VISHALYAGNA MARMA MODERN CORRELATION

1. Welcome U All

2. JOURNAL PRESENTATION
PRESENTATION BY
Dr. S. KAMALAKAR
1ST YEAR PG
DEPARTMENT OF SAMHITA SIDDANTA

3. International Ayurvedic Medical Journal
2014, 5(2), 160-163
A CONCEPTUAL REVIEW OF
VISHALYAGHNA MARMA
Bhosgikar Anup
Lecturer,
Department of Rachana Shareera,
N.K.Jabshetty Ayurvedic Medical College
& P.G Center Bidar, Karnataka.

4. AUTHOR LANGUAGESTYLE AND EXPRESSION
Very simple,
Easily understandable language
Gramatically correct,straight to point
Has systematically arranged the information
under proper headings

5. CONTENTS
1.INTRODUCTION
2.DESCRIPTION OF
VISHALYAGNA MARMA
3.DISCUSSION
4.AUTHOR’S CONCLUSION
5.FURTHER UNDERSTANDING
6.MY CONCLUSION

6.  Marmas is that vital organs / vital parts of the body where trauma /
injury may be cause sudden death and may be deformity in the body.
 These are 107 in number and classified under various categories,
Vishalyghna is one among them.
 injury to these causes death but it is after removal of shalya from
injured part
INTRODUCTION

7. What is criteria behind to
name marma as vishalyaghna

8.  The term vishalya coined as, it is not a fatal one up to removal of the
shalya (foreign body) i.e. the person will live till the removal of
foreign body.
 In this context, Acharya Sushruta tries to emphasize on the concept
that without removing the foreign body the person can survive, if it
stays and drops itself after paka (suppuration).(type of parinama)

9. The Vishalyaghna Marmas are Vayu Mahabhuta predominant,
totally three Vishalyaghna are present in the body.
There are
2 Utkshepa marma and
1 Sthapani marma
CLASSIFICATION

10.  It is located above the Shankha (temporal region) Marma as
literally reviewed regarding Utkshepa marma it is located near the
hair margin and it is half angula pramana (half finger unit).
 Structures come under this superficial and deep fascia of temporal
region i.e. up to the meninges.
 Penetrating wounds if effects the meninges there may be the
chances of intra cranial negative pressure rises, hemorrhage etc.
UTKSHEPA MARMA

11. UTKSHEPASANKHA

12.  The direct impact to temporal or occipital can produce basilar skull
fractures.
 Possibility it can lead to tear of dural vessels and injury to brain or
pial vessels with or without fractures resulting in epidural hematoma
 So if after injury of dural vessels and pial vessels hemorrhage can
lead to high negative pressure rise in the brain and the person will die
and, so the shalya will not be removed from the site.

13. STHAPANI MARMA
 It is located in between two eye brows , so anatomically it is also half
anguli in pramana.
 Structures come under this superficial and deep fascia, occipito-
frontalis muscle, frontal bone, and glabella and can also be considered
up to saggital sinus.
 Injury to one-third of saggital sinus can be treated by packing or by
legating the anterior one-third of superior saggital sinus.
 Injury to this may require micro-surgical repair which can be
extremely difficult in given situation, hence any depressed bony
fragments, and foreign body involving dural sinuses also should not
be removed

14. DISCUSSION
• When any foreign body is impacted in the skin or any part of body,
it tears the vessels or enters into them.
• Such foreign bodies as long as present there will be no bleeding but
if extracted forcibly, vessels are going to open and start to bleed.
• So if foreign bodies are allowed to remain there only the tissue
granulation chances will be there.
• This closes the mouth of vessels. Consequently there are less
chances of bleeding that may save the life of the individual.

15. CONCLUSION
• After reviewing all the facts reviewing of Vishalyghna marmas.these
become fatal only after removal of shalya from the injured site.
• Utkshepa can be taken as temporal region up to meninges and
Sthpani is taken as region of Glabella.
• Totally the conclusion what sushruta opines regarding not to remove
the shalya from the site it is scientific.

16. FURTHER
UNDERSTANDING

17. marma
 Any part of the body where the uneven pulsations are felt and
pressure over that part causes Pain, it is called as Marma.
 Areas where mamsa, sira, snayus, asthi, and sandhi all are present
sannipat(confluence) are called marmas(vulnerable areas)
 Dalhana has used the word sannipata,to denotes the close relationship
of all the aforesaid body structures like mamsa, sira, snayu
 Which are specially and by virtue of their nature are the seats of
prana(life)
 Therefore any trauma on any of these marmas invariably causes death

18. presence of
dosha and guna in marma
• Soma, vayu, tejas, sattwa,tamas,and jivatma all the factors are present
in marma.
• Therefore the living being cannot survive after an injury to marmas
• The body get consiousness due to its satwa, rajas and tamas
properties
• The satwa, rajas and tamas are also named as prana of the body.prana
lies in marma
• Hence when marmas are injured, prana escapes out of marmas and
the man die

19. prana
Factors comprising prana
Agni ,soma, vayu, satwa, rajas, tamas, panchendriya, bhutatma all are
representative of prana (su.sh.4/3)
sites of prana
According to charaka the ten pranayatanas are
Shiras, kanta, hridayam, nabhi, gudam, basti, oja, sukra, sonitham,
mamsa
(cha.sh.7/9)

21. classification marma
MARMAS ARE 107 IN NUMBER THEY ARE OF 5 TYPES
1. Mamsa(11)
2. Sira(41)
3. Snayu(27)
4. Asthi(8)
5. Sandhi(20) su.sh.6/3
PROGNOSTIC CLASSIFICATION OF MARMA
1. Sadhyo pranhara(19)-causing instant death
2. Kalantar(33)-causing death after some time
3. Vishalyaghna(3)-death comes after removing shalya
4. Vaiklyakara(44)-causing deformity
5. Rujkara(8)-causing severe pain (su.sh.6/14)

22. VISHALYGHNA MARMA
 Vishalyghna Marma is Vayupradhana.
 Hence, after the trauma the shalya which is impacted in the vital parts
gives protection to Prana until the wound heals normally on its own
and the shalya is drained out with pus
 But if the shalya is pulled intentionally before suppuration and auto-
healing process, there will be sudden exit of Vayu and death is the
only outcome.
 So that is safe to keep the shalya in its place as it is.

23. UTHKSHEPA MARMA

24. Urdhwa jatrugata marma
• Vishalyagna marma
• Snayu marma
• Ardhangula pramana
• Vayu pradhaana marma
• 2 in number
•Temporalis muscle and fascia

25. Pterion
• It is the area in the temporal fossa where four bones ( frontal,
parietal, temporal & sphenoind ) adjoin each other across an H-
shaped suture.
• It is an important land mark because it overlise the anterior
branches of the middle meningeal vessels
• A blow to the side of the head may fracture the thin bones forming
the pterion, rupturing middle meningeal artery, resulting
haematomas, excerts pressure on the cerebral cortex.

27. Utkshepa marma viddha
Shalyaapanayana
Vaayu vinirgathi
Mamsa,Rakta, Majja,
Masthulunga shosha
Shwasa, Kaasa
Marana
Injury to pterion region
Removal of the object
Haemorrhage
Lack of blood supply to
meninges & brain
Shock with metabolic
acidosis ( Air hunger,
Hyperventilation )
Death

28. STHAPANI MARMA

29. Urdhwa jatrugata marma
• Vishalyagna marma
• Sira marma
• Ardhangula pramana
• Vayu pradhaana marma
• 1 in number
•Nasal arch of frontal vein

30. 1.Supra trochlear artery
1.Supra orbital artery
2.Supra trochlear nerve
3.Frontal belly of occipito
frontalis
4.Fromtal bone
4.Frontal nasal bone joint1
24 3

31. Why is the penetrated object not removed???
• Patients in whom the penetrating object is left in place
have a significantly lower mortality than those in whom
the objects are inserted and then removed.
• Retained fragments have not been associated strongly
with infection, most authors have suggested they should be
removed only if the fragments are accessible.
• In gun shot wounds, the bullet is not removed unless it is
easily accessible because the risk of brain injury from the
retrieval of the bullet exceeds the benefit of its removal.

32. • If the missile can be located readily it should be removed,
but more damage may be done by searching through the
brain for the metal than by leaving it in place.
•In case of stab wounds the knife or penetrating object
should not be removed until the dura opened in the
operating room and the procedure can be performed under
direct vision.

33. CONCLUSION
Considering the above details one could safely make the
following comparisons:
 The Utkshepa marma to Pterion region.
 As it is a snaayugata marma, can be compared to the
Meninges and Temporal fascia
 Hence it is imperative to understand the regional anatomy
and applied aspect of individual marmas, so as to manage
and prevent complications pertaining to them more
efficiently.

34.  Extraction of Shalya from region of STHAPANI MARMA (A SIRA
MARMA) will lead to Profuse bleeding of Blood leading to escape of
Vayu in the form of Prana located in Rakta , Thus causing Dryness of
Mamsa , Vasa , Majja , Mastulunga and finally Death.
 If Depressed fractures (Shalya) of cranium are attempted to elevate
there is a risk of severe hemorrhage from Sinuses leading to death .So
these fractures are left alone and are not elevated .
 Fracture of Anterior cranial fossa leads hemorrhage from the nose
and escape of CSF (CSF rhinorrhoea) and even brain matter through
the nose.

35. REFERENCES
SUSHRUTA SAMHITA SHARIRA 4, 6, 29 CHAPTERS
CHARAKA SHARIRA 7 TH CHAPTER
ASTANGA HRIDAYA 3, 4 CHAPTERS
SHARIR SUBHASHIT PROF D.G. THATTE
SHARIRA RACHANA-DR.RAMASUNDAR RAO