्तुसिराःशरीरे
प्रायेणतामर्मसुसन्निविष्टाः॥
स्नाय्वस्थिमांसानितथैवसन्धीन्
सन्तर्प्यदेहंप्रतियापयन्ति॥१८॥
ततःक्षतेमर्मणिताःप्रवृद्धः
समन्ततोवायुरभिस्तृणोति॥
विवर्धमानस्तुसमातरिश्वा
रुजःसुतीब्राःप्रतनोतिकाये॥१९॥
रुजाभिभूतंतुततःशरीरं
प्रलीयतेनश्यतिचास्यसंज्ञा॥
अतोहिशल्यंविनिहर्तुमिच्छ
न्मर्माणियत्नेनपरीक्ष्यकषेत्॥२०॥

All the 4 sorts of siras found in our frame are most often discovered to be located within the marmas. These siras maintain and take care of the frame by means of nourishing the opposite 4 elements i.e. snayu, asthi, mamsa and sandhi.

This is the explanation the vata which will get annoyed when those marmas are injured would invade and motive abnormalities within the siras and thus produce serious ache within the frame.

The particular person thus suffering from serious ache brought about by means of vata would a great deal undergo and also will lose his awareness.

Therefore, a doctor / surgeon who’s making plans to drag out the overseas frame from their level of have an effect on within the frame will have to moderately read about the marmas found in its neighborhood. He will have to first perceive its nature and best after that he will have to pull out the salya – overseas frame.

एतेनशेषंव्याख्यातम्।।२१।।

By describing the actions of vata above, the writer has additionally defined the actions of the remainder doshas additionally.

Viddha sthāna phala – past due impact of harm 

तत्रसद्यःप्राणहरमन्तेविद्धंकालान्तरेणमारयति,कालान्तरप्राणहरमन्तेविद्धंवैकल्यमापादयति,विशल्यघ्नंवैकल्यकरंचभवति,वैकल्यकरंकालान्तरेणक्लेशयतिरुजांचकरोति,रुजाकरमतीव्रवेदनंभवति॥२२॥ 

Pariņāma kāla – time of results 

तत्रसद्य : प्राणहराणिसप्तरात्राभ्यन्तरान्मारयन्ति,कालान्तरप्राणहराणिपक्षान्मासाद्व, तेष्वपितुक्षिप्राणिकदाचिदाशुमारयन्ति,विशल्यप्राणहराणिवैकल्यकराणिचकदाचिदत्यभिहतानिमारयन्ति।।२३।। 

Name of the Category of Marma	Effect when injured in the case of time taken
Sadyo Pranahara Marmas	Kills the individual inside seven days
Kalantara Pranahara Marmas	Kills the individual inside fortnight or a month time Even amongst those marmas, loss of life will once in a while be brought about in fast time when the Ksipra Marma is injured
Visalyaghna Marma and Vaikalyakara Marma	Sometimes motive loss of life when they’re a great deal injured

Site and names of deadly spots 

1. Sakthi marma – deadly spots of the leg 

अत‌ऊर्ध्वंसक्थिमर्माणिव्याख्यास्यम : -तत्रपादस्याङ्गुष्ठाङ्गुल्योर्मध्येक्षिप्रंनाममर्म,तत्रविद्धस्याक्षेपकेणमरणंमध्यमाङ्गुलीमनुपूर्वेणमध्येपादतलस्यतलहृदयंनाम,तत्ररुजाभिर्मरणंक्षिप्रस्योपरिष्टादुभयतःकूर्चीनाम,तत्रपादस्यभ्रमणवेपनेभवतःगुल्फसन्धेरध‌उभयत : कूर्चशिरः,तत्ररुजाशोफौपादजङ्घयोःसन्धानेगुल्फः,तत्ररुजःस्तब्धपादताखञ्जतावापाणिप्रतिजङ्घामध्ये‌इन्द्रबस्तिः,तत्रशोणितक्षयेणमरणंजबोर्वोःसन्धानेजानु,तत्र खञ्जताजानुन‌ऊर्ध्वमुभयतस्त्र्यङ्गुलमाणी,तत्रशोफाभिवृद्धिःस्तब्धसक्थिताच‌ऊरुमध्ये‌उर्वी,तत्रशोणितक्षयात्सक्थिशोष : उर्व्या‌ऊर्ध्वमधोवसणसंधेरूरुमूलेलोहिताक्षं,तत्रलोहितक्षयेणमरणंपक्षाघातोवावंक्षणवृषणयोरन्तरेविटपं,तत्रषाण्ढ्यमल्पशुक्रतावाभवति‌एवमेतान्येकादशसक्थिमर्माणिव्याख्यातानि।एतेनेतरसक्थिबाहूचव्याख्यातौ।विशेषतस्तुयानिसक्थ्निगुल्फजानुविटपानि,तानिबाहौमणिबन्धकूर्परकक्षधराणियथावङ्क्षणवृषणयोरन्तरेविटपमेवंवक्षःकक्षयोर्मध्येकक्षधरं,तस्मिन्विद्धेत‌एवोपद्रवाःविशेषतस्तुमणिबन्धेकुण्ठता,कूर्पराख्येकुणिः,कक्षधरेपक्षाघातः।एवमेतानिचतुश्चत्वारिंशच्छाखासुमर्माणिव्याख्यातानि॥२४॥ 

Further, we will be able to describe the deadly spots within the leg as follows 

Name of the Sakti Marma	Location	Effect of harm
Ksipra Marma	Between the massive toe and subsequent toe	Death by means of convulsions
Talahrdaya Marma	In line with the center toe upwards, within the heart of the only	Death from ache
Kurca Marma	Above the Ksipra Marma, on either side	Difficulty in strolling and bending the foot
Kurcasira Marma	Below the ankle joint, on either side	Pain and swelling
Gulpha Marma	At the assembly position of the foot and leg – ankle joint	Pain, stiffness of the foot, lameness / limping
Indrabasti Marma	In line with the heel, upwards and in the midst of the calf	Death by means of lack of blood
Janu Marma	At the assembly position of calf and thigh – knee joint	Lameness Limping
Ani Marma	3 angula (6cm) above the janu sandhi (knee joint), on either side	Increase of swelling and lack of motion of the thigh
Urvi Marma	Middle of the thigh	Wasting or thinning of the thigh because of lack of blood 1
Lohitaksa Marma	Above Urvi Marma and under the groin, on the base of the thigh	Death from lack of blood or Paksaghata – hemiplegia
Vitapa	Between groin and scrotum	Impotence, Deficiency of semen

Thus, the 11 marmas of 1 sakti – leg / decrease limb had been enumerated. With this, the marmas provide within the different leg and two bahu – palms / higher limbs too had been described (they create the similar names). Gulpha Marma, Janu Marma and Vitapa Marma are particular to the decrease limbs.

The names exchange within the higher limb. The counter portions within the higher limb are –

–       Manibandha Marma – wrist marma – instead of Gulpha Marma

–       Kurpara Marma – elbow marma – instead of Janu Marma

–       Kaksadhara Marma – instead of Vitapa Marma

Kaksadhara Marma is situated in between chest and axilla, identical to the Vitapa Marma within the higher limb is situated between the scrotum and groin. When injured, this marma will even give upward thrust to similar more or less troubles.

When Manibandha Marma is injured particularly, it reasons lack of purposes of the hand. Likewise, when Kaksadhara Marma is injured, it reasons paralysis of part portion of the frame – palms particularly.

In this manner, the forty-four marmas provide within the extremities – higher and decrease limbs in combination, had been described.

2. Madhyamāñga marma – deadly spots within the trunk 

अत‌ऊर्ध्वमुदरोरसोर्मर्माण्यनुव्याख्यास्यामः- तत्रवातवर्षोनिरसनस्थूलान्त्रप्रतिबद्धंगुदंनाममर्म,तत्रसद्योमरणंअल्पमांसशोणितोऽभ्यन्तरतःकट्यांमूत्राशयोबस्तिः,तत्रापिसद्योमरणमश्मरीव्रणादृते,तत्राप्युभयतोभिन्नेनजीवित,एकतोभिन्नेमूत्रस्रावीव्रणोभवति,सतुयत्नेनोपक्रान्तोरोहतिपक्वामाशययोर्मध्येसिराप्रभवानाभिः,तत्रापिसद्योमरणंस्तनयोमध्यमधिष्ठायोरस्यामाशयद्वारंसत्त्वरजस्तमसामधिष्ठानंहृदयं,तत्रापिसद्य‌एवमरणंस्तनयोरधस्ताद्व्यङ्गुलमुभयतःस्तनमूले,तत्रकफपूर्णकोष्ठतया(कासश्वसाभ्यां)म्रियतेस्तनचूचुकयोरूर्ध्वंव्यङ्गुलमुभयतःस्तनरोहितौ,तत्रलोहितपूर्णकोष्ठतयाकासश्वासाभ्यांचम्रियते‌अंसकूटयोरधस्तात्पार्वोपरिभागयोरपलापौनाम,तत्ररक्तेनपूयभावंगतेनमरणंउभयत्रोरसोनाड्यौवातवहे‌अपस्तम्भौनाम,तत्रवातपूर्णकोष्ठतयाकासश्वासाभ्यांचमरणम्‌एवमेतान्युदरोरसोर्टादशमर्माणिव्याख्यातानि॥२५॥ 

After this, the marmas of the stomach and chest can be described.

Name of the Udara-Urasa Marmas	Location	Effect of harm
Guda Marma	Attached to the huge gut, – rectum, anus Eliminates flatus and feces	Quick loss of life
Basti / Vasti Marma	Inside the pelvis, consisting much less of muscle tissue and blood It is the seat of urine	Causes quick loss of life When the wound is because of asmari – calculus, it does no longer motive loss of life. Even in case of presence of asmari, if the bladder will get torn on either side because of the stones, the individual would no longer live to tell the tale. If the harm is in anyone facet, there happens a wound which might exude urine. This situation heals whether it is handled with all efforts.
Nabhi Marma	In between the tummy and big gut – umbilicus / navel. Place of starting place of sira – veins.	Causes loss of life in fast time
Hrdaya Marma	In between the 2 breasts, within the chest, on the mouth / opening of the tummy – Heart. Seat of Sattva, Rajas and Tamas (thoughts).	Causes fast loss of life
Stanamula Marma	Below the breast, two añgula (4 cm) on both sides.	Death from kapha filling within the chest, generating cough and dyspnea.
Stanarohita Marma	Above the nipples, two angula (4 cm) on both sides.	Death from blood filling the chest, generating cough and dyspnea.
Apalapa Marma	Below the shoulder joint and on the best of the flanks.	Death because of the blood reaching the qualities of pus.
Apastambha Marma	On the 2 aspects of the chest. They purvey air.	Death because of accumulation of air within the chest generating cough and dyspnea.

 Thus, the twelve marmas provide within the stomach and chest had been described.

 

III. Prsthamarma – deadly spots within the again 

अत‌ऊर्ध्वंपृष्ठमर्माणिव्यख्यास्यामः – तत्रपृष्ठवंशमुभयतःप्रतिश्रोणिकाण्डमस्थिनीकटीकतरुणे,तत्रशोणितक्षयात्पाण्डुर्विवर्णोहीनरूपश्चम्रियतेपार्श्वयोर्जघनबहिर्भागेपृष्ठवंशमुभयतोकुकुन्दरे,तत्रस्पर्शाज्ञानमध : कायेचेष्टोपघातश्चश्रोणीकाण्डयोरुपर्याशयाच्छादनौपाश्र्वान्तरप्रतिबद्धौनितम्बौ,तत्राध : कायशोषोदौर्बल्याच्चमरणं,अधपान्तरप्रतिबद्धौजघनपार्श्वमध्ययोस्तिर्यगूर्ध्वंचजघनात्पार्श्वसन्धी,लोहितपूर्णकोष्ठतयाम्रियतेस्तनमूलाजूभयतःपृष्ठवंशस्यबृहती,तत्रशोणितातिप्रवृत्तिनिमित्तैरुपद्रवैम्रियतेपृष्ठोपरिपृष्ठवंशमुभयतस्त्रिकसंबद्धे‌अंसफलके,तत्रबाह्वोःस्वापशोषौबाहुमूर्धग्रीवामध्ये‌अंऽसपीठस्कन्धबन्धनावंसौ,तत्रस्तब्धबाहुता‌एवमेतानिचतुर्देशपृष्ठमर्माणिव्याख्यातानि॥२६॥ 

After this, the marmas of the again can be described.

Name of the PrshtaMarmas	Location	Effect of harm
Katikataruna Marma	On either side of the vertebral column, close to the bones of the pelvis	Death from lack of blood, generating pandu – anemia and lack of complexion
Kukundara Marma	In the 2 flanks, on outer facet of the buttocks, on both sides of vertebral column	Loss of sensation and serve as of the decrease a part of the frame
Nitamba Marma	Present above the pelvis, masking the inner organs, connected to the flanks	Death because of losing / emaciation of the decrease a part of the frame and debility
Parsva Sandhi Marma	Nearer to decrease finish of flanks, In between buttocks and flanks to the facet and above the buttocks	Death from accumulation of blood in stomach
Brhati Marma	Same instantly line from stanamulamarma, on either side of vertebral column	Death from headaches because of copious bleeding
Amsaphalaka Marma	Upper a part of the again on both sides of vertebral column and closer to trika. Trika is assembly position of neck and each shoulders i.e. higher again.	Loss of tactile sensation and losing / emaciation of palms
Amsa Marma	In between the palms, head and neck, binds the shoulder blade and shoulder	Loss of purposes of the palms

Thus, the twelve marmas provide within the again had been described.

4. Ürdhvāñga marma – deadly spots of head and neck 

अत‌ऊर्ध्वमूर्ध्वजत्रुगतानिव्याख्यास्यामः – तत्रकण्ठनाडीमुभयतश्चस्रोधमन्योद्वेनीलेद्वेचमन्येव्यत्यासेन,तत्रमूकतास्वरवैकृतमरसग्राहिताचग्रीवायामुभयतश्चतस्रःसिरामातृकाः,तत्रसद्योमरणंशिरोग्रीवयोःसन्धानेकृकाटिके,तत्रचलमूर्धताकर्णपृष्ठतोऽध : संश्रितेविधुरे,तत्रबाधिर्यंघ्राणमार्गमुभयतःस्रोतोमार्गप्रतिबद्धे‌अभ्यन्तरतःफणे,तत्रगन्धाज्ञानंभूपुच्छान्तयोरधोऽक्ष्णोर्बाह्यतोऽपाङ्गौ,तत्रान्ध्यंदृष्टयुपघातोवाभ्रुवोरुपरिनिम्नयोरावर्तीनाम, 

तत्राप्यान्ध्यंदृष्ट्युपघातोवाभ्रुवोरन्तयोरुपरिकर्णललाटयोर्मध्येशङ्खौ,तत्रसद्योमरणंशङ्खयोरुपरिकेशान्त‌उत्क्षेपौ,तत्रसशल्योजीवेत्पाकात्पतितशल्योवानोद्धतशल्यःभ्रुवोर्मध्येस्थपनी,तत्रोत्क्षेपवत्पञ्चसन्धयःशिरसिविभक्ताःसीमन्तानाम,तत्रोन्मादभयचित्तंनाशैर्मरणंघ्राणश्रोत्राक्षिजिह्वासंतर्पणीनां -सिराणांमध्येसिरासन्निपातःशृङ्गाटकानितानिचत्वारिमर्माणि,तत्रापिसद्योमरणंमस्तकाभ्यन्तरोपरिष्ठात्सिरासन्धिसन्निपातोरोमावर्तोऽधिपतिः,तत्रापिसद्य‌एव।एवमेतानिसप्तत्रिंशदूर्ध्वजत्रुगतानिमर्माणिव्याख्यातानि॥२७॥ 

After this, the marmas of the pinnacle and neck can be described.

Name of the Urdhwanga Marmas	Location	Effect of harm
Nila Manya Marma	On the 2 aspects of the trachea, 4 in quantity (4 dhamanis – arteries) i.e. 2 Nila and 2 Manya – one each and every on both sides of the trachea.	Muteness Abnormalities of voice Inability to understand and perceive other tastes
Matrka Marma	On two aspects of the neck, 4 in quantity, 2 on each and every facet	Causes loss of life in fast time
Krkatika Marma	In the assembly position of head and neck, 2 in quantity	Shaking of head
Vidhura Marma	Back / in the back of the ear and under it, 2 in quantity, one on each and every facet	Deafness
Phana Marma	On two aspects of the nostril, close to the higher a part of passages and likewise within them, 2 in quantity – one on each and every facet	Loss of sensation / belief of odor and incapability to know and differentiate other odors
Apanga Marma	At the tail finish of the brows, under and outdoor the eyes, 2 in quantity – one on each and every facet	Blindness or hindrance of sight / imaginative and prescient abnormalities
Avarta Marma	Above the brows, in depressions, 2 in quantity – one on each and every facet	Blindness or hindrance to sight / defects of imaginative and prescient
Sankha Marma	Above the extent of eyebrows, in between ears and brow – 2 in quantity, one on each and every facet – temples	Causes fast loss of life
Utksepa Marma	Above the temples, on the borders of the hair (hairline), 2 in quantity – one on each and every facet	As lengthy because the overseas frame is provide there, the affected person survives or till it falls off after suppuration (pus formation). On the opposite hand, the affected person does no longer live to tell the tale when the overseas frame is pulled out.
Sthapani Marma	Between the 2 eyebrows,	Similar impact as defined in Utkshepa Marma above
Simanta Marma	5 joints of bones – sutures, provide within the head, divides the cranium in numerous portions	Death because of madness, worry and lack of mind or psychological actions
Srngataka Marma	In the center of confluence of veins, supplying nourishment to the nostril, ears, eyes and tongue, within the head on the confluence of veins – 4 in quantity	Causes fast loss of life
Adhipati Marma	Inside the pinnacle, at its best It is the confluence of veins and joints, surrounded by means of ring of hairs	Causes fast loss of life

Thus, the thirty-seven marmas provide within the jatrurdhwa desha i.e. within the portions of the frame above the extent of collar bone / clavicle i.e. head and neck had been described.

Marma Pramāņa – Dimension of the deadly spots

भवन्तिचात्रश्लोका :
उर्व्यःशिरांसिविटपेचसकक्षपार्थे
एकैकमङ्गुलमितंस्तनपूर्वमूलम्॥
विद्धङ्गुलद्वयमितंमणिबन्धगुल्फं
त्रीण्येवजानुसपरंसहकूर्पराभ्याम्॥२८॥
हृदस्तिकूर्चगुदनाभिवदन्तिमूर्ध्नि
चत्वारिपञ्चचगलेदशयानिचद्वे॥
तानिस्वपाणितलकुञ्चितसंमितानि
शेषाण्यवेहिपरिविस्तरतोऽङ्गुलार्धम्॥२९॥

Some verses right here 

Marmas	Pramana – measurement in angula (1 angula = 2 cm)
Urvi Kurcasira Vitapa Kaksaparsva (Kaksadhara and Parsva) Stanapurvamula	1 angula each and every (2cm) in breadth
Manibandha Gulpha	2 angula each and every in breadth (4 cm)
Janu Kurpara	3 angula each and every in breadth (6 cm)
Hrdaya Basti Kurca Guda Nabhi 5 within the head – 4 Srngataka and 5 Simanta 12 in neck – 8 Matrka, 2 Nila, 2 Manya	Size of 1’s personal folded palm – 4 angula (8cm)
Other Marmas	½ angula (1 cm) each and every in breadth

एतत्प्रमाणमभिवीक्ष्यवदन्तितज्ज्ञाः
शस्त्रेणकर्मकरणंपरिहृत्यकार्यम्॥
पार्वाभिघातितमपीहनिहन्तिमर्म
तस्माद्धिमर्मसदनंपरिवर्जनीयम्॥३०॥

According to the opinion of clever individuals, surgeries together with use of sharp tools will have to be carried out after understanding the width of marmas, warding off harm to the marmas.

Injury carried out even to the perimeters of the marmas will even kill the individual. Therefore, the marmas will have to be moderately have shyed away from.

Apāya – hazards from harm 

छिन्नेषुपाणिचरणेषुसिरानराणां
सङ्कोचमीयुरसृगल्पमतोनिरेति॥
प्राप्यामितव्यसनमुग्रमतोमनुष्या :
संच्छिन्नशाखतरुवन्निधनंनयान्ति॥३१॥
क्षिप्रेषुतत्रसतलेषुहतेषुरक्तं
गच्छत्यतीवपवनश्चरुजंकरोति॥
एवंविनाशमुपयान्तिहितत्रविद्धा
वृक्षा‌इवायुधनिपातनिकृत्तमूला : ॥३२॥
तस्मात्तयोरभिहतस्यतुपाणिपादं
छेत्तव्यमाशुमणिबन्धनगुल्फदेशे॥ 

The veins within the fingers and ft get constricted when the fingers and ft are bring to an end. As a outcome, little bleeding happens. The particular person does no longer die despite experiencing nice struggling, identical to a tree which doesn’t die when its branches are bring to an end. 

Injury to Ksipra and Talahrdaya Marmas results in bleeding in huge amount and aggravation of vata, which produces ache. As a outcome, the individual dies when those marmas are injured, identical to the tree dies out when its roots are bring to an end by means of the tools. Hence, the fingers and ft of the individuals whose Ksipra and Talahrdaya marmas are injured will have to be amputated (bring to an end) briefly on the wrist joint and ankle joint respectively.

Importance of getting the information of marmas

मर्माणिशल्यविषयार्थमुदाहरन्ति
यस्माच्चमर्मसुहतानभवन्तिसद्यः।
जीवन्तितत्रयदिवैद्यगुणेनकेचित्ते
प्राप्नुवन्तिविकलत्वमसंशयंहि॥३३॥
संभिन्नजर्जरितकोष्ठशिर : कपाला
जीवन्तिशस्त्रनिहतैश्चशरीरदेशः।
छिन्नैश्चसक्थिभुजपादकरैरशेषैर्येषां
नमर्मसुकृताविविधाःप्रहाराः॥३४॥

Since individuals die briefly when their marmas are injured, the information of marmas is described as part of the information of Salya Tantra – surgical science. Even if anyone whose marma has been injured occur to live to tell the tale because of the ability and potency of the doctor / surgeon, he’ll undoubtedly finally end up affected by deformities.

If the marmas don’t seem to be injured by means of other sorts of attack and are preserved, the individual would no longer die despite his inside organs being punctured, cranium bones damaged to items, different portions of the frame having been lower by means of sharp guns and even if his legs, shoulders, ft and fingers are totally bring to an end.

Components of necessary / deadly spots

सोममारुततेजांसिरजःसत्त्वतमांसिच॥
मर्मसुप्रायशःपुंसांभूतात्माचावतिष्ठते॥३५॥
मर्मस्वभिहतास्तस्मान्नजीवन्तिशरीरिणः॥

The under discussed are living within the marmas particularly –

–       Soma – moon, kapha

–       Maruta – vata

–       Tejas – pitta, warmth

–       Rajas

–       Sattva

–       Tamas and

–       Bhutatma – soul

Hence residing beings whose marmas are injured won’t live to tell the tale.

Marmahatalaksana- results of harm 

इन्द्रियार्थेष्वसंप्राप्तिर्मनोबुद्धिविपर्ययः॥३६॥
रुजश्चविविधास्तीव्राभवन्त्याशुहरेहते॥
हतेकालान्तरघ्नेतुध्रुवंधातुक्षयोनृणाम्॥३७॥
ततोधातुक्षयाज्जन्तुर्वेदनाभिश्चनश्यति॥
हतेवैकल्यजननेकेवलंवैद्यनैपुणात्॥३८॥
शरीरंक्रिययायुक्तंविकलत्वमवाप्नुयात्॥
विशल्यनेतुविज्ञेयंपूर्वोक्तंयच्चकारणम्॥३९॥
रुजाकराणिमर्माणिक्षतानिविविधारुजः॥
कुर्वन्त्यन्तेचवैकल्यंकुवैद्यवशगोयदि॥४०॥

Category of Marma	Effect of harm
Sadyo Pranahara Marmas	Loss of sensory belief Abnormalities of thoughts and mind Different sorts of ache
Kalantara Pranahara Marmas	Dhatu kshaya – loss / lower of tissues Death because of serious ache brought about by means of tissue depletion
Vaikalyakara Marmas	Deformities provided that the frame is safe by means of a skillful and environment friendly doctor / surgeon
Visalyaghna Marmas	Have been described previous
Rujakara Marmas	Many sorts of ache Deformity happens if handled by means of quacks

Effects of harm to the marmas

छेदभेदाभिघातेभ्योदहनाद्दारणादपि॥
उपघातंविजानीयान्मर्मणांतुल्यलक्षणम्॥४१॥

When any upaghata i.e. minor harm of the under discussed sorts happen within the shut neighborhood of marmas, identical signs are produced –

–       Cutting

–       Breaking

–       Hitting

–       Burning by means of fireplace

–       Bursting / dividing and many others.

मर्माभिघातस्तुनकश्चिदस्ति
योऽल्पात्ययोवाऽपिनिरत्ययोवा॥
प्रायेणमर्मस्वभिताडितास्तु
वैकल्यमृच्छन्त्यथवाम्रियन्ते॥४२॥

Usually, a wide variety of accidents happening to the marmas both produce deformity or loss of life. Therefore, no harm to the marmas will have to be regarded as as mildly risky or not-dangerous.

मर्माण्यधिष्ठायहियेविकारा
मूर्च्छन्तिकायेविविधानराणाम्॥
प्रायेणतेकृच्छ्तमाभवन्ति
नरस्ययत्नैरपिसाध्यमानाः॥४३॥ 

In spite of treating them with all efforts, many sorts of sicknesses despite being curable most often grow to be very tough to remedy, once they expand in / at the area of marmas.

इतिश्रीसुश्रुतसंहितायांशारीरस्थानेप्रत्येकमर्मनिर्देशशारीरंनामषष्ठोऽध्यायः॥६॥

Thus ends the Sixth bankruptcy by means of title Pratyeka Marma Nirdeśa in Sarira Sthāna of Suśruta Samhita.