|Year : 2021 | Volume
| Issue : 3 | Page : 152-155
Marmacikitsa: Basic tenets in Ayurveda and therapeutic approaches
Pratibha P Nair
National Ayurveda Research Institute for Panchakarma, Thrissur, Kerala, India
|Date of Submission||06-Jan-2022|
|Date of Acceptance||13-Jan-2022|
|Date of Web Publication||22-Mar-2022|
Dr. Pratibha P Nair
National Ayurveda Research Institute for Panchakarma, Cheruthuruthy, Thrissur 679531, Kerala.
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Nair PP. Marmacikitsa: Basic tenets in Ayurveda and therapeutic approaches. J Res Ayurvedic Sci 2021;5:152-5
| Book Introduction|| |
Marmasastra or the science of Marma refers to the knowledge of subtler levels of energy flow in a living body and its optimization at varied vital points (Marma or Varma sites). The main subject matter of Marmacikitsa (therapeutic manipulation of Marma) is the conscious and intentional manipulation of such sensitive and vulnerable energy points so as to bring forth the desired therapeutic benefit. Though some books and articles are in print,,,,,,,, which give a bird’s eye view on Marmasastra in terms of theoretical notes and descriptions, no works till date offered an illustrated hand on content that would add on to the practical knowledge of the aspirants.
The Central Council for Research in Ayurvedic Sciences (CCRAS) is ambitiously involved in documenting unusual, rare, or socio-culturally endangered traditional practices and medicinal treatments. This aim is fueled by mandate and remarkable growth in fundamental research activities of CCRAS. The CCRAS took the initiatives towards creating a valuable compilation in the field of Marmavigyan and Cikitsa (knowledge and practical application of the science of Marma) entitled “Marmacikitsa: Basic tenets in Ayurveda and Therapeutic approaches.” This review represents that the book is aimed at readers who are Ayush system practitioners and have inculcate interest in rendering instantaneous clinical benefits by enhancing their manipulative skills over acute to chronic traumatic–nontraumatic musculoskeletal and bony clinical manifestations. Curious historians who are keen at unearthing global martial arts and efficient historical manipulative techniques of self-defense and assault too might find it interesting as an initial book to refer to.
It becomes clear in the book that the compilers have had privileged access to major veterans in Marmacikitsa, with whom they have conducted in-depth interviews and along with their own share of knowledge and expertise, systematically compiled and documented their observations into this textbook. Prime importance has been given to documentation of Marma stimulation/manipulation techniques in a very categorical and practical manner. The compilers thereby have tried to explore the scope of integration of such traditional techniques into mainstream Ayush practices
| Content of the Textbook|| |
The introductory chapter is the most decisive and imperative part of the textbook and one has to definitely read the introductory remarks so as to understand the essence of what follows in the next couple of chapters. The first chapter details the current status of Marmasastra, reasons for its endangered existence, lacunae, gap in generating critical evidences, and scope in terms of opportunities and challenges in updating, upgrading and effectively integrating Marma manipulating techniques into mainstream Ayush clinical practice. The historical transition of Marmavigyan, from the theological origin which eventually ended up transcribed with mortals is detailed here. Tripartite citation of Marmavigyan is explained wherein references of Marma practices could be traced back to (i) Great Indian epics, Yogasastra and Ayurveda, (ii) Varmasastra colloquially referred to as Varmology which is closely connected to Siddha practices especially in the state of Tamil Nadu with sage Agastya as its profounder (which in turn had three schools of thought namely Agastyar, Bogar and Ramadevar), and (iii) Kalarimarma or Kulabhyasamarma practices originated from sage Parasuram, which is a prominent form of martial arts as well as therapeutics now famous in the state of Kerala. It is stated that Marmasastra was practiced in parallel to medical care and was mostly used at times of adversities such as warfare or as a part of martial training. Practical application of Marmavigyan seemed quite guarded and reserved and was mostly transferred in a Guru-shishya tradition alone. This was noted down in the textbook as one of the main reasons, why Marmasastra was always lesser explored, which eventually resulted in diminution of such practices.
Opinions and debates of veterans from different stream and backgrounds of Marmavigyan on the vital parts that correspond to the initial point of origin of energy flow that later circulated across the body is mentioned in the first chapter and is commendable. Varmology is relatively more detailed in the textbook in terms of methods to be adopted to stimulate Varma points that too along with different pressure gradients so as to bring out the desired therapeutic effect. Certain peculiar terms in Tamil dialect related to stimulation of different Varma points, pressure gradients, hand movements of the Marma specialist and their therapeutic benefits such as Paati Kanakku, Maatrai Kanakku, Kai Bhagam, and Sai Bhagam incites curiosity in the minds of readers. Adangal which refers to techniques for reviving unconscious people and Tiravukal which are procedures to be adopted as last resort when Adangal does not help and when the person’s life is ebbing from his body are detailed in the first chapter and is quite inquisitive. But the exact procedural details of such critical procedures are lacking, maybe owing to the fact that all of it could not be compiled into one textbook or the Marma specialists could not have detailed more––as against their tradition, believes, and practices. In the first chapter, the reader is introduced to some of the classical regional textbooks on Varma such as Adangal, Avadhinool, and Vilvisai Ulsootram.
Kalarimarma (Kerala tradition of Marmavigyan) and Kalaripayatu (martial training associated with Kalarimarmavigyan) are further explained in the chapter wherein subclasses of this tradition were identified: namely, northern Kalarimarma practices (inspired by the so-called Aryan-Brahmanic influences wherein Sage Parasuram is worshipped and his principles are followed) and southern Kalarimarma practices (Dravidian ideas, wherein Agastyar tradition is followed). The fact remains that the Aryan invasion theory in itself is quite debatable. As mentioned in the textbook, Kalari tradition in northern Kerala seems to have a proper therapeutic lineage wherein they were specialized orthopedic/musculoskeletal traumatic injuries. The citation of Kulamarma, Kochumarma, and Abhyasamarma points, which might have life-threatening or temporary disabling aftermaths though startling, shall definitely fascinate readers. The chapter ends detailing the need for contemporary understanding and mainstreaming of Marma practices and integration of such techniques into Ayush clinical practice. To a significant extent, the compilers of the textbook justify the objectives and give readers a gratifying background to what follows in subsequent chapters.
The second chapter entitled “Fundamentals of Marmacikitsa” imparts theoretical knowledge on Marmasastra and compiles Marma contexts from Ayurvedic lexicons, Vedas, Upanishats, and epic poems like Mahabharata. In varied ways Marma are classified; for instance, based on gender, sites, and source of trauma. Data are depicted in tabular forms that summarize Ayurvedic Marma contexts. As far as Varmology is considered certain unique techniques that strike readers such as Etirkalatadaval Muraigal is mentioned wherein complementary Varma points of affected Varma are identified and manipulation is done. Stage-wise symptomatology of trauma at Varma points too is detailed.
The third chapter is quite unique in terms of illustrations. The exact location of each Marma is depicted as easily comprehensible photographs that everyone can follow. This method of Marma point identification along with its stimulation techniques and benefits of manipulation were relatively lacking in prior prints on Marmavigyan. Also, the description on Kalarimarma as per the text viz. Marmadarpanam is compiled here. Self-Marma therapy is dealt with as a separate section. Bodily physiological systems getting involved with peculiar Marma manipulation are also compiled here. A bird’s eye view on pain management with respect to Marma points is summarized in a table, which could have been a bit elaborate considering its clinical significance. Also, the relation between yoga and Marmasastra in this chapter seems a bit odd or nonblending as it could have been included in the initial chapters. At the end of the prescribed chapter, there is a co-relational table that tries to analyze and summarize Marmas as per different traditions. It would serve as a primary reference to understand the anatomical sites of Marma points.
The next two chapters are the elaboration of Marma manipulation/stimulation techniques that were introduced in the first chapter. There is a chapter dedicated to different massages/strokes entitled as “Abhyangamardanavidhi––massage techniques used in Marmacikitsa.” The clinicians might find it quite interesting and handy. Also, there are illustrations with graphics that would give an idea about the direction and the appropriate site for such manipulations. Even massages at peculiar clinically significant sites such as the knee and ankle are shown. In the next chapter, practical applications of bandaging techniques in peculiar clinical conditions with illustrations are displayed. This chapter also includes traction techniques and stretching exercises. In the 8th chapter, the application of Marmavigyan in the management of different clinically prevalent conditions is explored. Separate chapters are constituted that speak on the relevance of Marmacikitsa and associated manipulation techniques in a very relevant arena of orthopedics and sports medicine. Correlation of different clinical conditions as explained in traditional texts with contemporary findings of fractures, avulsions, and dislocations as displayed in radiological pictures is quite informative. Stage-wise management strategies in some of these conditions are also available. Immobilization techniques mentioned in classical textbooks and their comparisons with plaster casts and splints are relatively novel to the textbook. To add on to evidence-based clinical practices, data from case reports too are added that may definitely excite researchers and clinicians equally. The scope of such traditional practices in terms of rehabilitative care in mal-union, delayed union of fractures, and dislocation is nonspecifically mentioned. The book ends with a chapter on single drugs and compound formulations that are exclusively used in Marmacikitsa. Mode of preparation of some common formulations along with the botanical identity of source plants that goes into such formulations is presented in a tabular manner. Pictures of source plants utilized as ingredients in these formulations are depicted at the end.
| Discussion|| |
The demand for informative and handy works on traditional practices such as Marmacikitsa has been very loud and clear. The book’s publication seems appropriate and timely owing to a significant gap in scientific validation and hands-on application of the historical Marma practices as evident from published data to date. The textbook with its easily comprehensible writing introduces the readers to a very guarded and reserved ancient Indian system of warfare, martial arts, and therapeutics namely the Marmavigyan and Marmacikitsa. As a background to this publication, the book ensembles a vast area viz. the fundamental principles of Marmavigyan and Marmacikitsa, philosophical and mythological perspectives and lacunae, and gaps in current knowledge that eventually resulted in diminution of Marmasastra in primary healthcare. As one reads the introduction, he/she gets the notion that the compilers tried extracting relevant information that came from veterans by the method of in-depth interviews. Thereby it seems quite a task, so as to summarize and display qualitative findings into a relatively actualized and comprehensible format. However, the compilers, to a significant extent have justified the aims of this publication. Relatively newer terminologies especially with respect to Varmasastra have been introduced in almost every chapter. Every single page seems to provide newer terms and contexts. All the contributors are efficiently and contextually acknowledged. The contact details of contributors are displayed, which adds to the credibility and transparency of this textbook. The absence of an index of terminologies at the rear end evokes the necessity of a strategic approach and systematic skimming of the contexts to pick up all threads for a satisfying read. The order of chapters is logical. There are some resemblances between this work and works in print in terms of historical perspectives of Marmasastra and general classification of different Marma points. Interesting associations can be built on cross-referring such works while reading this textbook. The novelty of this book which is significantly appreciable is the fact that practical manipulation techniques of clinical significance are categorically displayed. Also, appropriate illustrations shall definitely engage one’s senses and thereby most part could be easily memorized. As the name of the textbook suggests; more importance has been given to highlighting indigenous therapeutic utilities of Marma/Varmavigyan and Kalarimarma compared to co-relating martial art forms depicted in this context with global martial art forms.
| Conclusion|| |
This textbook is a systematically arranged compilation that aims at introducing Marmacikitsa in a very practical and comprehensible manner that would excite Ayush clinicians and researchers as well as historians. Various traditions of Marmavigyan with their respective historical origin are detailed here which will enhance knowledge on a very guarded, secretive, and reserved technique of Marmasastra. The compilers of this book have tried to explore the lacunae and gaps that eventually resulted in diminution of Marmacikitsa in primary healthcare. This book also points out the scope of integration of such traditional techniques into mainstream Ayush practices. It is evident that the textbook shall surely strengthen the fundamentals of Marmavigyan and can serve as the hands-on approach guide for clinicians aspiring Marmacikitsavigyan.
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Conflicts of interest
There are no conflicts of interest.
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