Vasant Lad Marma Points of Ayurveda

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Marma Points of Ayurveda

The Energy Pathways for Healing Body, Mind and Consciousness with a Comparison to Traditional Chinese Medicine
by Vasant D. Lad, B.A.M.S., M.A.Sc. and Anisha Durve, M.S.O.M., Dipl. Ac., A.P.

Sonam Targee Traditional Chinese Medicine Reviewer

Albuquerque, New Mexico

The Ayurvedic Press, Albuquerque 87112 Copyright 2008 by The Ayurvedic Press, Vasant D. Lad and Anisha Durve. All rights reserved. No part of this book may be reproduced in any form by any electronic or mechanical means, including information storage and retrieval systems, without permission in writing from the publisher, except by a reviewer who may quote brief passages in a review. Although the information contained in this book is based on Ayurvedic principles practiced for thousands of years, it should not be taken or construed as standard medical treatment. For any medical condition, always consult with a qualified health care practitioner. This book is printed on acid-free paper. Edited by Jack Forem. Cover design by Michael Quanci. Illustrations by Yvonne Wylie Walston, CMI, of Creative Imagery, Inc. Layout design by Laura Humphreys. Project manager: Laura Humphreys.

Printed in the Canada.

10 9 8 7 6 5 4 3 2

Library of Congress Cataloging-in-Publication Data

Lad, Vasant, 1943Marma points of Ayurveda : the energy pathways for healing body, mind, and consciousness with a comparison to traditional Chinese medicine / by Vasant D. Lad and Anisha Durve. p. cm. Summary: Presents healing energetics of Ayurvedic marma points and compares them with Chinese system of acupuncture. Based on traditional medicine system from India, provides commentaries of diagnostic and therapeutic scope for each marma point including techniques for massage, detoxification, acupressure, aromatherapy, yoga and meditation--Provided by publisher. Includes bibliographical references and index. ISBN-13: 978-1-883725-08-2 (alk. paper) ISBN-10: 1-883725-08-9 (alk. paper) 1. Acupuncture points. 2. Medicine, Ayurvedic. I. Durve, Anisha. II. Title. RM184.5.L32 2008 615.538--dc22 2005032880

For more information on Ayurveda contact: The Ayurvedic Institute, P.O. Box 23445, Albuquerque, N.M. 87192-1445. Phone (505) 291-9698 or www.ayurveda.com.

Table of Contents
Foreword xv Preface xvii The Use of Sanskrit xix

Introduction | 1 INTRODUCTION TO PART ONE | 5 Introduction to yurveda | 7

The Five Elements 9 The Three Doshas 11 Vta 12 Pitta 13 Kapha 14 The Seven Dhtus (Bodily Tissues) 15 The Prakruti/Vikruti Paradigm in Ayurvedic Medicine 16

Introduction to Marmni | 19
The History of Marmni 19 Mechanisms of Action 20 Functions of Marmni 21 Communication 21 Diagnostic Indicators 21 Therapeutic Influences 21 Mechanism of Pain Relief 22 Stimulation of Agni and Detoxification of ma 22 Calming the Mind and Balancing Emotions 22 Enhancing Awareness 23 Preventative Care and Rejuvenation 23 Classification of Marmni 23 Location 23 Elemental Associations 23 Marmni and Doshic Subtypes 24 Corresponding Organs And Srotmsi 24 Degrees Of Vitality of Marmni 24 Sadyah Prnahara Marmni 24 Conclusion 25

The Spiritual Dimension of Marmni | 27

The Spiritual Value of Touch 27 Mahad: Innate Intelligence of the Body and the Universe 27 Universal Mind and Particular Mind: Opening to Infinity 28 Marmni and Mind/Body Medicine 28 Chakra System 30 Emotions: Origin, Expression and Healing 32 Go With the Flow: Marmni and the Art of Calming the Mind 34

vii

yurveda and Traditional Chinese Medicine | 37

The Creation Model in Traditional Chinese Medicine 37 Yin and Yang 37 The Five Principles of Yin and Yang 38 The Five Elements in TCM 40 Comparing the Philosophies of TCM and Snkhya 41 Unity 41 Duality 41 Qualities 41 Qi and Prna 42 The Five Elements 43 Individual Constitution 44 Health and Disease in yurveda and TCM 44 Etiology and Pathogenesis in yurveda 45 TCM Etiology 45 TCM Pathology and Diagnosis 46 Diagnosis in yurveda 46 Diagnosis in yurveda and TCM 47 Models of Pain 47 Pain in TCM 48 Pain in yurveda 48

Channels, Energy Points and Measurements in yurveda and Traditional Chinese Medicine | 51
Channels 51 Channels in TCM 52 Channels in yurveda: Srotmsi and Nd 56 Nds 56 Srotas 57 Functions of Srotmsi and Nds 58 Comparison 58 Energy Points 58 Classification of Acupuncture Points 59 Classification of Marmni 59 Measurements 60

Samprpti: Pathogenesis and Disturbance of Marmni | 63

Etiological Factors 63 Samprpti (Pathogenesis) 64 Vyadhi Mrga, the Three Pathways of Disease 67 Vikruti, the Present Imbalance 67 Role of Marmni in Relation to Samprpti and Pathways of Disease 68 Marmni as Khvaigunya 68 Marmni in Relation to ma and Agni 69

Introduction to Chikits, yurvedic Therapy | 73

Types of Chikits and the Role of Marmni 73 Shodhana, Cleansing through Marmni 73 Shamana, Palliation of Doshas via Marmni 74 Rasyana, Rejuvenation via Marmni 74 Apunarbhava Chikits, Preventive Therapy through Marmni 75 Sadyah Phaladai Chikits, Marmni as First Aid Therapy 75

viii

Tanmtr, Five Element Chikits 75 Shabda (Sound) 75 Sparsha (Touch) 76 Rpa (Vision) 76 Rasa (Taste) 78 Gandha (Smell) 78 Context of Marma Chikits within yurvedic Therapy 79

Techniques of Marma Stimulation Guidelines for the Practitioner | 81

Techniques of Marma Chikits 10 Methods of Stimulating Marma Points 81 Snehana (Oleation) 81 Svedana (Sudation) 82 Mardana (Deep Connective Tissue Massage) 82 Pdana (Deep, Dry Pressure) 82 Veshtana (Binding or Holding) 83 Lepana (Application of Paste) 83 Agni Karma (Application of Heat) 83 Schi Bharana (Puncturing with Needles) 84 Trasana (Irritation) 84 Rakta Moksha (Bloodletting) 84 Guidelines for Practitioners of Marma Chikits 84 Clinical Knowledge 84 Meditation and Breath Awareness 85 Guidelines for Touch and Pressure 86

INTRODUCTION TO PART TWO | 89 Mukha (Face) and Shiro (Head) Marmni | 92

Mrdhni or Adhipati 94 Brahmarandhra 97 Shivarandhra 98 Spiritual Aspects of Mrdhni, Brahmarandhra and Shivarandhra 100 Kapla 101 j or Sthapan 102 Shankha 104 Bhrh Antara / Bhrh Madhya / Bhrh Agra 105 Ashr Antara / Ashr Madhya / Ashr Agra 107 Kannaka 108 Apnga 109 Antara Vartma / Madhya Vartma / Bhya Vartma 110 Ns Mla 112 Ns Madhya 113 Ns Agra 114 Ns Puta 115 rdhva Ganda 116 Adhah Ganda 117 Kapola Ns 118 Kapola Madhya 119 Oshtha 120 Hanu 122 Chibuka 123 Marma Head and Facial Massage 124 ix

10 Shiro (Head), Grv (Neck) and Karna (Ear) Marmni | 126

Manymla 128 Vidhuram 129 Kriktik 131 Grv (4) 132 Manymani 133 Kantha 134 Kanthand 136 Mantha 137 Sirmantha 138 Akshaka 139 Jatru 140 Karnapl 142 Karnapla or Karna rdhva 143 Karnamla (2) 144 Marma Massage for Back of the Head and Neck 145 Kakshadhara or Skandadhara 150 Apastambha 151 Hrid Marmni (3) 152 Hridayam 154 Agra Patra 155 Stanya Mla 156 Stanya or Chuchuka 157 Stanya Prshva 158 Prshva Sandhi 159 Vankri 160 Yakrut 161 Plh 163 Srya or mshaya 164 Nbhi Marmni (5) 165 Basti 168 Bhaga 169 Vankshana 171 Lohita 172 Marma Massage for the Trunk 173 Amsa Phalaka 176 Prushtha or Antar Amsa (3) 177 Bruhat 178 Vrukka 179 Kukundara 181 Kati 182 Trik 183 Marma Massage for the Back 184 rdhva Skandha 188 Amsa 189 Adhah Skandha 190

11 Antaradhi (Chest and Trunk) Marmni | 148

12 Prushtha (Back) Marmni | 174

13 rdhva Shakhah (Upper Extremities) Marmni | 186

Kaksha 191 Bhu rv 192 n 193 Bh Indrabasta 194 Krpara 196 Bhya Krpara 197 Angushtha Mla 198 Bhya Manibandha 199 Manibandha 200 Krcha Shira 201 Tala Hrida 202 Krcha 203 Hasta Kshipra 204 Tarjani 205 Kanshthika 206 Marma Massage for the Arms and Hands 208

14 Adha Shakha (Lower Extremities) Marmni | 210

Sphij 213 r (2) 214 Lohitksha 215 Medhra and Yoni Jihv 216 Vrushana and Yoni Oshtha 217 Sakthi rv (2) 218 Jnu (2) 219 Charana (2) 221 Indrabasta (2) 222 Gulpha (2) 223 Pda Charana 225 Pda Kshipra 226 Prshni 227 Pda Madhya 228 Marma Massage for the Legs And Feet 229

INTRODUCTION TO PART THREE | 231

15 Aromatherapy, Essential Oils and Attars in yurveda | 233 16 Marmni that Treat Channel Disturbance | 241
Introduction to Srotmsi 241 Disturbance and Treatment of Srotmsi 242 Prna Vaha Srotas 243 Ambu/Udaka Vaha Srotas 243 Anna Vaha Srotas 244 Rasa Vaha Srotas 244 Rakta Vaha Srotas 245 Mmsa Vaha Srotas 246 Meda Vaha Srotas 247 Asthi Vaha Srotas 248 Majj Vaha Srotas 248 Shukra/rtava Vaha Srotas 249 Pursha Vaha Srotas 250

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Mtra Vaha Srotas 251 Sveda Vaha Srotas 251 Mano Vaha Srotas 252

17 Management of Specific Disorders with Marma Chikits | 255

Sadyah Phaladai Chikits yurvedic First Aid 255

18 Yoga Therapy and Marmni | 263

sana and Marmni 266

Appendix A: Specialized yurvedic Information | 275 Appendix B: Specialized TCM Information | 285 Appendix C: Marma Illustrations | 291 Appendix D: Marmni and Acupoints: Correspondences, Locations and Lists | 307 Glossaries: yurvedic, Chinese and Medical | 315
Ayurvedic Glossary 315 Chinese Glossary 328 Medical Glossary 329

Bibliography and References | 333 Acknowledgments | 335 Index | 337

xii

The Spiritual Dimension of Marmni

Marma chikits is the precise art of touching an individual in exactly the right place at a critical moment in time, for the purpose of healing. Marmni serve as points of access to the bodys innate intelligence, opening the doorway to health and well-being. They are vehicles to reach the ultimate goal of yurveda: perfect health, firmly rooted in a vibrantly alive body and fully awakened mind. In this chapter, we discuss the rich and significant spiritual dimensions of marmni. Because marmni are intimately connected to thoughts, perceptions and emotions as well as to the entire fabric of the physical body, marma chikits can be a powerful ally on the spiritual path, helping to settle the mind and enhance awareness in such practices as meditation, prnyma (breath control) and yogsana, and to free the mind and body of the accumulated stresses and toxins that limit consciousness and burden the heart.

touch can engender radical change in the neurochemistry. The human body is a unique chemical laboratory; a touch through the energy points of marmani can open new pathways that affect our inner pharmacy. Certain marma therapies can not only enhance thinking, feeling, and perception, they also have the potential to evoke a state of choiceless, passive awareness and transform it into a transcendental state of samdhi. Thus, the total healing of body, mind and spirit can happen through marma chikits.

Mahad: Innate Intelligence of the Body and the Universe

In Snkhya philosophy, mahad or cosmic intelligence creates order in the universe. It permeates every aspect of creation from the gross to the subtle and from the macrocosm to the microcosm, from the order governing the vast galactic universe to the infinitesimal genetic code guiding the unfoldment of life within every living cell. On the physical level, the body is shaped by mahad to reflect the perfect harmony of structure and function. The five elements govern structure, the three doshas rule function, and the seven dhtus (bodily tissues) influence both structure and function. This microcosmic mahad is evident in the precise locations of the marmni mapped within the matrix of majj dhtu, the nervous system. On the mental level, cosmic intelligence manifests as individual consciousness, which expresses itself as the principal mental faculties: manas (sensory

The Spiritual Value of Touch

Touch begins on the physical level, but it can go much deeper, traversing the media of thoughts, feelings, and emotions. Touchthe skilled touch of a sincere practitioner of the healing artscan convey its message of love through prna into the manas, buddhi, smruti. It can penetrate ahamkra and speak its silent message through chitta into the soul. 1 Along the way, and especially at this deepest level,
1. We have discussed these levels and facets of the mind in chapter 1, in outlining the Snkhya philosophy. In brief, mind is generally referred to as manas, the mental faculty that regulates perception, thought and emotion. A subtler aspect of mind is buddhi, the individual intellect and faculty of discrimination and recognition. Buddhi in turn has three subdivisions: dhcognition, dhrutiretention, and smrutimemory. Ahamkra is ego, the sense of I.

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The Spiritual Dimension of Marmni

mind) and buddhi (intellect). The marmni are intimately connected to the mind via majj dhtu and mano vaha srotas (channels of the mind). On the spiritual level mahad, which on the cosmic scale is the flow of consciousness or intelligence that facilitates harmony among all aspects of creation, is given voice in the body through the flow of prna. Prna is the breath that animates the organism and allows its spirit to reside in the body. The entry of consciousness into the marmni allows communication within and between the body and mind via the flow of prna. Marmni are especially relevant to the development of spirituality because of their close association with the chakra system (see below). Thus, they support the integration of all three levels of being: body, mind and spirit.

so on, based upon our particular background. The more our background dominates our experience, the more we lose the ground. Particular mind freezes our perception. And because of our frozen perception, we see our world as we see it now. Marma therapy has the capacity to help us unfreeze this perception, via the media of majj dhtu and mano vaha srotas. In this way marma chikits can improve the quality of perception. It brings clarity. Clarity of perception becomes compassion; and compassion is love.

Marmni and Mind/Body Medicine

Within one month, we have totally new skin, as far as the atoms and cells are concerned. Our superficial self dies and a new one takes shape. In the space of four days, we have a completely new gastro-mucous lining. In a period of six months, all the atoms of the liver are replaced and we have an entirely new liver. Like these constant changes in the body, everything in the universe is changing. There is nothing permanent in this world. Only change itself is permanent. These changes are happening on the vast screen of awareness, which is eternal, timeless existence, the unchanging ground upon which all change occurs. At this time in history, important changes are taking place in the Western scientific understanding of mind and body, and of the nature of life itself. The old paradigm, which held that mind lives in the brain, is giving way to a new paradigm that says the brain lives in the mind. The old paradigm assumed that mind is within the body. The new paradigm asserts that the body is in the mind. According to the old paradigm, mind and body are separate and distinct, the concrete, solid, material body being real and the abstract, non-physical mind grudgingly accorded a shadowy sort of existence. The new paradigm says that we cannot separate body from mind. The body is crystallized mind, and mind is the energy aspect of the body. To speak of mind and body as two distinct entities is simply not true, and creates confusion and separation. That is why we speak today of mind-body medicine. yurveda has always recognized this. From the yurvedic perspective, going back thousands of years, we really should speak of mind-body or bodymind, because they are one. Anything that happens in mind influences the body, and vice versa. Mind is a flow of thought, as a river is a flow of water. As

Universal Mind and Particular Mind: Opening to Infinity

According to the Snkhya philosophy of creation, there is universal mind, called vibhu, and individual mind, called anu. Universal mind is the ground mind, and individual mind is particular mind. Universal mind is vast, unbounded, infinitely creative and eternally pure, unclouded consciousness. Particular mind is conditioned mind, based upon its stockpile of thoughts, feelings, and emotions stored in memory. Memory is the background to all we think, feel and perceive, and imposes itself upon the foreground of pure, direct experience. The more the particular mind fails to apprehend the ground mind, the more life becomes suffering. The root cause of suffering is this division between the ground mind and the particular mind. Through marma therapy, new pathways are opened within the mano vaha srotas, which allow particular mind to transcend its conditioned state and expand into universal mind. This unity of individual mind and universal mind brings radical transformation and total healing in the life of the individual. Ground mind belongs to all. It operates through the sun, the moon, rivers, mountains, oceans, the flowers and the trees. In our daily perception, particular mind creates division in which you become the observer and that becomes the object, the thing to be observed. When the observer is unaware of both the pure essence of ground mind and its all-permeating presence within all things, our powers of observation are very limited. This limited observation creates judgment, criticism, like and dislike and

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Mahad: Innate Intelligence of the Body and the Universe

the water, so the river. If the water is clear, the river is clear. If the water is polluted, the river is polluted. Likewise, as the thought, so the mind. If our thoughts breathe fear, mind becomes fearful. If angry thoughts flow or flood through the mind, the mind becomes anger. On the other hand, if thought is clear, mind is clear. As a change in the water is a change in the river, a change in the nature of our thoughts is a change in the mind. Moreover, every change in our mental state is instantaneously reflected in the chemistry and functioning of the body. On the cutting edge of this newly emerging model, in which the ancient understanding is being corroborated by extensive research, mind and body are no longer considered two different vehicles of experience. Mind is not a localized entity, to be sought somewhere in the electrochemical activity of the brain, but rather it pervades the entire physical body from every cell to every fiber. Mind and body are not just interconnected, but are one cohesive entity with both physical and mental manifestations. The term mano vaha srotas means the pathway of the mind. Mano means mind, vaha implies carrying, and srotas means pathway or channel. To describe the mind as a lively channel of energy captures its reality as fluid movement. Mano vaha srotas is not a thing but a continuous flow or stream of consciousness. It is one of the fourteen principal channels described in more detail in chapter 16.

Each channel is a network comprised of a root, a pathway and an opening. Mano vaha srotas has its root in the heart, brain and chakra system. The mind originates through these three centers. The pathway of mano vaha srotas encompasses the entire person, through what the Vedanta school of Indian philosophy calls the five koshasauric fields representing five planes or sheaths of existence of varying density. Ranging from subtle to gross, these are:
nandamaya kosha (bliss body) vijnamaya kosha (wisdom body) manomaya kosha (mental body) prnamaya kosha (breath body) annamaya kosha (physical or food body)

The koshas are discussed extensively in Sanskrit texts but the subject is too vast for this presentation. (H.H. Adi Shankaracharaya 1999) The opening of mano vaha srotas is where the energy flourishes and can be accessed. There are three principal openings for the channel of the mind: the synaptic space between neurons, the sense organs and the marmni. Thus, marmni provide direct access to the mind, bridging it with the physical body. Majj dhtu, nervous tissue, is the medium through which the marmni express themselves. It acts as an intermediary between prna vyu, which governs sensory stimuli, and apna vyu, which governs motor response. Each dhtu is associated with a channel system. Majj vaha srotas is the channel of the nervous system. Its roots are the brain, spinal cord and bone marrow; its passage is the entire central nervous system, including the sympathetic and parasympathetic nervous systems; and its opening is the synaptic space and neuromuscular cleft. Majj vaha srotas includes structures such as the cerebrum, cerebellum, spinal nerves, and sensory and motor nerves. Majj dhtu and majj vaha srotas are intimately related, function together harmoniously, and are the substratum of mano vaha srotas. Majj provides the structure, while mano vaha srotas is the function. Majj dhtu forms the cable wires through which the electric current of mano vaha srotas passes. Together, they govern all the basic cognitive functions of the mind: comprehension, recognition, memory storage and communication. They facilitate

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The Spiritual Dimension of Marmni

the capacity to perceive clearly, concentrate and meditate. These mental functions operate based on three subdoshas: tarpaka kapha is responsible for memory, sdhaka pitta for cognition and prna vyu for sensory perception. Deeper examination of the mind reveals its presence at the marma sites. Each energy point is related to manas, the sensory mind, and directly communicates perception, thought and emotion. Every marma is also related to buddhi, via cognition, retention and memory, because marmni are doorways to the nervous system and related mental faculties. The subconscious memories mentioned above in our discussion of ground mind and particular mind are stored in the deep connective tissue of majj dhtu. These memories can be directly accessed by stimulating the marmni, as they are a part of majj dhtu. Marmni are intrinsically connected to the mind via the media of majj dhtu and mano vaha srotas. There is a dynamic interplay between the mind and the energy points, and understanding this relationship is essential for healing. In a healthy system, marmni are sites of vitality where consciousness flourishes and flowers. Pure awareness flows gracefully through the doorways of marmni and, as all rivers finally merge into the ocean, all pranic energy that courses through the marmni finally merges in the ocean of awareness. However, when the mind becomes stagnant or clogged, the flow of prna is similarly obstructed, like a river that is stagnant or polluted, and the marmni mirror this. Blockage at a marma is the obstructed flow of awareness. If the mind is overactive, the marmni reflect this too, becoming painful, sensitive or tender. Likewise, disturbance at the level of a marma is reflected in the mindrevealing the inherent mind/body connection. This is why, for rapid spiritual evolution, a comprehensive mindbody program is so helpful;2 a program that integrates meditation and breathing with purification procedures for the body and nervous system.

Chakra means a vortex of energy. The chakra system comprises seven principal energy centers aligned along the spinal column, from the crown of the head to the tip of the tailbone. Chakras are nonphysical in nature, but correspond to major nerve plexuses that relate to the endocrine centers. The chakra system is one of the pathways of mano vaha srotas in yurveda. Thus, each chakra is deeply connected to the mind and reflects a specific quality or level of consciousness. For example, survival is associated with the root chakra and enlightenment with the crown chakra. Table 48 on page 282 in appendix A outlines the properties of each chakra and table 49 on page 282 elucidates various subtle therapies based on the chakras. A brief description of each chakra and its relationship to the elements and koshas follows. Mldhra. This is the root chakra of survival and groundedness. Related to the earth element, it is where matter meets with matter, environmental matter with bodily matter. Mldhra is connected to the annamaya kosha, the physical or food body and is governed by apna vyu. Svdhishthna. The basic survival needs that drive a person dominated by Mldhra chakra are food, shelter and clothing. Once a person has these, he or she thinks about sex and procreation, where the male energy meets the female energy. Svdhishthna is the chakra of self-esteem, and procreation. This chakra is associated with the water element. Without water, there is no sexual pleasure; dry sex is painful. Both the Cowpers gland in men and the corresponding Bartholins gland in women secrete a lubricating fluid during sexual intercourse. This gives joy and ecstasy to both partners. Thus, this chakra is the meeting point of male and female energy. Manipra. This chakra, literally the city of gems, is the chakra of power, prestige, and position in society, of ambition, competitiveness and aggressiveness. It is the fire element chakra, and is related to pitta dosha. Once people have food to eat, shelter and a sexual partner, they think about power and politics. Here, leader meets with the led. Like Mldhra and Svdhishthna, Manipra belongs to our animal nature. Every animal needs food, shelter, sex and power. Birds have their pecking order, monkeys have an alpha monkey, a king, bees have a queen who controls millions of other bees. Most creatures, driven by the need to survive and thrive, vie with each other for dominance in their group.

Chakra System
The nature of the mind-body model can also be analyzed and understood in terms of the chakra system.
2. As explained in chapter 18, Yoga Therapy and Marmni.

30

rdhva Shakhah (Upper Extremities) Marmni

90. Bhya Manibandha

Yangxi LI-5

84

Hegu LI-4

89. Angushtha Mla

9
Shaochong HT-9

96. Tarjani
Shangyang LI-1

Yuji

97. Kanshthika

Lao PC-

92. Krcha Shira

Triquetral Bone Ulnar Head
Hasta (Hand) Marmni (9) # 89 90 91 92 93 94 95 96 97 Marma Points Angushtha Mla Bhya Manibandha Manibandha Krcha Shira Tala Hrida Krcha Hasta Kshipra Tarjani Kanshthika Page 198 199 200 201 202 203 204 205 206 Acupoint LI 4 LI 5 PC 7 SI 5 PC 8 LU 10 LU 11 LI 1

HT 9

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Chapter 13

Upper Extremities Marmni

80. rdhva Skandha

Jianjing GB-21
(all points are paired)

rdhva Skandha
Location. At the superior aspect of the trapezius muscle, midway between the tip of the spinous process of C7 and the tip of the acromion. Associated Doshic Subtypes. Prna Vyu, Udna Vyu, Vyna Vyu, Avalambaka Kapha, Shleshaka Kapha

Action
Relieves local pain Relieves stiffness in shoulder Facilitates flow of prna into lungs and upper chest Relieves occipital headaches Relieves stress, calms the mind Releases stagnant, unexpressed emotions

Indications
Pain, stiffness or tightness in neck and upper back Radiculopathy (pinched nerve) Interscapular pain due to muscle tightness Degenerative joint disease (DJD) Adhesive capsulitis (frozen shoulder), bursitis, shoulder pain Rotator cuff tendonitis, bicipital tendonitis Occipital headaches Shortness of breath, asthma, hiccups, bronchitis Stress, mental fatigue, insomnia

Commentary
Two principal marma points influence the shoulder. One is rdhva Skandha on the upper aspect of the trapezius muscle, and the other is Adhah Skandha on the lateral aspect of the shoulder. They can be used in conjunction with each other to relieve disturbance of the shoulder joint. The marma on the right corresponds to the liver and on the left to the spleen. Skandha may be poetically translated as shouldering responsibility. rdhva Skandha is located at a part of the body associated with support. The Grv marmni located on the back of the neck are also linked with responsibility. Many individuals in modern society carry the weight of the world on their shoulders. As a result, they develop pain and stiffness in the neck, shoulders and upper back; commonly, the necks range of motion also becomes limited. Pain may radiate to the occipital region of the head. Indeed, stress is one of the most common causes of occipital or tension headaches. Tension accruing in these areas also leads to mental fatigue and insomnia. Stimulating rdhva Skandha relieves these conditions and facilitates the flow of prna to the lungs and upper chest. Hence, treatment here benefits many lung conditions and may relieve hiccups, a disturbance of udna vyu, the upward moving energy. Pressure on rdhva Skandha stimulates the downward flow of energy.

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Amsa

Skandha is the name of one of the sons of Lord Shiva and his wife Prvat, two important deities in Hinduism. (The other son is Ganesha.) In South India, the deity Skandha is also known by the names Murga, Krttikeya and Subramanyam. He is often portrayed as a warrior armed with bow and arrow who carries tremendous responsibility. His bow rests on his shoulder and touches Skandha marma.

Treatment
Skandha marmni may be massaged with vacha or camphor oil, along with other marmni on the upper limbs. Deep massage with mahnryana oil or Tiger Balm relieves pain and stiffness locally and soothes tense muscles.

Corresponding Acupoint: GB 21, Jianjing (Shoulder Well)

GB 21 is a principal acupoint on the Gallbladder meridian. It is located midway between GV 14 (which corresponds to Manymani at the base of C7) and the tip of the acromion. It shares the same functions as rdhva Skandha for aligning the shoulders and descending rebellious Qi, the equivalent of hyperactive udna vyu. Unlike Skandha marma, GB 21 is not indicated for insomnia, headaches in the occipital region, or any of the lung conditions mentioned. GB 21 also benefits the breasts for local pain, abscesses and difficulty with lactation. Classical texts mention its use for uterine bleeding and phlegm accumulation into nodules.

Amsa
Location. At the top of the shoulder at the center of the acromion. Associated Doshic Subtypes. Prna Vyu, Vyna Vyu, Udna Vyu, Avalambaka Kapha, Kledaka Kapha, Shleshaka Kapha

81. Amsa

Action
Gives freedom of movement to the shoulder Relieves pain and stiffness locally Enhances flow of prna Benefits ears Stimulates pancreatic function Relieves stress

Indications
Shoulder pain, bursitis Rotator cuff tendonitis, bicipital tendonitis Adhesive capsulitis (frozen shoulder) Asthma, bronchitis Palpitations Tinnitus (ringing in the ears), earache Pancreatic dysfunction Emotional tension, stress, fatigue

Jianyu LI-15

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Chapter 13

Upper Extremities Marmni

Commentary
Amsa is translated as the top part of the shoulder or lung. Similar to rdhva Skandha, Amsa can relieve shoulder pain and improve conditions where there is a limited range of movement. Both marmni stimulate shleshaka kapha, which lubricates the joints and is affected whenever there are joint disorders. Both also enhance the flow of prna to the lungs and treat asthma and bronchitis. Of the two, rdhva Skandha is more effective. Stimulating udna vyu via these marmni promotes vitality and energy, thereby reducing stress, fatigue and emotional tension. Amsa calms down palpitations, a disturbance of vyna vyu. It also aids in balancing blood sugar and can be massaged if there is pancreatic dysfunction. The marma on the right is associated with the liver and on the left with the spleen, similar to rdhva Skandha.

Treatment
Refer to rdhva Skandha Treatment section, page 189.

Corresponding Acupoint: None

Close to LI 15, Jianyu (Shoulder Bone) LI 15 shares Amsas ability to benefit the shoulder and arm. It dispels Wind according to TCM theory, an action similar to Amsas ability to balance the vyus, subtypes of vta dosha. Unlike Amsa, LI 15 is also indicated for the treatment of goiter, seminal emission and hypertension.

Adhah Skandha
Location. On the lateral side of the upper arm, in a depression between the insertion of the deltoid and brachialis muscle. Associated Doshic Subtypes. Prna Vyu, Vyna Vyu, Udna Vyu, Avalambaka Kapha, Kledaka Kapha, Shleshaka Kapha, Pchaka Pitta

82. Adhah Skandha

Action
Benefits upper extremities and shoulders Influences lungs and stomach Relieves stress, stagnant emotions

Binao LI-14

Indications
Adhesive capsulitis (frozen shoulder), shoulder pain, bursitis Neuropathy of upper extremities, tremors Poor circulation, cold hands, forearm pain Lymphedema (swelling) of upper extremities Congestion in lungs, asthma, bronchitis High acidity, gastritis Emotional disturbance

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Vasant Lad

Marma Points of Ayurveda The Energy Pathways for Healing Body, Mind and Consciousness with a Comparison to Traditional Chinese Medicine
384 pages, publication 2008

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