A STUDY ON SANDHI MARMA W. S. R. TO REGIONAL AND …
Transcript of A STUDY ON SANDHI MARMA W. S. R. TO REGIONAL AND …
A STUDY ON SANDHI MARMA W. S. R. TO REGIONAL AND APPLIED ANATOMY OF KURPARA MARMA
BY
DR. SIBGATH ULLA SHARIFF R, B.A.M.S
Dissertation submitted to the
Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka
In partial fulfillment of the requirements for the degree of
DOCTOR OF MEDICINE (AYURVEDA)
IN
SHAREERA RACHANA
UNDER THE GUIDENCE OF
DR. G. M. KANTHI. B.S.A.M.; D.H.A.; Ph. D (RACHANA)
PROFESSOR
DEPARTMENT OF P.G. STUDIES IN SHAREERA RACHANA
DEPARTMENT OF P. G. STUDIES IN SHAREERA RACHANA
S. D. M. COLLEGE OF AYURVEDA, UDUPI
2010 - 2011
Observation 52
Department of Shareera Rachana, SDMCA, Udupi.
STUDY METHOD
The dissection of five cadaver in which ten Elbow joint specimen has been carried
out as per the Cunningham’s Manual of practical anatomy. Dissection procedure carried
out layer by layer, observed and studied thoroughly.
SKIN:
The skin consists of hair follicles.
SUPERFICIAL FASCIA:
Following Structures were observed in superficial fascia –
Median Cubital vein.
Cephalic vein.
Basilica vein
DEEP FASCIA:
It is continuous with the fibers of the superficial fascia, and sends wide partition
or septa between the muscles from its deep surface.
BICIPITAL APONEUROSIS:
It is a strong slip which extends medially from the tendon of biceps into the deep
fascia. Thus it is indirectly attached to the subcutaneous, posterior border of the ulna
which is fused with the deep fascia.
Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka
DECLARATION BY THE CANDIDATE
I hereby declare that this dissertation entitled “A STUDY ON SANDHI
MARMA W. S. R. TO REGIONAL AND APPLIED ANATOMY OF KURPARA
MARMA” is a bonafide and genuine research work carried out by me under the
guidance of Dr. G. M. Kanthi, B.S.A.M.; D.H.A.; Ph. D, Professor & Head, Department of P.G.
Studies in Basic Principles.
.
DATE: Signature of the Candidate
PLACE: UDUPI (DR. SIBGATH ULLA SHARIFF. R)
Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka
CERTIFICATE BY THE GUIDE
This is to certify that the dissertation entitled “A STUDY ON SANDHI
MARMA W. S. R. TO REGIONAL AND APPLIED ANATOMY OF KURPARA
MARMA” is a bonafide research work done by Dr. Sibgath Ulla Shariff R., in partial
fulfillment of the requirement for the degree of Doctor of Medicine in Ayurveda, under
my guidance.
Signature of the Guide
Dr. G. M. Kanthi B.S.A.M.; D.H.A.; Ph. D Professor,
DATE: Dept, of P.G Studies in Shareera Rachana,
PLACE: UDUPI S D M College of Ayurveda, Udupi
Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka
CERTIFICATE BY THE H.O.D, / PRINCIPAL HEAD OF THE
INSTITUTION
This is to certify that the dissertation entitled “A STUDY ON SANDH MARMA
W.S.R. TO REGIONAL AND APPLIED ANATOMY OF KURPARA MARMA” is
a bona fide research work done by Dr. Sibgath Ulla Shariff R under the guidance of
Dr. G. M. Kanthi, B.S.A.M,; D.H.A,; Ph. D, Professor & Head, Department of P.G. Studies in
Basic Principles.
Signature of the H.O.D. Signature of the Principal
Dr. U. Govindaraju Dr. U. N. Prasad M .D (Ayu) M. D (Ayu)
Dean & Head. Principal Dept. of P.G Studies in Shareera Rachana S D M College of Ayurveda, Udupi S D M College of Ayurveda, Udupi
DATE: DATE:
PLACE: UDUPI PLACE: UDUPI
COPYRIGHT
DECLARATION BY THE CANDIDATE
I hereby declare that the Rajiv Gandhi University of Health Sciences, Bangalore,
Karnataka shall have the rights to preserve, use and disseminate this dissertation in print
or electronic format for academic / research purpose.
DATE: Signature of the Candidate
PLACE: UDUPI (DR.SIBGATH ULLA SHARIFF. R)
© Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka
Lists
Department of Shareera Rachana, SDMCA, Udupi.
INDEX
SL. NO. CONTENTS PAGE NO.
1 INTRODUCTION 1 – 2
2 OBJECTIVES 3 – 4
3 REVIEW OF LITERATURE 5 – 50
4 METHODOLOGY 51
5 OBSERVATION 52 – 56
6 REGIONS OF DISSECTION 57 – 59
7 RADIOLOGICAL FILMS 60 – 62
8 DISCUSSION 63 – 67
9 CONCLUSION 68
10 SUMMARY 69 – 70
11 SHLOKA’S 71 – 84
12 BIBLIOGRAPHY 85 – 101
Lists
Department of Shareera Rachana, SDMCA, Udupi.
LIST OF TABLES
Table No.
Description
Page No.
01.
Sadhya Pranahara Marma
10
02.
Kalantara Pranahara Marma
10
03.
Vishalyaghna Marma
11
04.
Vaikalyakara Marma
11
05.
Rujakara Marma
12
06.
Anguli Pramana
13
07.
Classification of Marma
14
08.
Urdhwa Shakhagata Marma
15 – 20
13.
Marma Paancha Bhoutikatva
21
14.
Rujakara Marma
27
15.
Classification of Synovial Joint
37
16.
Movements and Definition
40
Lists
Department of Shareera Rachana, SDMCA, Udupi.
LIST OF FIGURES
Figure number
Description
Page no.
01
Ligaments of Elbow Joint (Ant. Aspect)
48
02
Intracapsular & Annular Ligament.
48
03
Ligaments of Elbow Joint (Lateral Aspect)
49
04
Ligaments of Elbow Joint (Medial Aspect)
49
05
Posterior Aspect of Elbow Joint
50
06
Region of Elbow Joint( Right)
57
07
Articular Capsule
57
08
Capsular Ligament
58
09
Radial Collateral ligament
58
10
Ulnar Collateral Ligament
59
11
Articular Surfaces of Elbow joint
59
12
RadiologicalFindings
60 - 62
Acknowledgement
Department of Shareera Rachana, SDMCA, Udupi.
ACKNOWLEDGEMENT
At this jovial jiffy of elated integrate of my work, I meekly bow my head on the
feet of almighty who have poured in me constant shore up for the liberation of crossing
this mile stone as well as all success, progress & achievements in my life.
I am in short of words while paying my chivalrous & affable regards to my
admired Dad Sri Rahamath Ulla Shariff & my beloved Mother Fathima Begum, in whom
I experience the blessings of God, for their supports, sacrifice & encouragement which
brought me up to this stage. My inner strength, really none other than my beloved
Brother Sadath Ulla Shariff & my sister Dr. Saba Shabnam, whose prop up, suggestion,
adore & care is the dynamic force in each & every steps of my life.
I take this opportunity to express my earnest gratitude to The Principal, SDM
College of Ayurveda, UDUPI, Dr. U.N Prasad for letting me disentangle the world of
Ayurveda and explore the colossal possibilities.
I put into words my deepest feeling of admiration towards my beloved teacher &
guide, Dr. G .M. Kanthi, Prof. & H.O.D, Dept. of Basic Principle’s whose stirring
brainwave; persistent guidance finely tuned me to plot this murky task. Besides this, his
tangy prosperity always provided me enough courage to filch up with each & every task.
I am short of glossary to thank my beloved respected preceptor and honourable
Dean, Professor & HOD Dept. of Shareera Rachana, Dr. U. Govindraju whose masterly
suggestions & ablest guidance at every step which has molded, twisted, and enlightened
my elfin work into achievement.
I bring about my authentic thankfulness to Dr. V.K.S. Holla, Prof. Dept. of
Shareera Rachana, for his shrewd direction, stanch benefaction, logical & significant
suggestion which fictitious this activity a prolific.
I convey my ingenuous gratefulness to my adored tutor Dr. Krishnamurthy,
Lecturer, Dept. of Shareera Rachana, for his diligent work, gleaming conception for
various difficulties right from the beginning, which made this work possible.
Acknowledgement
Department of Shareera Rachana, SDMCA, Udupi.
I am indebted to utter my thanks to my beloved master of solutions Dr.Nithin
Kumar Lecturer, Dept. of Shareera Rachana, for his astute guidance & shall forever be
beholden to Dr. Rajendra Pai & Dr. Prahlad for their sensible direction.
It is my privilege to eloquent my heartfelt thanks to Dr.Muralidhara Sharma, Prof.
Dept of Shalya Tantra, whose sanguine views, noble nature, always put vigor in me to
overcome the obstacles.
I sequester this occasion to eloquent my gesticulate to resourceful Surgeons, Dr
Raju (MS Ortho), Dr. Satya Surendra Sai (MS Ortho), Dr. Shaanu Bag (MS Ortho), Dr.
Venkatesh (Gen. Surgeon) for their deliberating pedagogic views which helped me to
extract the concealed principles.
I wish to offer my earnest thanks to Former Deans Prof. Dr.B.V.Prasanaa, & Prof.
Dr. Shrinkanth U, for Post Graduate faculty, S.D.M. college of Ayurveda for their
encouragement and support.
I cannot move further before thanking to my cherished friends Dr. Thushara, Dr.
Seetharam, Dr.Vijaynath, Dr.Vipin, Dr. Shreekumar, Dr. Vineeth, Dr.Shailesh,
Dr.Ananth, Dr.Prakash, for being with me by providing honest support to surmount each
& every barrier successfully.
It is gaffe to my element if I won’t tell thanks to my seniors Dr. Anju, Dr. Harsha,
Dr. Pratibha, & Dr. Indu & also express appreciation to my juniors, Dr. Paramesh,
Dr.Shakti, Dr.Jyoti, Dr.Remitha, & Dr. Vibha for their academic support.
I am very thankful to Mr. Prabhakar, & Mr. Sadhu attenders dept. of Shareera
Rachana, staff of Library, Hospital, Samruddhi Xerox and all my volunteers for their
brand teamwork, which was very much requisite for the booming sleeve up of this work.
Last but not least I thank to Mrs. Radha and all those who have directly or
indirectly contributed to the successful completion of this notion work.
Abstract
Department of Shareera Rachana, SDMCA, Udupi.
ABSTRACT
Marma’s are described as the vital points in the human body, injury to which ends
in various hazardous crises. The Acharyas mentioned the total numbers of Marma are
107. Acharya Sushruta classified Marma as Mamsa Marma, Sira Marma, Snayu Marma,
Asthi Marma, Sandhi Marma. Archarya Vagbhata added one more classification as
Dhamani Marma, respectively.
Sandhi Marmas are twenty in number. The Kurpara Sandhi Marma is one among
the sandhi marm. It belongs to Vaikalyakara marma.
Although the gross regional and the Viddha lakshana’s are available in Samhitas,
but detail description of particular structures present in Kurpara Marma region are
lacking in ancient texts.
Objective of this study were to make the comprehensive and conceptual study on
Kurpara Marma as mentioned in texts, in the view of regional and applied anatomy
described in the contemporary science, and to study Kurpara Marma sthanagata shareera
with modern regional and applied anatomy by cadaver dissection and x-rays.
Literary and conceptual study will be on the data compilations from various
Classical books and cadaveric dissection is done to see the structures related to Kurpara
Marma pradesha and discussed particular regional anatomy and its applied anatomy and
structures involved with the help of x-ray is discussed related to the Kurpara marma.
Key words: Kurpara Marma, regional anatomy, applied anatomy.
Introduction 1
INTRODUCTION
Ayurveda is one of the most reliable, novel and complete ancient medical science
which have proved for more than 5000 years. Even though the modern science is
changing from time to time AYURVEDA has maintained its special place till date.
This science existed, such a long and extensive voyage of time, by its fundamental
principles. The unique themes of nature that have been scrutinized, analyzed researched
by the different Ayurvedic Scholars and then applied to the cure of human ailments are
THE BASIC PRINCIPLES OF AYURVEDA.
Without implementation of these principles any science cannot stand for long time
period. These principles are scattered through out the treatise and thus their study is need
of time.
.
Ayurveda has its own principles or concepts which stand in modern era also. The
concept of Marma is one such Imperative and Unique principle of Ayurveda.
Marma Vijnyana was developed as science of war. There are so many references
from Vedas regarding attack on Marmasthanas of enemies and protecting one’s Marmas
by wearing metallic protectants.
Marma’s are the vital points in the body which prove to be fatal when subjected to
trauma. Detail knowledge of Marma is important from surgical point of view; surgical
procedures like Agnikarma, Ksharakarma & Shastrakarma are used as a part of the
surgery. While conducting these surgical procedures, the knowledge of Marma Sthana, is
required, with proper knowledge of Marma Sthana we may perform the procedures
without any complications. In trauma condition the knowledge of trauma site, structures
involving and deformity identification is necessary. So treatment and surgical procedures
both aspect Marma study is important.
Department of Shareera Rachana, SDMCA, Udupi.
Introduction 2
Even in today’s fast life it is very important to protect our Marma Sthanas because of
heavy road traffic which results in accidents causing injury to Marmas. Developing
science invents new military armaments increasing severity of injury during war.
SCOPE OF STUDY
Severe traumatic injuries to Sandhi Marma are very common in today’s advance
life. The incidence of trauma takes place in road accidents of two wheeler and four
wheelers. Pedestrians also gets injury to Kurpara Sandhi when they land in un – noticed
ditched in the street, or fall. Many people twist, sprain and fracture their Kurpara Sandhi
in bath rooms or accidentally toppling over small barricades in the house hold or in the
streets. Ladies slip their feet over slippery kitchens or over the staircases. In players,
while playing the game of football, hockey,cricket, kabaddi, kho – kho etc. The incidence
of severe traumatic injuries to Krupara Sandhi is very common. This was identified at the
time of Ayurveda and such vulnerable spots in the body were called as ‘Marmas’.
The Anatomical changes taking place at Kurpara Sandhi after trauma, injuries
and its correlations with Karupara Sandhi Marma as Vaikalyakara Marma is not fully
worked upon and this knowledge is useful for the precaution, medical and surgical
traumatic of Kurpara Sandhi injured patient and players. So I’m inspired to select this
topic for my research work.
Department of Shareera Rachana, SDMCA, Udupi.
Aims & objectives 3
I) AIMS:
The main aim is to study the Anatomical Structural changes taking place at
Kurpara Sandhi after severe traumatic injuries.
2) OBJECTIVES:
To study the Marma Shareera.
To study the Vaikalyakara Marma in detail.
To study the Kurpara Marma according to Ayurvedic concept.
To study the Kurpara Sandhi Shareera (Anatomy) from Ayurvedic and Modern
point of view.
To compare the Anatomical changes taking place at Kurpara Sandhi after severe
traumatic injuries (i.e. Marmaghata) to the Granthokta Viddha Lakshanan of
Kurpara Marma as Vaikalyakara Marma.
To find out the Anatomical structures situated at the site of Kurpara Marma with
help of Cadaveric dissection.
Department of Shareera Rachana, SDMCA, Udupi.
Aims & objectives 4
PREVIOUS WORK DONE
1. Gupta N.B – Sandhi marmonke samanya pariprekshya mein seemanta marma ka
vaisyanika adhyayan.1991, NIA,Jaipur.
2. Borkar B.A – Urdhwa shakhagata vaikalyakara marma; ek rachanatmaka
adhyayana, 1997, Govt.Ayurved College, Nagpur.
Department of Shareera Rachana, SDMCA, Udupi.
Historical Review 5
HISTORICAL REVIEW
The Marma Sthanas are consider as the vital points in the body, injury to those
Marma Sthanas will leads to different consequences according to their type, location,
structure and effect as they belongs. Sandhi Marmas are one among the marma
classification explained by Acharyas.
Here an attempt has been made to study on Sandhi Marma with special reference
to regional and applied anatomy of Kurpara Marma from Vedic period up to the 21st
century.
VEDIC PERIOD
In Atharvaveda, the term Marma has been point out; if injury takes on Marma
Sthana then it cause death. Also we find the reference of the term Kavacha or corselet or
breast-plate for the protection of Marma Sthanas.
In Rig-veda, reference of the words like varman and drapi, that is some kind of
body armor or corselet to protect the body from assault of enemy weapons on Marma
Sthanas.
The king of then has also been advised to keep their vital parts covered with
“Kavacha” a kind of protector.1
Vishwakarma sharpened Ayudha (weapon) for Indra which was known as Vajra
to be used.
God Indra tormented Vratra(demon) with the help of same by attacking on Marma
sthaana.2
The plastic surgery was practiced in Vedic period due to frequent wars. Ashwini
devas performed plastic surgery on Shayava at three cut places and made him to move.3
Vishphala was rehabilitated by Ashwini kumara providing artificial iron legs.4
Fire (Agni) was used to be the greatest weapon to destroy Marma Sthanas.5
MARMA IN UPANISHAD
Following references can be consider regarding Marma and associated subject
available in different Upanishad.
Department of Shareera Rachana, SDMCA, Udupi.
Historical Review 6
Description of vessels and blood circulation.6
Vascular injuries.7
Characteristics of Sira and Dhamani.8
Physio-anatomy of Hrudaya.9
Marma and Kavacha.10
Marma .11
Dhamani.12
107 Marma’s described in Garbhopanishad.13
PURANA KALA
In Mahabharata the great epic, also we find many references for the Marma or the
Varman.14
In Ramayana, the arrow triggered accidentally by Dasharatha on Marma sthana of
Shravana kumara.15
SAMHITA KALA
The description about Marma Sthanas and structures involved in Sandhi Marma
pradesha along with detailed explanation of Viddha lakshana, and diseases has been
explained in almost all the classical texts written during Samhita kala. All Acharyas are
accepted total numbers of Marmas are 107.
CHARAKA SAMHITA
Acharya Charaka given much importance to the Trimarmas - these are Shira,
Hridaya and Basti by keeping physician in mind. He also mentioned that according to the
surgeon point of view, total numbers of Marmas are 107 in Chikitsa sthana 26th chapter.16
SUSHRUTA SAMHITA
Acharya Sushruta given much importance to Marma Sthansa, he explained
detailed description on Marma, their types, numbers, locations, symptoms if they injured
in Shareera sthana 6th chapter.17
Department of Shareera Rachana, SDMCA, Udupi.
Historical Review 7
DALHANA
Dalhana, the commentator of Sushruta Samhita explained about Marma in
Shareera shthana 6th chapter.18
ASTANGA SANGRAHA AND ASTANGA HRUDAYA
Reference of Marma and its classification is also available in both the grantha’s.
Vruddha Vaagbhata mention about the mama in 7th chapter and laghu vagbhata in 4th
chapter.19, 20
KASHYAPA SAMHITA
Kashyapa accepted trimarma Shira Hridaya and Basti as the view of Charaka and
consider these three Marma are Mahamarma in Shareera sthana 4th chapter.21
BHAVAPRKASHA
Bhava prakasha mentioned detailed description regarding Marma similar to
Sushruta in purva khanda garbha prakarana adhyaya.22
MODERN PERIOD
In the field of modern anatomy and medicine, the vital point structures related to
surface, regional and applied anatomy can be traced in various text books.
Marma Vignana may be taken as synonym of Traumatology. Preference of
surgery is a skill which requires perfect knowledge of pre operative, operative and post
operative measures. The history of trauma can be anticipated from the date, survival is
the fittest existing.
Trauma has posed a major civil problem of today. Widespread use of auto
mobiles and frank use of fire arms have lead to trauma epidemic.
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 8
REVIEW OF LITERATURE
MARMA SHABDHA VYUTPATTEE
Marma word meaning is Jeeva sthana.
According to Shabda Kalpa Druma, Marma word is derived from Mru Dhatu
combined with Manin Pratyaya gives rise to word Marma which means Jeeva sthane,
sandhi sthane or taatparya.23
MARMA SHABDA NIRUKTI
Marma’s are the specific locations on the human body, which when traumatized,
will either surely cause death or permanent deformity with extreme pain.24
MARMA DEFINATIONS
‘Marma’s (vital spots) consists of aggregate of Mamsa, Sira, Snayu, Asthi, Sandhi
in which Prana by nature stays, that is why injury to marma’s leads to respective
consequences’.25
Dalhana explains Prana as Agnyadaya.26
Aacharya Sushruta explains the Dvadasha Pranas as Agni, Soma, Vayu, Satva,
Rajasa, Tamasa, Panchaendriyas and Bhutatma are considered as Prana, because right
from the fertilization they perform and control the functions of life till death.27
Acharya Charaka explains Dasha Prana as Murdha, Kantha, Hridaya, Nabhi,
Guda, Basti, Ojah, Shukra, Shonita and Mamsa. First six ie Murdha, Kantha, Hridaya,
Nabhi, Guda, Basti are comes under Marma Sankhya.28
According to Ashtanaghridya, Marma is that spot of the body which exhibits a
peculiar pulsation or unusual throbbing and cause pain on pressure..29
Marma’s are considering as Jeevadharani, where mainly prana resides. 30
The point of the body which leads to death when injured is marma.31
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 9
The Marmas (vital spots) are so called because they cause death when injured and
they are the meeting place of Mamsa, Asthi, Snayu, Dhamani, Siras and Sandhi, life
entirely resides in them.32
That which leads to death or which gives misery to individual similar to death when
injured is called Marma. This clarifies that some marma on injury are fatal, some are fatal
after period of marmas when injured.33
CLASSIFICATION OF MARMA
There are total 107 Marma’s in the human body34.These are classified according to
location types, structures involved, and effect wise after trauma. They are classified into
five types.
It is clear mentioned that there is no any other sixth type of Marma than Mamsa, Sira,
Snayu, Asthi, Sandhi.35
‘Dalanhacharya’ states that though Marmas can be classified in to many subtypes, all
of them can be included in five principal types explained by Sushrutacharya. This
principal is also applicable to ‘Dhamani’ Marma, described by Vaghabhattacharya.36
I) CLASSIFICATION ACC. TO SHADANGA SHARIRA 37, 38, 39
1) Shakhagata - 11 (11x4) = 44
2) Madhya Shareera - 14 + 12 = 26
3) Jatru Urdhwgata Marma - = 37
. -
Total = 107
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 10
II. CLASSIFICATION ACC. TO EFFECT OF MARMA
1. SADHYA PRANAHARA MARMA40, 41
Sr. No. Name No. Sr. No. Name No.
1)
3)
5)
7)
Shrungataka 04
Shankha 02
Guda 01
Basti 01
2)
4)
6)
8)
Adhipati 01
Kantha Sira (Matruka) 08
Hridaya 01
Nabhi 01
Table – 1: Showing Sadhya Pranahara Marma
2. KALANTARA PRANAHARA MARMA42, 43
Sr. No. Name No. Sr. No. Name No.
1)
3)
5)
7)
9)
11)
Stanamula 02
Apalapa 02
Simanta 05
Kshipra 04
Katikatarua 02
Bruhati 02
2)
4)
6)
8)
10)
12)
Stana Rohita 02
Apstambha 02
Talahridaya 04
Indrabasti 04
Parshva Sandhi 02
Nitamba 02
Table – 2: Showing Kalantara Pranahara Marma
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 11
3. VISHALYAGHNA MARMA 44, 45
Sr. No. Name No. Sr. No. Name No.
1) Utkshepa 02 2) Sthapani 01
Table – 3: Showing Vishalyaghna Marma
4. VAIKALYAKARA MARMA 46, 47
Sr. No. Name No. Sr. No. Name No.
1)
3)
5)
7)
9)
11)
13)
15)
17)
Lohitaksha 04
Janu 02
Kurcha 04
Kurpara 02
Kakshadhara 02
Krukatika 02
Amsa-Phalaka 02
Nila 02
Phana 02
2)
4)
6)
8)
10)
12)
14)
16)
18)
Aani 04
Urvi 02
Vitapa 02
Kukundhara 02
Vidhura 02
Amsa 02
Apanga 02
Manya 02
Avarta 02
Table – 4: Vaikalyakara Marma
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 12
5. RUJAKAR MARMA48, 49
Sr. No. Name No. Sr. No. Name No.
1)
3)
Gulpha 02
Kurcha Shira 04 2) Manibandha 02
Table – 5: Showing the Rujakara Marma
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 13
III. CLASSIFICATION OF MARMAS
ACCORDING TO ANGULI PRAMANA 50
Sr. No.
AnguliPranam
Name of Marma
Total
No.
1) One Anguli 1) Urvi - 04
1) Vitap – 02
2. Kurcha Shira – 04
2. Kakshadhar – 02
10
2) Two Anguli 1. Stanmula – 02
3. Gulpha – 02
2. Manibandha – 02
06
3) Three Anguli 2. Kurpara – 02 Jaanu- 02 04
4) Four Anguli 1. Hridaya – 01
3. Kurcha – 04
5. Nabhi – 01
7. Simanta – 05
9. Neela – 02
2. Basti – 01
4. Guda – 01
6. Shrungataka – 04
8. Matruka – 08
10. Manya - 02
29
5) Half Anguli 1. Adhipati – 01
3. Talahridya – 04
5. Indra-basti – 04
7. Apastambha – 02
10.Parshvasandhi – 02
14. Nitamba – 02
16. Utkshepa – 02
18. Aani – 04
20. Vidhura – 02
22. Amsa – 02
23. Apanga - 02
24. Phana - 02
2. Shankha – 02
4. Kshipra - 04
6. Apalapa – 02
8. Stanarohita – 02
9. Katikataruna – 02
11. Bruhati – 02
13. Sthapani – 01
15. Lohitaksha- 04
17. Kukundara – 02
19. Krukatika – 02
21. Amsa-Phalaka – 02
26. Avarta – 02
56
Table – 6: Showing the Anguli Pramana
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 14
CLASSIFICATION OF MARMAS ACC. TO ACHARYA SUSHRUTA
& VAGBHATA
Sr. No. Classification Sushruta Vagbhata
1. Rachananusara
(Structural
Classification)
1. Mamsa 11
2. Sira 41
3. Snayu 27
4. Asthi 08
5. Sandhi 20
1. Mamsa 10
2. Sira 37
3. Snayu 23
4. Asthi 08
5. Sandhi 20
6. Dhamani 09
2. Shadangaanusara
(Regional Classification)
1. Upper Extremity 22
2. Lower Extremity 22
3. Abdomen & Thorax 12
4. Back of the Trunk 14
5. Heat & Neck 37
1. Upper Extreity 22
2. Lower Extremity 22
3. Abdomen & Thorax 12
4. Back of the Trunk 14
5. Head & Neck 37
3. Parinamanusara
(Prognostic
Classification)
1. Sadhya Pranahara 19
2. Kalantara Pranahara 33
3. Vishalyaghna 03
4. Vaikalyakara 44
5. Rujakara 08
1. Sadhya Pranahara 19
2. Kalantara Pranahara 33
3. Vishalyaghna 03
4. Vaikalyakara 44
5. Rujakara 08
4. Pramana Bheda
(Metrical Classification )
1. Panitala 29
2. Three Anguli 04
3. Two Anguli 06
4. One Anguli 12
5. Half Anguli 56
1. Panitala 29
2. Three Anguli 04
3. Two Anguli 06
4. One Anguli 12
5. Half Anguli 56
Table – 7: Showing Classification of Marma
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 15
URDHWA SHAKHAGATA MARMA51
Sr.
No
.
Name Sthana Rachan
a
Anusara
Parinama
Anusara
Pramana Anatomical Structure
Involved
Viddha Lakshanas
1. Kshipra - 2 Angustha
Agnuli
Madhye
Snayu
Marma
Kalantara
Pranhara
Marma
½ Anguli 1. Flexor Policis Brevis M.Abductor
Policis Brevis M. Adductor Policis. 1st
Palmar & Dorsal Interossei.
2. Inter Meta Carpal Joint of 1st & 2nd
Metacarpels.
3. Arteria, Radialis Indicis & Princeps
Policis.1st Dorsal Metacarpel Art.
4.Lat.Division Median N. Recurrent
Muscular Branches of Median N.
Aakshepakena
Maranam.
2.
Talahridaya
- 2
Madhyama
Anguli
Anu
Purvena
Mdhya
Mamsa
Marma
Kalantara
Pranhara
Marma
½ Anguli
1. Tendon of Flexor Digitorum,
Superficialis & Profondus, Adductor
Policis Transverse Head,
PalmarAponeurosis, 2nd & 3rd Palmar
interossei muscles, 2nd & 3rd Lumbricals.
Ruja and Marana.
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 16
Talasya 2. Superficial & Deep Palmar Arch.
3. Deep br.of Ulnar N & Communicating
br. Medial branch of Median N.
4. Deep transverse metacarpal lig.binding
the metcarpals.
3. Kurcha-2 2 Angula
Proximal to
Kshipra on
both sides
(Ant &
Post).
Snayu
Marma
Vaikalyakara
Marma
4 Anguli 1.Tendon of, Extensor Policis Longus,
Extensor Digitorum, Extensor Indicis,
Extensor Carpi Radialis Longus,
Extensor Carpi Radialis Brevis, & Flexor
Carpi Radialis.
2. Deep br.of Radial N or
Post.Interosseous N.
3. Inter Metacarpal & Carpometacarpal
Articulations.
Bhramana & Vepana
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 17
4. Kurcha
Shira-2
Below
Manibhand
ha
Snayu
Marma
Rujakara
Marma
1 Anguli 1. Tendon of, Flexor Digitorum
Superficialis & Profundus. Apex of
Palmar Aponeurosis. Flexor
Retinaculum.
2. Intercarpal Joints & Carpo metacarpal
joints.
3. Superficial br. Of Ulnar N.
4. Lig.of Intercapal & Carpometacarpal
joints.
Ruja & Shopha.
5 Mani
bandha-2
Junction of
forearm &
hand.
Sandhi
Marma
Rujakara
Marma
2 Anguli Wrist Joint
Upper – Inf.surface of lower end of the
radius and articular disc of the inferior
radioulnar joint.
Lower –Scaphoid, Lunate and Triquetral
bones.
Ligaments –Articular capsule, palmar
radio & ulnarcarpal lig, dorsal
radiocarpal lig, RCL & UCL
Kunthata
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 18
6 Indra basti-2 Middle of
forearm
Mansa
Marma
Kalantar
Pranhar Marma
½ Anguli 1. Palmaris Longus, Flexor Carpi
Radialis & Ulnaris. Flexor Digitorum
Profundus, Superficialis, Flexor Policis
Longus M.
2. Muscular br.of Ulnar A & Ant.
Interosseous A, Muscular br. Of Radial
Art.
Shonita Kshayena
Maranam.
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 19
7. Kurpara-2 Junction
b/w arm &
forearm
Sandhi Vaikalyakara
Marma
3 Anguli Elbow Joint
Upper – Capitulum & trochlea of
humerus.
Lower – Upper surface of the head of the
radius articulates with the capitulum,
trochlear notch of the ulna articulates
with the trochlea of humerus.
Sup.radio ulnar joint, humeroradial
humero ulnar and sup.radiounlar joint.
Capsular lig, Ant & Post lig,
RCL & UCL, Annular lig.
Kunihi.
8. Ani-2 3 Anguli
above the
Krupara on
both ant. &
post.
Aspect.
Snayu
Marma
Vaikalyakara
Marma
½ Anguli
1. Biceps, Brachialis and Triceps M.
2.Radial N, Median N,
Musculocutaneous N
Shopha & Vridhi.
9. Bahvi-2 Middle of Sira Vaikalyakara 1 Anguli 1. Biceps Brachii & Brachialis Muscle. Shonita Kshaya &
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 20
Arm. Marma Marma 2. Brachial A.
3.Brachial V.
Sakthi Shosha.
10. Lohitaksha-
2
Above the
Bahvi
below the
Kakshadha
ra in
Bahumoola
Sira
Marma
Vaikalyakara
Marma
½ Anguli 1. Teres Major & Latissimus Dorsi M.
2.3rd part of Axillary A, Ant. & Post.
Circumflex humeral A.
3. Axillary Vein.
Lohita Kshayena
Maranam or
Pakshaghata.
11. Kakshadhar
a-2
Middle of
chest &
axilla.
Snayu
Marma
Vaikalyakara
Marma
1 Anguli 1. Teres Major, Latissimus Dorsi,
Pectoralis Major and Subscapularis M.
2. Brachial Plexus with its branches.
Pakshaghata.
Table – 8: Showing Urdhwa Shakhagata Marma
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 21
MARMA PANCHABHOUTIKATVA52
Sr. No. Type of Marma Total No. MahaBhuta Effect after injury
1. Sadhya Pranahara 19 Agni Immediate loss of Agni Mahabhuta
Causing death immediate or within
one week
2. Kalantara
Pranahara
33 Agni &
soma
Immediate loss of agni but gradual
loss of Soma Mahabhuta (i.e. within
one month)
3. Vishalyaghna 03 Vayu Marmas fatal after extraction of
shalya are predominant of vayu, as
long as vayu stays inside obstructed
by the tip of the shalya the person
lives but as soon as it is extracted
vayu positioned at the site of marma
comes out ie, why the patient
survives till the shalya is there and
after its extraction he dies or if the
shalya comes out after suppuration
then also survives.
4. Vaikalyakara 44 Soma Marmas causing disabilities are
predominance of Soma Mahabhuta,
due to firmness and coldness sustain
life.
5. Rujakara 08 Agni &
Vayu
Marmas casusing pain are
predominant in qualities of Agni &
Vayu Mahabhuta as they particularly
cause pain, some how ever say that
pain is related to all 5 bhutas.
Table – 9: Showing Pancha bhoutikatva of marma
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 22
PRANA ADHISHTAN IN MARMANaturally ‘Prana’ reside in Marma.53
Soma, Maruta, and Tejas as well as Satva, Raja and Tama along with Bhutatma
stays in marmas. That is why if any injury takes place on marma the person will not
survive.54
Marma’s are comsiderd as ‘Jivanadhara’ by Rishi Muni’s, and also mentioned
‘Prana’ is situated in the marma sthanas.55
Acharya Charaka explains Trimarmas ie Basti, Hridaya, Shira are Ashraya for
prana. If any kind of pressure occurs over these marmas, the Vata gets aggravated and
produce different kinds of vedana or may also leads to death.56
Marma sthana is the combination of Mamsa, Sira, Snayu, Asthi and Sandhi with
each other, and ‘Prana’ especially situated in the marma sthana.57
Marma’s are so called because they cause death when injured and they are the
meeting place of Mamsa, Sira, Snayu, Asthi and Sandhi.58
Agni, Soima, Vayu, Satva, Raja, tama, Panchgnyanendriya, Bhutatma are called
‘Prana’ & this ‘Prana’ resides in Marma-sthana.59
GENERAL SYTMPTOMS OF MARMABHI GHATA ‘Marmaghata’ leada to ‘Dehaprasupti’, ‘Guruta’, Sammoha, Shitakamita, Sweda,
Murcha, Vamihi, Shwasa..60
1) MAMSA MARMA VIDDHA LAKSHANA When Mamsa, Marma is injured, there will be continuous bleeding, viscosity of blood
is reduced, blood resembles meat washed water, pallor of the skin, loss of function of
sense organs & quick death of the person.61
2) SNAYU MARMA VIDDHA LAKSHANA When Snayu Marma, are injured, there will be bending of the body, convulsions,
very severe pain, inability for riding, sitting etc. distortions of anga or even death of a
person. 62
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 23
3) SIRA MARMA VIDDHA LAKSHANA
When Sira Marma are injured, blood which is thick flows out of sira
continuously in large quantity, due to blood loss, thirst, giddiness, dyspnoea, delusion,
unconsciousness and hiccup manifest leading to death of a person. 63
4) ASTHI MARMA VIDDHA LAKSHANA When Asthi Marma are injured, there is discharge of thin fluid mixed with bone
marrow intermittently and severe pain contineously.64
5) SANDHI MARMA VIDDHA LAKSHANA When Sandhi Marma are injured, the site of injury feels as though full of thorns, even
after healing of the wound there is shortening of the arm, lameness, decrease of strength
and movement, emaciation of body and swelling of joints occurs.65
6) ACC. TO VAGBHAT DHAMANI MARMA VIDDHA
LAKSHANA When Dhamani Marma are injured, the blood flows out frothy and warm comes out
with a sound and the person becomes unconscious.66
EFFECT OF MARMA’S If Sadhya Pranahara Marma gets injured it may leads to Kalantara Pranahar or
death. If Kalantara Pranahara Marma gets injured it may lead to Vaikalyakara. If
Vishalyghna gets injured it may lead to Vaikalykara. If Vaikalyakara gets injured it wil
leads to distress and pain after a certain period while Rujakara Marma injury leads to
mild pain.67
TYPES OF MARMA GHATA An effect of stroke on Marma due to incision, stabing, burning, and external
stroke will produce same as symptoms of Marmaghata.68
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 24
IMPORTANCE OF MARMA Experts say that surgical operations are performed after considering the
measurement of the marma’s so as to avoid them. As injured even on margin marma
leads to death, the site of vital spots should be avoided altogether.69
IMPORTANCE OF MARMA PARIVISTARA / PRAMAN An incision should be made at the spot a finger’s width remote from the Urvi,
Kurcha Shira, Vitapa, Kaksha, and a Parshva Marma, whereas, a clear space of two
fingers should be avoided from its situation in making any incision about stanamula,
manibhandha or Gulpha Marma. Similarly a space of four fingers should be avoided in
respect of the four shringataks, five simantas and ten Marmas in neck nila etc; a space of
half a finger being the rule in respect of the remaining (fifty six). 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 take into account and the
incision should be made in a way as an incision, even extending or effecting in the least,
the edge or the side of the Marma, may prove fatal. Hence, all the Marma sthanas should
be carefully avoided in surgical operation. 70, 71
IMPORTANCE OF MARMAS IN CHIKITSA In human beings; vata, pitta and kapha are situated in Basti; Hridaya and Shiras
respectively. Due to their vital locations, they should be eliminated by the nearest roots.72
Shira, Hriday and Basti are most important ‘Marmas’ out of all hundred seven, as
they are major sites for, kapha, pitta and vata respectively.73
IMPORTANCE OF MARMA IN SHALYA TANTRA
Knowledge of Marma is very important to do Shastra Karma. Acharya Sushruta
explains that the surgeon should apply the Shastra following the direction of hairs
avoiding Masrmas, Siras, Snayus, Asthi, Sandhi and Dhamani’s till pus is seen.74
Acharya Sushruta also explains that kshara should not be applied to Marma Sthanas,
Siras, Snayus, Sandhis, Taruna asthi, Sevani, Dhamani, Throat, Nabhi, Nail bed, Pennis,
Sroatas and thinly muscle parts and eyes.75
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 25
Marmas are said to be cover half of the Jurisdiction of surgery because persons die
immediately if they are injured even if some of them survive due to surgeon’s efficiency
they definitely become victim of disability.76
IMPROTANCE OF SIRA IN MARMA This is further corroborated by the fact that the four classes of sira or vessels
(which respectively carry the vata, pitta, kapha and the rakta) are found to enter into the
Marmas for the purpose of maintaining the moisture of the local Snayu, Asthi, Mamsa
and Sandhi and thus sustain the organism. The vayu agrevated by an injury to a Marma,
blocks up (those four classes of vessels) in their entire course throughout the organism
and gives rise to great pain which extends all over the body. 77
SADYHA PRANHARA MARMA (INSTANTLY FATAL)
Time of fatal effect:
Trauma to Sadhya pranhara Marma causes death immediately or within seven
days.78
COMPOSITION AND VIDDHA LAKSHANA All the five elements together constitute Sadhya Pranahara Marma, Trauma to this
Marma, results in inability of sense organs to perceive their respective subjects. Mind and
intelligence can’t function properly severe pain precedes the death.79
CAUSES OF DEATH Sadhya pranhara Marma has Agni element in it prominently. If it is traumatized,
fire element vanishes. Hence, immediate death occurs.80
Rakta- Dhatu holds human- body. It is basic pillar of our body. By any means, we
should protect it, as life (Prana) resides in this dhatu.81
Blood loss should not be neglected because ‘Prana’ resides in blood. 82
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 26
KALANTARA PRANHARA MARMA
Marmaghata period (15 days to the month) 83
COMPOSITION AND VIDDHA LAKSHANAAgni and Soma resides at the site of these Marmas. First there is a loss of Agni
and then loss of ‘Soma’ and then death occurs.84
Damage to Kalantara Pranahara Marma causes ‘Dhatu-Kshay’, which results in
extreme pain leading to eventual death. 85
VISHALYAGHNA MARMA
FATAL PERIOD Fatal period of Vishalyaghna Marma is not described Death does not occur until
weapon exists at site of entry. As soon as weapon is removed death occurs.86
VIDDHA LAKSHNA OF VISHALYAGHNA MARMA This Marma is the house for Vayu Mahabhuta. As soon as weapon is removed,
Mamsa, Vasa, Majja, Mastulunga are all dried. It causes shwasa, Kasa and results in
death.87
CAUSES OF DEATH Marmas fatal after extraction of shalya are predominant in vayu, as long as vayu
stays inside obstructed by the tip of the shalya the person lives but as soon as it is
extracted vayu positioned at the site of marma comes out that is why the patient survives
till the shalya is there and after its extraction he dies or it the shalya comes out after
suppuration then also survives.88
Vishalyaghna becomes vaikalyakara if it is pierced at the end or margin and also
if the injury is not serves. On the contrary if it is severe it can become Kalantara
Pranahara.89
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 27
VAIKALYAKARA MARMA Soma guna is predominant in Vaikalyakara Marma, which does the Sthiratva,
Sheetatva and also does the Prana Avalambana.90
If this Marma is traumatized, permanent disability is produced. Fatal period of
Marmaghata Kala is not given.91
VIDHA LAKSHANA If Vaikalyakara Marma is traumatized death supervences immediately or after
some time.92
RUJAKARA MARMA 93, 94 , 95
There are 8 Rujakara Marma in human body
Sr. No. Name No.
1) Gulpha Marma 02
2) Manibandh Marma 02
3) Kurcha Shira 04
Total No. 08
Table – 14: Showing Rujakara Marma
DEFINATION A marma which produce pain after injury is called as Rujakara Marma.96
MARMAGHATA PERIOD A marmaghata period of Rujakara Marma is not mentioned in Samhita but
practically pain is felt on Marma site after injury immediately.
SWABHAVA Rujakara Marma are predominant in qualities of Agni & Vayu as they particularly
cause pain; some or however say that pain is related to all the five mahabhutas.97
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 28
PERIOD OF FATALITY No fatality has been mentioned. Only it wil produce severe pain.98
KURPARA MARMA SHAREERA AND VIDDHA LAKSHANA The word Kurpara means Elbow.99
The word Kurpara means Kaphoni which means Elbow.100
Kurpara is the junction between Prapani and Prabahu.101
Kurpara means Kaphoni which is also called Kuhuni.102
There are two Kurpara Sandhi Marma’s are present and their pramana is 2 angula,
which are Vaikalyakara in nature.103
Kurpara Marma resembles the Janu Marma, on injury it will leads to Kunitva.104
KUNIHI The word Kunihi means Kubjitakaraha.105
The word Kunihi means Sankuchita Bahu Madhya.106
The word Kunitvam means Bahu Pani Anguli Kubjata.107
Kunihi means Vikruta Karaha.108
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 29
AYURVEDIC VIEW OF SANDHI SHARIRA
NIRUKTI OF SANDHI Sandhi’s are the junction of Bones and are seat of kapha; they help to keep the
body parts together.109
SANDHI UTPATTI Sandhi word is derived from the root san + dha + ki which mean sandhanamiti
means that which holds together, joining or binding.
According to Aacharya Charaka and Sushruta during 3rd month of gestation
development of all body parts takes place simultaneously in subtle nature.110
SANDHI RACHANA Anatomically two separate entities constitute a joint. From the mobility and
dislocation point of view Sushruta has considered only bony joints, while from the point
of establishing the equilibrium of internal environment the dosha, Dhatu etc.111
Bones play vital role in the Dharana Karma of Sharira and bones are joined to
each other with the help of Mamsa, Sira Snayu binding together to form joints. Hence the
Mamsa, Sira, Snayu and Asthi binding each other are collectively can be considered as
Sandhi.112
Acharya Sushruta described the importance of sandhi and snayu as, Man built a
ship by to many bindings and then the ship can able to float with various types of
weight.113
SANDHI AND GARBHA BHAVA Aacharya Charaka has described the Garbhaja Bhava in Sharirsthana while
describing pitruja bhavas of Garbha, Aacharya illustrated Pitruja Bhava’s such as Asthi,
Sira, and Snayu which are also constituents of joints.114
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 30
SANDHI AND MAHABHAUTIKATVA The matruja, pitruja bhavas etc are also the products of Mahabhuta along with the
touch, tactile organs, roughness, impulsion, shaping of dhatus and physical activities are
derived from Vaayu.115
All the movements like Aakunchan, Prasaran, and Gamana etc. are Vayaviya
Bhava. There is also Prithvi Mahabhuta predominance in Sandhi due to presence of
bones, muscles and tendons in Sandhis.116
SANDHI AND DOSHA The Kapha is responsible for Sthiratva, Snigdhatva, and Sandhi Bandhana. 117
The Shlesma that resides in Sandhi named as Shleshaka Kapha. It facilitates free
movements of the Sandhi and lubricates it as well.118
SANDHI AND DOSHASTHANA SAMBHANDHA Joints are the structures which come under the circulatory system of Vata and
Asthi is the major Dhatu associated with joints and which is the seat of Vata Dosha .119
SANDHI AND PRAKRUTI Person of vata prakruti is krush and his sandhi becomes sashabda.120
The joints of person having pitta prakruti are shithila and binded by mansa.121
Joint of kapha prakruti persons are stable, snigdha and shlistha and binded by
muscle i.e. goodha.122
SANDHI AND KALA The fourth kala is known as shlesmadhara kala lies with in the Sandhi. It
lubricates the joint and allows free movements of area of the bones and lines the fibrous
capsule of the elbow joint.123
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 31
DUSTI LAKSHAN OF MAJJAVAHA SROTAS When majja vaha srotas gets vitiated due to nidana, there are symptoms like joint
pains, crepetaion of attempted movement; vertigo etc. hence to keep proper working of
sandhi majja vaha srotas must be normal.124
AYURVEDIC CLASSIFICATION OF SANDHI Sandhi are classified into 2 kinds viz - 1) Chestavanta and 2) SthiraSandhi.125
The cheshtavanta means movable joints. The sthira sandhi’s are again classified in
to 2 types 1) Alpa Cheshtavanta (Slightly Movable) and 2) Bahu Cheshtavanta (Freely
Movable). So the cheshtavanta sandhi’s usually present in shakha’s, and hanu pradesha.
Alpa chala sandhi presents in the kati (intervertebral joint region). The Sthira Sandhi is
present in the Shiras.
SANDHI SANKHYA According charak there are only 200 joints in the body.126
According to Sushruta there are 210 joints in the body. According to
Shadangaanusara, in Shakha – 68, in Koshtha – 59, in Greeva pradesha – 83 Sandhi’s are
present.127
DESCIPTIION AND TYPES OF JOINTS 128
1. Kora Sandhi : Resembles a budding flower.
These are present in Interphalangeal joint, Wrist joint,
Ankle joint, Knee joint and Elbow joint.
2. Ulukhala Sandhi : Resembles the shape of Mortar ie a Stone Grinder.
These joints are present in Shoulder, Hip, and Teeth with
the gums.
3. Samudaga Sandhi : Resembles like a covered base, fittend into one another.
These are present in Acromio clavicular joint, Sacro
coccygeal joint, Pubic symphysis, Illio sacral joint.
4. Pratara : Resembles Floating joints ie supported by a cushion.
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 32
These are present in Vertebral column.
5. Tunnasevani : Resembles Suture like in shape.
These joints are present in flat bones of Skull and between
three parts of Hip bone.
6. Vayastunda : Resembles A Crow’s beak like portion.
These are present in Temporo mandibular joint.
7. Mandala Sandhi : Resembles like Cirucular.
These are present in Kantha nandi, Hridaya naadi, Netra
naadi, Kloma naadi.
8. Sahnkhavarta : Resembles Spiral shaped like shell of common Snail.
These are present in Shrungatakas of ears present in
petrous part of temporal bone. Bony labrynth of cochlea.
KURPARA SANDHI
It is a chesta vanta sandhi of Kora variety.
It comes under Sandamsha kora sandhi.129
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 33
MODERN REVIEW
INTRODUCTION Joints are meeting place of Bones.130
Joint is a point of contact between bones, bwtween cartilage and bones, or
between teeth and bones.131
In anatomical usage, a joint is a junction between two or more bones or cartilages.
The term articulation means a joint in Latin. The term arthrology (i.e. study of joints)132
or term arthritis (i.e. study of joints ) or term arthritis (i.e. inflammation of a joint) are
derived from term arthron which means a joint in Greek.
CLASSIFICATION OF JOINTS133, 134,
The joints can be classified according to their structure and function.
A) FUNCTIONAL CLASSIFICATION It is based upon the degree of mobility of the joints. They are of three types.
1. Immovable joints (synarthrosis)
2. Slightly movable joints (amphiarthrosis)
3. Freely movable joints (diarthrosis)
SYNARTHROSES These are immovable joint. It is of 3 types.
1. Suture – Frontal Suture.
2. Gomphosis – Roots of teeth with sockets of the alveolar processes of the
maxilla and mandible.
3. Synchondrosis – joint connects the epiphysis and diaphysis of growing bone.
Department of Shareera Rachana, SDMCA, Udupi.
Observation 55
Department of Shareera Rachana, SDMCA, Udupi.
Brachioradialis –
Radial Nerve branch.
Origin on Flexor group of forearm muscles from medial epicondyle.
Extensor Muscles –
Triceps –
Radial nerve branch.
Anconeus –
Radial nerve branch.
Origin of Extensor group of forearm muscles from lateral epicondyle
ELBOW JOINT:
Nerve Supply –
The joint receives branches from the Ulnar, Median, Radial, Musculocutaneous
nerves.
Ligaments –
1) Capsular Ligament.
• Synovial membrane.
2) Anterior Ligament and Posterior Ligament.
3) Ulnar Collateral ligament.
4) Radial Collateral ligament.
5) Annular ligament.
6) Quadrate ligament.
Observation 56
Department of Shareera Rachana, SDMCA, Udupi.
Articular surfaces –
Upper –
The capitulum & trochlea of humerus.
Lower –
1) Upper surface of the head of radius articulates with the capitulum.
2) Trochlear notch of the ulna articulates with trochlea of the humerus.
Here some of the x –ray reports has been collected and attempt is made to identify
the structures involved in the kurpara marma abhighatha.
Review of Literature 34
AMPHIARTHROSES
These are slightly movable joints. It is of 2 types.
1. Syndesmosis – Distal articulation between the tibia and fibula.
2. Symphysis – Pubic symphysis.
DIARTHROSIS Freely movable joints. It is of 6 types.
1. Gliding Joint – Carpals, Tarsals.
2. Hinge Joint – Knee, Elbow, Ankle & Interphalangeal joints.
3. Pivot joint – Atlas rotates around the dense of Axis.
4. Condyloid Joint – The Temporomandibular joint and metacarpophalangeal
joint.
5. Saddle Joint – The joint between trapezium of the carpus and metacarpal of
thumb.
6. Ball and Socket Joint – Shoulder and Hip joints.
B) STRUCTURAL CLASSIFICATION 1) Fibrous joints
2) Cartilaginous joints
3) Synovial joints
Fibrous Joint – If there is no synovial cavity and the bones are held together by fibrous
connective tissue.
Cartilagenous Joint – If there is no synovial cavity and the bones are held together by
cartilage.
Synovial Joint – If there is a synovial cavity and the bones forming the joint are united by
a surrounding articular capsule and frequently by accessory ligaments.
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 35
SYNOVIAL JOINTS 135
These joints possess a cavity and the articular ends of bones forming the joint are
enclosed in a fibrous capsule. As a result they are separate by a narrow cavity, the
articular cavity (or the joint cavity), which is filled with a fluid called synovial fluid (like
an egg albumin), which acts as a lubricant. The synovial joints are the most evolved and
freely movable joints. They are often termed as diarthrodial joints.
THE CHARACTERISTIC FEATURES OF SYNOVIAL JOINTS ARE
AS FOLLOWS 1. The articular surfaces are covered by a thin plate of hyaline cartilage.
2. The cavity of the joint is lined by synovial membrane except over the articular
cartilages.
3. The cavity is filled with synovial fluid secreted by synovial membrane which
provides lubrication to the articular surfaces and nutrition to the articular
cartilages.
4. Some additional structures are present within the joint cavity, e.g.: (a) articular
discs are usually composed of fibrocartilage, (b) fat pads, and (c) tendons.
COMPONENTS OF SYNOVIAL JOINTS AND THEIR FUNCTINAL
SIGNIFICANCE The following are the components of synovial joints:
1. Fibrous capsule: It completely invests the joints like a sleeve and encloses a synovial cavity. It is
attached by continuous lines to the bones forming the joint close to the articular
cartilages.
Function: The fibrous capsule stabilizes the joint in such a way that it permits
movements but resists dislocation.
Department of Shareera Rachana, SDMCA, Udupi.
Observation 53
Department of Shareera Rachana, SDMCA, Udupi.
ELBOW REGION
CUBITAL FOSSA:
Cubital fossa is a triangular fossa forms the hollow depression on the front of the
elbow.
Boundaries:
Base –
It is formed by an imaginary line joining right & left epicondyles of humerus.
Apex –
It is directed below & is formed by the convergence of the lateral & medial
boundaries.
Laterally –
Medial border of the brachioradialis.
Medially –
Lateral border of the pronator teres.
Floor –
Brachialis & Supinator muscles.
Roof –
Deep fascia of forearm, bicipital aponeurosis. Superficial to bicipital aponeurosis
lie median cubital vein, medial and lateral cutaneous nerves of forearm.
Observation 54
Department of Shareera Rachana, SDMCA, Udupi.
CONTENTS OF CUBITAL FOSSA:
NERVES –
Cutaneous Nerve –
Medial cutaneous nerve.
Lateral cutaneous nerve.
Posterior cutaneous nerve.
Median Nerve.
Radial Nerve.
VESSELS –
Brachial Artery
Radial Artery
Ulnar Artery.
Common interosseous Artery.
vAnterior and Posterior Interosseous Arteries
MUSCLES OF THE ELBOW REGION:
The muscle which produces flexion and extension movements was recognized.
Flexor Muscles -
Brachialis –
Musculocutaneous Nerve & Radial Nerve branch.
Biceps Brachii –
Musculocutaneous Nerve branch.
Review of Literature 36
2. Ligaments :
These are thickened bands of collages fibers
a. True ligaments:
Permit the movements in one plane and prevent unwanted movements in other
plane. In addition they also stabilize the joint.
b. Accessory ligaments:
Provide additional reinforcement the joint and limit the range of movements.
3. Synovial membrane :
It is a thin highly vascular membrane of connective tissue lining the inside of the
fibrous capsule is reflected from the fibrous capsule is reflected onto the bone, which
covers right up to the articular cartilage.
Function: The synovial membrane produces synovial fluid in sufficient quantity to
keep the surfaces properly lubricates.
4. Articular cartilage:
With few exceptions the articular cartilage is made up of hyaline cartilage.
Function: The articular cartilage provides smooth friction free movements and
resists compression forces.
5. Articular disc or meniscus:
The articular discs are pads on fibrocartilage interposed between the articular
surfaces of some joints.
Function: Helps in lubrication of a joint by maintaining an interval between the
articular surfaces.
6. Bursae:
These are pouch – like sacs of connective tissue filled with synovial fluid, found
near certain synovial joints.
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 37
Function: The function of bursae is to cushion certain muscles and to facilitate the
movement of tendons or muscles over bony or ligamentous surfaces.
7. Fat pads:
These are pads of fat placed between synovial membrane and fibrous capsule or
between synovial membrance and bone, e.g. acetabular fat of hip joint.
Function: As fat is very plaint, the pads can accommodate themselves to changing
condition of the joint during different movements.
CLASSIFICATION OF SYNOVIAL JOINT136
Synovial joint and Its Sub Classification
Plane
Hinge
Pivot
Condylar
Ellipsoidal
Saddle
Ball
and
socket
Intercarpal
Elbow
Superior
Radioulnar
Temporo-
Mandibular
Radio-
carpal
(wrist)
First
Carpo-
metacarpal
Hip joint
Intertarsal
Knee
Median
atlanto-
axial
Metacarpo-
phalangeal
Atlanto –
occipital
Sterno –
clavicular
Shoulder
joint
Intermetatar
sal
Ankle
Metacarpo –
Phalangeal
Calcaneo –
cuboid
Incudo –
stapedial
(smallest)
Intermetaca
rpal
Interphalang
eal
Metatarso
–
phalangeal
Incudo –
malleolar
(smallest)
Table – 15: Showing classification of Synovial joint
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 38
Uniaxial Joint In these joints the movements occur in one plane around a transverse axis.
Eg: Elbow joint etc.
Biaxial Joints In these joints the movements occur in tow planes or axis. Eg: Knee joint.
.
Multiaxial (polyaxial) Joints
In these joitns movements occur in three planes or axis.
Eg: Shoulder.
ACCORDING TO THE NUMBER OF ARTICULATING BONES
Simple Joints When two bones articulate in the formation of a joint.
E.g. interphalangeal joints of fingers.
Compound Joints More than two bones articulate within the capsule.
Eg.Wrist joint, Elbow joint.
Complex Joint When joint cavity is divided by an intra - articular disc.
Eg. Temporomandibular joint, acromioclavicular joint, sternoclavicular joint.
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 39
MOVEMENTS OF SYNOVIAL JOINTS Active Movements
Gliding or slipping movements.
Angular movements.
Rotary or circular movements.
BLOOD SUPPLY TO SYNOVIAL JOINTS It is derived from the periarticular network of arteries (circulus articularis
vasculosus) that surround the joint Articular cartilages are avascular.
The fibrous capsule and ligament have poor blood supply.
The synovial membrane is richly supplied by blood.
NERVE SUPPLY TO SYNOVIAL JOINTS The synovial joints have rich nerve supply. Sensory nerve fibers conveying pain.
Sensory nerve fibers conveying proprioceptive sensations
Autonomic fibers which have vasomotor effects.
HILTON’S LAW The Hilton’s law states that the nerves supplying the joint also supply the muscles
regulating the movements of the joint and skin over the joint.
CLINICAL CORRELATION If the joint is excessively stretched or suffers from a disease or injury, the
irritation of nerves supplying the joint cause muscles acting on the joint to contract in
such way that the joint is brought in a position of maximum comfort to protect the joint.
The pain of the joint is referred to skin overlying the joint.
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 40
MOVEMENT’S DEIFINITIONS
Movement Definition
Angular movements
Flexion Bending (decreasing joint angle) the joint
occasionally backward, e.g. knee joint
Extension Straightening the joint (increasing the joint
angle)
Abduction Movement away from the midline of the
body.
Adduction Combination of flexion, extension,
abduction and adduction
Special Movements
Rotation Movement round the long axis of the bone
Supination Turning the palm of the hand forward or
upward
Pronation Turning the palm of the hand backward or
downward
Inversion Turning the sole of the foot inwards
Eversion Turning the sole of the foot outwards
Protraction Forward movement parallel to ground.
Retraction Pulling back the protracted part
Elevation Lifting upward
Depression Moving downward
Table – 16: Showing Movement’s Deifinitions
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 41
LAST’S FORMULATION OF SEGMENTAL INNERVATION Segmental Innervation of the joints
Segmental Regulating of the joint movements
Joint Segmental innervations
Hip L 2, 3, 4, 5
Knee L3, 4, 5 and S1
Ankle L4, 5 and S1, 2
Segment regulating the movements
Hip joint Flexion Extension
L 2, 3 L 4, 5
Knee joint Extension Flexion
L 3, 4 L 5, S1
Ankle joint Dorsilflexion Plantarflexion
L 4, 5 S1, 2
FACTORS MAINTAINING THE STABILITY OF SYNOVIAL JOINTS
1. Bones
2. Ligaments
3. Muscles
ELBOW JOINT137
It is a compound joint and consists of humeroulnar & humero radial parts; the
latter is continuous with the superior radio – ulnar joint. All the three components posses
one synovial cavity & are collectively known as cubital articulation. But for functional
consideration, the elbow joint is restricted to the humero – ulnar & humero – radial parts
and basically forms a hinge joint, permitting flexion and extension.
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 42
Humero – Ulnar part
It is formed by the articulation between the trochlea of humerus and the trochlear
notch of ulna. Humero – ulnar joint is of hinge variety, the lower end of humerus presents
two non articular depressions – coronoid fossa in front and deeper and triangular
olecranon fossa behind. The coronoid fossa accommodates the anterior margin of the
ulnar coronoid process in flexion; the tip of the olecranon process of ulna occupies the
olecranon fossa in extension.
The trochlear notch of ulna is reciprocally saddle shaped and formed by the
articular surfaces of olecranon and coronoid processes, separated by a non articular
narrow strip.
Humero – Radial part
Structurally, it is a ball and socket type. The ball is represented by the capitulum
of humerus which is articular in front, and below. The disc like concave upper surface if
the head of radius forms its socket. The radial head comes in contact with the lower
surface of capitulum in extension and rotates on its anterior surface during flexion; in full
flexion peripheral rim of the head lodges in a depression, radial fossa, above the
capitulum.
Superior Radio – ulnar joint
It is a pivot joint between the strip of the articular circumference of the head of
radius and the osseo – fibrous ring, formed by the radial notch of ulna and the annular
ligament. The radial head rotates with in the ring; one fifth of the ring is bony and four –
fifth fibrous.
Ligaments of the elbow joint
It posses capsular ligament, ulnar and radial collateral ligaments.
Capsular ligament
The fibrous capsule envelops the joint completely. It is thin in front and behind to
permit flexion and extension, and is thickenend at the two sides in the form of collateral
ligaments in order to provide stability of the joint.
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 43
Proximally, the fibrous capsule is attached to the lower end of humerus in a
continuous line, which excludes the two epicondyles but includes the three fossae to gain
attachments along the upper margins of the coronoid and radial fossae, and falling short
of upper limit of olecranon fossa. Distally, it is attached to the margins of the trochlear
notch and blends with the annular ligament of the superior radio – ulnar joint.
The synovial membrane lines the inner surface of fibrous capsule and the bones
with in the capsule including the three fossae and extends upto the periphery of articular
cartilage. Cushions of extra – synovial fat fill up the three fossae.
Ulnar collateral (Medial) ligament
It is triangular in shape and extends from the lower part of medial epicondyle to
the medial margins of trochlear notch. The ligament consists of three bands – anterior,
posterior, and inferior. The anterior band is attached to tubercle on the medial margin of
the coronoid process; the posterior band is attached to the medial margin of olecranon
process; the inferior band extends obliquely between the olecranon and coronoid
processes, and forms a foramen between the band and the trochlear notch through which
the extra – capsular fat is continuous with intra capsular fat.
The medial ligament is overlapped by the triceps, flexor carpi ulnaris and flexor
digitorum superficialis, and is closely related with ulnar nerve.
Radial collateral (Lateral) ligament
It forms a triangular expansion and extends from the lateral epicondyle to the
annular ligaments. It is intimately related to the supinator and extensor carpi radialis
brevis muscles.
Annular ligament
It keeps the radial head in position and is attached to the two ends of radial notch
of ulna. The ligament is some what cup shaped presenting smaller circumference below.
The annular ligament is continuous above with the fibrous capsule of elbow joint.
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 44
Quadrate ligament
A few fibers from annular ligament form a thin quadrate ligament which covers
the synovial membrane reflected on to the radial neck.
Bursae in relation to the joint
Above the olecranon, between the triceps tendon and capsule of the joint.
A subcutaneous bursa on the dorsal triangular surface of olecranon process;
Between the biceps tendon and the smooth anterior part of radial tuberosity.
Arterial supply
From the numerous periarticular branches derived from the anastamosis around
the elbow.
Anastamosis around the elbow joint links the brachial artery with the upper ends
of the radial & ulnar arteries. It supplies the ligaments and bones of the joint. The
anastamosis can be subdivided into the following parts.
Infront of lateral epicondyle of the humerus, the anterior descending (radial
collateral) branch of the profunda brachii anastamosis with the radial recurrent branch of
the radial artery.
Behind the lateral epicondyle of the humerus, the posterior descending branch of
profunda brachii artery anastamoses with the interosseous recurrent branch of the
posterior interosseous artery.
Infront of the medial epicondyle of the humerus, the inferior ulnar collateral
branch of the brachial artery, and occasionally a branch from the superior ulnar collateral
artery, anastamoses with the anterior ulnar recurrent branch of the ulnar artery.
Behind the medial epicondyle of the humerus, the superor ulnar collateral branch
of the brachial artery anastamoses with the posterior ulnar recurrent branch of the ulnar
artery, and a branch from the inferior ulnar collateral artery.
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 45
Nerve supply
The joint is mainly supplied by :
Muculo- cutaneous nerve supplies the anterior part of capsule through the branch
to the brachialis.
Radial nerve to the posterior and lateral part of the capsule through the nerve to
anconeus and the ulnar collateral branches;
Ulnar nerve to the ulnar collateral ligament.
Movements
The chief movements at the elbow joint are flexion and extension.The ulnar is
slightly pronated in extension and supinated in flexion.
The range of flexion is about 1500, and is limited only when the flexor surfaces of
the arm and forearm approximate. Hand to mouth movement consists of flexion at the
elbow, and medial rotation at the shoulder joint or pronation of the radius at the radio
ulnar joint.
Full extension at the elbow is reached when the arm and the forearm assume
straight line. Extension makes the joint close – packed and is limited bythe tension of the
anterior part of the capsule and the muscles in front of the joint along with the
accommodation of the tip of the olecranon in the olecranon fossa.
Pronation
During pronation the head of radius spins within the annular ligament around a
more or less a vertical axis and retains its position lateral to the ulna. But the lower end of
radius, carrying the hand with it, rotates forward and medially across the lower part of
ulna. In this process the interosseous membrane in spiralised.
Supination
The rotation is reversed, the lower end of radius regains its original position
lateral to the ulna and the interosseous membrane is despiralised.
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 46
Carrying angle
When the elbow is fully extended and the forearm supinated, the arm and the fore
arm form an obtuse angle which is open on the lateral side. This is known as carrying
angle which measure about 1630, so bhrachialis, biceps brachii and at the ulnar border of
the forearm does not come in close contact wit the lateral surface of the thigh and this
facilitates to carry a heavy object grasped by the hand.
Muscles producing movements
Flexion
Brachioradials; chief flexor muscle is brachialis. The biceps acts best when the
forearm is supinated and acts a spurt muscles; the brachioradilis acts best in mid prone
postion and represents a shunt muscle.
In flexion against resistance pronator teres and flexor carpi radialis comes into play.
Extension
Triceps anconeus and assisted by gravity.
Pronation
Pronator quadrates, assisted by pronator teres, flexor carpi radialis and gravity.
Anconeus assists lateral displacement of ulna in full pronation.
Supination
Supinator in extension, and biceps brachii in flexion.
Spinal segment controlling the movements
Flexion – c5 and c6
Extension – c7 and c8.
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 47
REGIONAL ANATOMY – ELBOW Structures which passes through the elbow joint:
In front:
Brachialis, tendon of biceps, median nerve, medial cutaneous nerve of forearm,
lateral cutaneous nerve of forearm, and brachial artery, median cubital vein, receives
tributay of median antebrachial vein.
Behind:
Triceps and anconeus, posterior cutaneous of forearm, medial & lateral cutaneous
nerve of forearm.
Medially:
Common origin of superficial flexor muscles of forearm, flexor carpi ulnaris and
ulnar nerve, basilica vein.
Laterally:
Common origin of superficial extensor muscles of forearm, supinator, extensor
carpi radialis brevis, radial nerve and its superficial and deep branches, cephalic vein.
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 48
NORMAL ANATOMY OF ELBOW JOINT
Fig – 1 Shows Ligaments of Elbow Joint Anterior Aspect
Fig – 2 Shows Intra Capsular & Annular Ligament.
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 49
Fig – 3 Shows Ligaments of Elbow Joint Lateral View.
Fig – 4 Shows Ligaments of Elbow Joint medial View.
Department of Shareera Rachana, SDMCA, Udupi.
Review of Literature 50
Fig – 5 Shows Posterior Aspect of Elbow Joint
Department of Shareera Rachana, SDMCA, Udupi.
Methodology 51
METHODOLOGY
SOURCE AND METHOD OF COLLECTION OF DATA The subject of thesis is both conceptual and observational study by cadaver
dissection.
Material and methods
Source of data
Literary and conceptual study will be on the data completions from the
Bruhatrayees, Laghutrayees, and other classical books including journals, presented
papers, previous work done and co-related, analyzed with the knowledge of
contemporary science on the subject.
Dissection of the Kurpara Sandhi marma region in the dept. of Shareera Rachana
of S.D.M. College of Ayurveda, Udupi was carried. Observations are analyzed and co-
related in the view of ancient description of Kurpara Sandhi Marma and its viddha
lakshana with special reference to modern science.
Method of collection of the data Books, thesis, journals including published on the concept related to subject will
be reviewed and related information will be collected and analyzed scientifically.
Cadaver and specimen study will be conducted in Shareera Rachana dept. of
S.D.M. Ayurveda College, Udupi.
Assesment Criteria Observation and identification of the regional anatomy of Kurpara marma sthana
on the cadaver dissection and co- related with Kurpara marma shareera explained in
Ayurveda classics Kurpara marma vidha lakshanas are identified with the help of modern
parameters like x – ray and structures were identified.
Department of Shareera Rachana, SDMCA, Udupi.
Dissection Photo 57
Department of Shareera Rachana, SDMCA, Udupi.
Dissection Photos
Fig-5: Right Elbow Region
Fig-6: Articular Capsule
Dissection Photo 58
Department of Shareera Rachana, SDMCA, Udupi.
Fig-7: Capsular Ligament
Fig-8: Radial Collateral Ligament
Dissection Photo 59
Department of Shareera Rachana, SDMCA, Udupi.
Fig-9: Ulnar Collateral Ligament
Fig-10: Articular Parts
Radiological findings 60
Department of Shareera Rachana, SDMCA, Udupi.
RADIOLOGICAL FINDINGS OF ELBOW JOINT
1) Left Elbow Joint X-Ray AP & Lateral View shows Coronoid Process Fracture
3) Right Elbow Joint X-Ray AP & Lateral View shows Medial Epicondyle Fracture
Radiological findings 61
Department of Shareera Rachana, SDMCA, Udupi.
5) Left Elbow Joint X-Ray Lateral View shows Supra Condylar Fracture with dislocation of Elbow and Radioulnar Joint.
7) Right Elbow Joint X-Ray Lateral View shows Lateral Collateral ligament avulsion
Radiological findings 62
Department of Shareera Rachana, SDMCA, Udupi.
5) Right Elbow Joint X-Ray AP & Lateral View shows Fracture of Neck of Radius and Coronoid Process of Ulna.
6) Left Elbow Joint X-Ray Lateral View Show Supra Condylar Fracture
Discussion 63
DISCUSSION Study of Kurpar Sandhi Marma has been carried out by collecting reference from
different Ayurvedic literature and modern anatomy text books and studied critically.
Structures present in the Kurpara Marma pradesha are identified with the help of
dissection. Structural changes were studied in Kurpara marmabhighata with the help of x-
ray, AP and Lateral view.
The Kurpara marma lies in the Kurpara sandhi, the detail discussion of these
points are as follows:
LOCATION As per the available reference from Samhita, the exact location of Kurpara sandhi
marma is mentioned as junction between Hasta and Baahu. So the junction of hasta and
bahu may be considering as elbow joint.
MAMSAAccording to Acharya Sushrutha 5 peshi’s are present in the Kurpara sandhi. We
won’t find any detail reference regarding these peshi’s present in the Kurpara Sandhi.
While dissecting the elbow region we observed the following muscles which are present
in and around the elbow joint. So the peshi’s may consider which helps in movement of
elbow joint and are originated and insertion in relation to Elbow Joint.
Anteriorly – Following muscles were observed -
Tendon of Biceps & Bicipital Aponeurosis.
Brachialis.
Brachioradialis.
Origin of Flexor Group of Muscles of forearm from the medial epicondyle.
Origin of Extensor Group of Muscles of forearm from the lateral epicondyle.
Posteriorly – Following muscles were observed-
Anconeus.
Tendon of Triceps muscle.
Pronator teres.
Department of Shareera Rachana, SDMCA, Udupi.
Discussion 64
SIRA As such there is no direct reference about Sira’s present in the Kurpara sandhi
region, but in the context of Siravyadha vidhi sharira while explaining the Sira vyadha in
the disease Yakrutdalyodara, it has been explained as Sira vyadha should be done at the
Dakshina Kurpara sandhi and in Plihodara at Vama Kurpara sandhi. So with this
reference we may consider the Sira’s lies in the Kurpara sandhi Marma. The superficial
veins like Cephalic, Basilic and Cubital veins in the marma sthana.
SNAAYUPrathaanavathi variety of snaayu present in urdhwa shaakha. As Kurpara sandhi is
present in the urdhwa shaakha, we can state that snaayu present in the Kurpara sandhi is
also of prathaanavathi variety. Acharya Sushruta has explained ten snayu’s are present in
Kurpara Sandhi. The snayu which are also helps in binding the bones. The ligaments
which are present at the elbow joint may be considered as snayu’s which are mentioned
in the Samhita’s.
According to modern explanation the following ligaments are found during
dissection in the elbow joint.
Capsular ligament.
Anterior and Posterior ligaments.
Ulnar collateral ligament.
Radial collateral ligament.
Annular ligament.
Quadrate ligament.
ASTHIAachaarya Sushrutha opines that, there is one Kurpara asthi in the Kurpara
sandhi. In the elbow region the articular parts of the humerus, radius and ulna are
observed as bony parts which help to form the elbow joint. These bony parts may
consider as the asthi in the marma sthana.
Department of Shareera Rachana, SDMCA, Udupi.
Discussion 65
SANDHI The Kurpara sandhi is a Sandamsha Kora variety of Cheshtavanta sandhi. The
shleshaka kapha and shleshmadhara kala are located in all the sandhi’s. This shleshma
dhara kala and shleshaka kapha will help for the free movement of joint and protection of
the joint. As per modern concern this joint is hinge variety of synovial joint. The same
synovial membrane and synovial fluid may correlate with the shleshmadhara kala &
shleshaka kapha respectively. According to modern science the elbow joint includes -
• Humeroradial joint – Hinge joint.
• Humeroulnar joint – Hinge joint.
• Superior radioulnar joint – Pivot joint.
These joints may be correlated with classification explained by Dr. Gananath Sen
as total elbow joint as a Kora sandhi. Kora sandhi sub varieties are Khalla Kora,
Paraspara Kora, Chakra Kora and Sandamsha Kora. The humero radial and humero
ulnar joint are types of sandamsha kora (hinge joint), the superior radio ulnar joint is
chakra kora sandhi (pivot joint) variety of Kora shndhi.
DISCUSSION ON PRAMANA The demarcation of a marma is the determination of location of marma. This may
be measured by an anguli pramana which was specified in the Samhitas. Here the praman
of the kurpar marma is 3 angula pramana.The area occupied by the marma is explained in
terms of own finger’s breadth (svanguli). While mentioning the pramana of Kurpara
marma it is mentioned just as 3 angula pramana, without much explanation about its
upper limit and lower limit of the site, and also regarding the length breadth and depth of
the marma. So we may consider 3 angula pramana equally as length, breadth or as
diameter present over the middle of Kurpara sandhi . The 3 anguli praman of kurpara
marma may consider the structures involving in and around the elbow joint. The anguli
pramana has considered as per Acharya Sushruta.
Department of Shareera Rachana, SDMCA, Udupi.
Discussion 66
DISCUSSION ON PRANA Marma’s consists of aggregate of Mamsa, Sira, Snayu, Asthi and Sandhi in which
Prana by nature resides, that is why injury to marma’s leads to respective consequences.
Acharya Dalhana comments that Prana is Agnyadaya. Acharya Sushruta mentioned
Prana by nature and especially resides in the marma, particularly Acharya Sushruta
mentioned Sapta Prana takes ashraya in marma i.e Soma, Maruta, Tejas, Satva, Raja,
Tama and Bhutatma. While on commenting on dwadasha prana Dalhana gives openion
that Soma, Maruta, Tejas as Tridosha and Satva, Raja, Tama as Triguna these are the
vital things which on injury leads to hazardous consequences in any marma sthana.
By injury to the marma both shareerika and manasika dosha’s are gets aggravated
which mya destroys both shareera and manas.
DISCUSSION ON MARMA VIDDHA LAKSHANA The Sandhi marma viddha lakshana’s are Vastu Shookarivakirna, Rudhe (the site
of injury feels as though full of thorns, even after healing of the wound) and Kunihi
(shortening of arm) Khanjata (lameness), Bala cheshta kshaya (decrease of strength &
movement), Shosha (emaciation), and Parva shopha sandhija (swelling of joints). Except
Khanjata all other lakshana’s like Vastu Shookarivakirna, Kuni, Bala cheshta kshaya,
Shosha and Parva shopha sandhija are seen in the Kurpara marma viddha lakshana.
Immediately after injury person feels the injury site as though full of thorns because of
the fractured bony fragments or due to damage to the nerves of elbow joint.
The fracture of the bones and related muscle injury definitely leads to shortening
of the limb i.e. Kunihi. Because of the nerve and vessel injury along with shortening of
limb there will be decrease in strength, movements and also there will emaciation of the
limb.
The vaikalyakara marma are predominance of Soma guna, firmness and coldness
are the quality of soma sustains life. This can be interpreted as Shleshaka kapha present
in the sandhi gets vitiated when the marma viddha occurs leading to vikalata. Kapha
dosha is predominantly formed from Ap mahabhoota, it is sheeta guna yukta and it is
responsible for the strength of our body and therefore it is called as Balasa. Thus kapaha
is responsible for sustaining life.
Department of Shareera Rachana, SDMCA, Udupi.
Discussion 67
DISCUSSION ON X – RAY: As a diagnostic tool, radiography has proved of great value in detection of the
early stages of deep seated diseases, when the possibility of cure is greatest. But here as
far as concern to our study we have collected x-ray report just to identify the structures
involving in Kurpara marma viddha. In most of the X-rays, a fracture of the bones which
forms the elbow joint was observed. So as per the observation we may consider Kunihi
i.e. Sankuchita Baahu madhye is because of fractures of bones like Lower end of
Humerus, upper ends of Radius and Ulna. In fact fractures will lead to damage of
surrounding structures like muscle, ligaments, and vessels. Here in the elbow region most
of the muscles get insertion in the form of tendon. So any tendon injury will lead to loss
of particular movement.
Department of Shareera Rachana, SDMCA, Udupi.
Conclusion
Department of Shareera Rachana, SDMCA, Udupi.
68
CONCLUSION
Kurpara marma sthana is the region of kurpara sandhi (elbow joint), which is
formed by the articulations of the lower end of the humerus, and upper end of the
radius and ulna including surrounding structures.
According to the observation, the fracture and dislocation of bones at the elbow
joint may leads to Kunihi (shortening of the limb), and it is the viddha lakshana of
Kurpara marma,
The injury to the nerves, blood vessels, muscles and ligaments may leads to
decrease in length, strength, movements and also there will emaciation of the
limb.
The vaikalyakara marmas are predominance of Soma guna, due to the soma guna
predominance firmness and coldness sustains life. Shleshaka kapha is soma guna
and responsible for Bala and maintenance of the life.
Other viddha lakshanas according to Acharya Vagbhata are Vastu
Shookarivakirna, Rudhe (the site of injury feels as though full of thorns, even
after the healing of the wound) and Khanjata (lameness), Bala cheshta kshaya
(decrease of strength & movement), Shosha (emaciation), and Parva shopha
sandhija (swelling of joints). These lakshanas may be observed clinically.
Summary
Department of Shareera Rachana, SDMCA, Udupi.
69
SUMMARY
The dissertation entitled “A STUDY ON SANDHI MARMA W.S.R TO
REGIONAL AND APPLIED ANATOMY OF KURPARA MARMA” comprises of 8
chapters namely Introduction, Objectives, Review of literature, Methodology,
Observation, Discussion, Conclusion and Summary.
Chapter 1:
General information regarding the Sandhi Marma and Kurpara Marma Viddha
lakshanas, has been covered in the introduction part of dissertation along with need of
this study in the present scenario is been highlighted.
Chapter 2:
Gives an plan about aims and objectives of the study.
Chapter 3:
This chapter explains Review of literature is subdivided into Historical review,
Ayurvedic review, and Modern review of the subject.
Historical review section comprises of references pertaining to Marma.
In Ayurvedic review, definition, location, measurement, classification, effect of
injury of Marma Pradesha explained in detail.
In the modern review detail gross regional and applied anatomy of Elbow joint
has been explained.
Chapter 4:
Methodology chapter explains about method of data collection, inclusion criteria,
exclusion criteria, assessment criteria and dissection procedure of Kurpara Marma
(Kurpara Sandhi).
Summary
Department of Shareera Rachana, SDMCA, Udupi.
70
Chapter 5:
The inferences based on radiological findings are presented in the observation
chapter. Photo plate of cadaver dissection of Kurpara Sandhi and x-rays of Elbow region
are also presented in this chapter.
Chapter 6:
In the discussion part, conceptual study regarding Marma and Kurpara Marma
Viddha lakshana has been highlighted along with radiological aspects of Elbow joint
injury.
Chapter 7:
Conclusion drawn from various sections of the work is given.
Chapter 8:
This chapter summarizes the entire work.
Shlokas 71
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SHLOKA REFERENCE:
23) qÉ× - qÉÌlÉlÉç – ÎeÉuÉxjÉÉlÉå, xÉÇÍkÉxjÉÉlÉå iÉÉimÉrÉïcÉ || (zÉ.Mü.SØ.6/44
24) qÉÉUrÉliÉÏÌiÉ qÉqÉÉïÍhÉ | (xÉÑ.vÉÉ. 6/3)369
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28) SzÉmÉëÉhÉÉrÉiÉlÉÉÌlÉ; iÉkrÉjÉÉ – qÉÔkÉÉï, MühPû:, ¾ûSrÉÇ, lÉÉÍpÉ:, aÉÑSÇ, oÉÎxiÉ:,
AÉãeÉ:, zÉÑ¢Çü, zÉÉåÍhÉiÉÇ, qÉÉÇxÉÍqÉÌiÉiÉåwÉÑ wÉOèû mÉÔuÉïÂmÉÉÍhÉ qÉqÉïxÉQèû.ZrÉÉÌlÉ ||
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30). qÉqÉÉïÍhÉ eÉÏuÉÉkÉÉUÉÍhÉ mÉëÉrÉãhÉ qÉÑlÉrÉÉã eÉaÉÑ : || (vÉÉ.mÉë.ZÉÇ. 5/39)52
31) ÍqÉërÉiÉåÅÎxqɳɅ. EmÉWûiÉå CÌiÉ qÉqÉï || (A.¾û.zÉÉ 4)409
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33) AÌmÉ cÉ - qÉUhÉMüÉËUiuÉÉlqÉqÉï | (A. xÉÇ. zÉÉ 7/48)323
34) xÉmiÉÉå¨ÉUÇ qÉqÉïzÉiÉqÉç | (xÉÑ. zÉÉ. 6/3)369
35) lÉ ZÉsÉÑ qÉÉÇxÉÍxÉUÉxlÉÉruÉÉÎxjÉxÉÎlkÉurÉiÉËUMåühÉÉlrÉÉÌlÉ |
qÉqÉÉïÍhÉ pÉuÉÎliÉ, rÉxqÉɳÉÉåmÉsÉprÉliÉå || (xÉÑ. zÉÉ. 6/3)369
Shlokas 72
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36) rÉiÉÉå qÉÉÇxÉÉÌSwuÉåuÉ x§ÉÉåiÉ: mÉpÉ×iÉÏÌlÉ xÉÎliÉ |
iÉxqÉÉlqÉÉÇxÉÉSÏÌlÉ mÉgcÉæuÉ qÉqÉÉïhÉÏÌiÉ || (xÉÑ. zÉÉ. 6/3) 369
37). iÉãwÉÉqÉãMüÉSvÉæMüÎxqÉlÉç xÉÎYjÉlÉ pÉuÉÎliÉ, LiÉãlÉãiÉUxÉÎYjÉ oÉÉWÕû cÉ urÉÉZrÉÉiÉÉæå |
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38). xÉmiÉÉãiÉUÇ qÉqÉï vÉiÉqÉç iÉãwÉÉqÉãMüÉSvÉÉÌSvÉãiÉç |
mÉ×jÉMç xÉYjlÉÉã: iÉjÉÉ oÉÉWûÉåx§ÉÏÍhÉ MüÉã¸ã lÉuÉÉãUÍxÉ ||
mÉ׸ã cÉiÉÑSïvÉÉãkuÉïÇ iÉÑ eɧÉÉåÎx§ÉÇzÉŠ xÉmiÉ cÉ || (A. Wè . vÉÉ. 4/1-2)409
39. xÉmiÉÉãiÉUÇ qÉqÉïvÉiÉÇ, iÉ§É cÉiÉѶÉiuÉÉËUÇvÉcNûÉZÉÉxÉÑ,
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40). ´É×aXûÉOûMüÉlrÉÍkÉmÉÌiÉ : vÉZÉçXûÉæ MühPûÍxÉUÉ aÉÑSqÉç |
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41) A¹Éæ cÉ qÉÉiÉ×MüÉ : xÉbÉÉæ ÌlÉblÉlirÉãMüÉã³ÉÌuÉÇvÉÌiÉ ||
xÉmiÉÉWû mÉUqÉxiÉãwÉÉÇ MüÉsÉ MüÉsÉxrÉ MüwÉïhÉã | (A.Wû.vÉÉ. 4/52-53)415
42) uɤÉÉãqÉqÉÉïÍhÉ xÉÏqÉliÉiÉsÉͤÉmÉëãlSìoÉxiÉrÉ: |
MüOûÏMüiÉÂhÉã xÉlkÉÏ mÉμÉïeÉÉæ uÉ×WûiÉÏ cÉ rÉÉ |
ÌlÉiÉqoÉÌuÉÌiÉ cÉæiÉÉÌlÉ MüÉsÉÉliÉUWûUÉÍhÉ iÉÑ || (xÉÑ.vÉÉ.6/10)370
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43) §ÉrÉÎx§ÉÇvÉSmÉxiÉqpÉiÉsÉWûimÉÉμÉïxÉlkÉrÉ: |
MüOûÏiÉÂhÉxÉÏqÉliÉxiÉlÉqÉÑsÉãlSìoÉxiÉrÉ: |
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46) sÉÉãÌWûiÉɤÉÉÍhÉ eÉÉlÉÑuÉÉïMÔücÉï ÌuÉOûmÉMÔümÉïUÉ : ||
MÑüMÑülSUã Mü¤ÉkÉUã ÌuÉkÉÑUã xÉM×üMüÉÌOûMãü ||
AÇxÉÉÇxÉTüsÉMüÉmÉÉXaÉç lÉÏsÉã qÉlrÉã TühÉÉæ iÉjÉÉ ||
uÉæMüsrÉUÉhÉÉlrÉÉWÒûUÉuÉiÉÉæï ²Éæ iÉjÉæuÉ cÉ | (xÉÑ.vÉÉ.6/12-13)370
47) TühÉÉuÉmÉÉXaÉçûÉæ ÌuÉkÉÑUã lÉÏsÉã qÉlrÉã M×üMüÉÌOûMãü |
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xÉeÉÉlÉÑsÉÉãÌWûiÉɤÉÉÍhÉMü¤ÉÉkÉ×Mçü MÔücÉïMÑümÉïUÉ : |
uÉæMüsrÉÍqÉÌiÉ cÉiuÉÉËU cÉiuÉÉËUÇvÉccÉ MÑüuÉïlÉã ||
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Shlokas 74
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48) aÉÑsTüÉæ uSÉæ qÉÍhÉoÉlkÉÉã uSÉæ uSã uSã MÑücÉïÍvÉUÉÇÍxÉ cÉ |
ÂeÉÉMüUÉÍhÉ eÉÉlÉÏrÉÉS¹ÉuÉãiÉÉÌlÉ oÉÑÎbSqÉÉlÉç || (xÉÑ.vÉÉ.6/14)370
49) A¹Éæ MÔücÉïÍvÉUÉãaÉÑsTüqÉÍhÉoÉlkÉÉ ÂeÉÉMüUÉ: | (A.Wû.vÉÉ.4/59)415
50) EurÉï: ÍzÉUÉÇÍxÉ ÌuÉOûmÉå cÉ xÉMü¤ÉmÉÉμÉï
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52) iÉ§É xÉbÉ: mÉëÉhÉWûUÉÍhÉ AÉalÉãrÉÉÌlÉ, AÎalÉaÉÑhÉãwuÉÉvÉÑ ¤ÉÏhÉãwÉѤÉmÉrÉÎliÉ |
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xÉvÉsrÉÉã eÉÏuÉÌiÉ ESèkÉ×iÉvÉsrÉÉã ÍqÉërÉiÉã | (mÉÉMüÉimÉÌiÉiÉvÉsrÉÉã uÉÉ eÉÏuÉÌiÉ)
uÉæMüsrÉMüUÉÍhÉ xÉÉæqrÉÉÌlÉ, xÉÉæqÉÉã ÌWû ÎxjÉUiuÉÉcNæûirÉÉccÉ mÉëÉhÉÉuÉsÉqoÉlÉÇ MüUÉãÌiÉ;
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53) iÉãwÉÑ xuÉpÉÉuÉiÉ LuÉ ÌuÉvÉãwÉãhÉ mÉëÉhÉÉÎxiɸÎliÉ || (xÉÑ. zÉÉ .6/15)371
54) xÉÉãqÉ qÉÉÂiÉ iÉãeÉÉÇÍxÉ UeÉ: xÉiuÉiÉqÉÉÇÍxÉ cÉ |
qÉqÉïxÉÑ mÉëÉrÉvÉ: mÉÑÇxÉÉÇ pÉÔiÉÉiqÉÉ cÉÉuÉÌiɸiÉã |
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56) xÉmiÉÉã¨ÉUÇ qÉqÉïvÉiÉÇ rÉSÒ£üÇ vÉUÏU xÉÇZrÉæqÉÍkÉM×üirÉ iÉãprÉ : |
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58) xrÉÉlqÉqÉãïÌiÉ……iÉãlÉÉ§É xÉÑiÉUÉÇ eÉÏÌuÉiÉÇ ÎxjÉiÉqÉç | (A.Wû.vÉÉ. 4/38)413
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61) ÌuÉ®åÅeÉxÉëqÉxÉ×YxÉëÉuÉÉã qÉÉÇxÉkÉÉuÉlÉuɨÉlÉÑ : |
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65) uÉxiÉÑ vÉÔMæüËUuÉÉÌMühÉïÇ ÂRåû cÉ MÑüÍhÉZÉgeÉiÉÉ |
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66) U£üÇ xÉvÉoSTãülÉÉãwhÉÇ kÉqÉlÉÏxjÉã ÌuÉcÉãiÉxÉ: | (A.Wû.vÉÉ.4/49)415
67) iÉ§É xɱ: mÉëÉhÉWûUqÉliÉã ÌuÉbSÇ MüÉsÉÉliÉUãhÉ qÉÉUrÉÌiÉ,
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68) NãûSpÉãSÉÍpÉbÉÉiÉãprÉÉã SWûlÉɱÉUhÉÉSÌmÉ |
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69) LiÉimÉëqÉÉhÉqÉÍpÉuÉϤrÉ uÉSÎliÉ iÉe¥ÉÉ:
vÉx§ÉãhÉ MüqÉïMüUhÉÇ mÉËUWûirÉ MüÉrÉïqÉç ||
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70) EurÉï: ÍvÉUÉÇÍxÉ ÌuÉOûmÉã cÉ xÉMü¤ÉmÉÉμÉï
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mÉÉ´uÉÉïÍpɱÉÌiÉiÉqÉÌmÉWû ÌlÉWûÎliÉ qÉqÉï
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71) mÉÇcÉÉvÉiwÉOè cÉ qÉqÉÉïÍhÉ, ÌiÉsÉÌuÉëÌWû xÉqÉÉlrÉçÌmÉ |
C¹ÉÌlÉ qÉqÉÉïhrÉlrÉãwÉÉqÉç || (A.Wû.vÉÉ.4/63)413
Shlokas 78
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72) uÉÉiÉÌmɨÉMüTüÉlÉ×hÉÉÇ oÉÎxiÉWûlqÉÔkÉï xÉÇ´ÉrÉÉ :|
iÉxqÉɨÉixjÉÉlÉxÉÉÍqÉmrÉÉ®iÉïurÉÉ uÉqÉlÉÉÌSÍpÉ:||
AkrÉÉiqÉsÉÉãMüÉã uÉÉiÉÉkÉæsÉÉãïMüÉã uÉÉiÉUuÉÏ lSÒÍpÉ: |
mÉÏQûrÉiÉã kÉÉrÉïiÉã cÉæuÉ ÌuÉM×üiÉÉÌuÉM×üiÉæxiÉjÉÉ ||
ÌuÉÂbSæUÌmÉ lÉ iuÉãiÉã aÉÑhÉÉæblÉïÎliÉ mÉUxmÉUqÉç |
SÉãwÉÉ: xÉWûeÉxÉÉiqrÉiuÉÉ̲wÉÇ bÉÉãUqÉWûÏÌlÉuÉ ||
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qÉqÉÉïÍhÉ oÉÎxiÉ WûSrÉÇ ÍvÉUc´É| mÉëkÉÉlÉpÉÑiÉÉÌlÉ uÉSÎliÉ iɥɥÉÉ: ||
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75) iÉjÉÉ qÉqÉïÍxÉUÉxlÉÉrÉÑxÉÎlkÉ iÉÂhÉÉÎxjÉxÉåuÉlÉÏkÉqÉlÉÏaÉsÉlÉÉÍpÉlÉZÉÉliÉ: zÉåTü:
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(xÉÑ.zÉÉ. 6/33)375
Shlokas 79
Department of Shareera Rachana, SDMCA, Udupi.
77) cÉiÉÑÌuÉïkÉÉ rÉÉxiÉÑ ÍxÉUÉ: vÉUÏUã mÉëÉrÉãhÉ iÉÉ qÉqÉïxÉÑ xÉͳÉuÉ¹É : |
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78) iÉ§É xɱ: mÉëÉhÉWûUÉÍhÉ xÉmiÉUɧÉÉprÉliÉUÉlqÉÉUrÉÎliÉ || (xÉÑ.vÉÉ. 6/23)372
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80) iÉ§É xɱ: mÉëÉhÉWûUÉhrÉÉalÉãrÉÉÌlÉ, AÎalÉaÉÑhÉãwuÉÉvÉÑ ¤ÉmÉrÉÎliÉ || (xÉÑ.vÉÉ.6/17)371
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iÉxqÉɱ¦ÉãlÉ xÉÇU¤rÉÇ U£üÇ eÉÏuÉ CÌiÉ ÎxjÉÌiÉ: || (xÉÑ.xÉÔ 14/44)66
82) lÉ cÉ ¤ÉhÉqÉÌmÉ EmÉã¤ÉãiÉ |
mÉëÉhÉ: mÉëÉhÉpÉ×iÉÉÇ U£üÇiÉi¤ÉrÉÉiÉç ¤ÉÏrÉiÉã AlÉsÉ: |
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83) MüÉsÉÉliÉU mÉëÉhÉWûUÉÍhÉ mɤÉÉlqÉÉxÉÉuSÉ iÉãwuÉÌmÉ iÉÑ
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85) WûiÉã MüÉsÉÉliÉUblÉã iÉÑ kÉëÑuÉÉã kÉÉiÉѤÉrÉÉã lÉ×hÉÉqÉç |
iÉiÉÉã kÉÉiÉѤÉrÉÉelÉliÉÑuÉãïSlÉÉÍpÉ¶É lÉvrÉÌiÉ || (xÉÑ.vÉÉ.6/37)375
Shlokas 80
Department of Shareera Rachana, SDMCA, Udupi.
86) ÌuÉvÉsrÉmÉëÉhÉWûUÉÍhÉ uÉÉrÉurÉÉÌlÉ, vÉsrÉqÉÑZÉÉuÉÂbSÉã
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(xÉÑ.vÉÉ. 6/16)371
87) Ei¤ÉãmÉÉæ xjÉmÉlÉÏ §ÉÏÍhÉ ÌuÉvÉsrÉblÉÉÌlÉ, §ÉrÉ ÌWû |
uÉÉrÉÑqÉÉïÇxÉuÉxÉÉqÉelÉqÉxiÉÑaXûÉÌlÉ vÉÉãwÉrÉlÉç |
vÉsrÉÉmÉÉrÉã ÌuÉÌlÉaÉïcNûlÉç शu्ÉÉxÉÉiMüÉxÉÉccÉ WûlirÉxÉÔlÉç || (A.Wû.vÉÉ.4/55-56)415
88) ÌuÉvÉsrÉmÉëÉhÉWûUÉÍhÉ uÉÉrÉurÉÉÌlÉ, vÉsrÉqÉÑZÉÉuÉÂbSÉã
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(xÉÑ.vÉÉ. 6/16)371
89) ÌuÉzÉsrÉblÉÇ uÉæMüsrÉMüUÇ cÉ pÉuÉÎliÉ | (xÉÑ. zÉÉ. 6/22)372
90) uÉæMüsrÉMüUÉÍhÉ xÉÉæqrÉÉÌlÉ, xÉÉåqÉÉå ÌWû ÎxjÉUiuÉÉcNæûirÉÉŠ mÉëÉhÉÉuÉsÉqoÉlÉÇ MüUÉåÌiÉ | (xÉÑ.zÉÉ.6/16)37
91) yiÉå uÉæMüsrÉMüeÉlÉlÉå MåüuÉsÉÇ uÉækrÉlÉæmÉÑhÉÉiÉç |
zÉUÏUÇ Ì¢ürÉrÉÉ rÉÑ£Çü ÌuÉMüsÉiuÉqÉuÉÉmlÉÑrÉÉiÉç || (xÉÑ.zÉÉ.6/38)375
92) uÉæMüsrÉMüUÉÍhÉ cÉ MüSÉÍcÉSirÉÍpÉWûiÉÉÌlÉ qÉÉUrÉÎliÉ || (xÉÑ.zÉÉ.6/23)372
93) aÉÑsTü ²Éæ qÉÍhÉoÉlkÉ ²Éæ ²å ²å MÔücÉïÍzÉUÉÇÍxÉ cÉ ।
ÂeÉMüUÉÍhÉ eÉÉÌlÉrÉÉS¹ÉuÉãiÉÉÌlÉ oÉÑÎbSqÉÉlÉç || (xÉÑ.vÉÉ.6/14)370
Shlokas 81
Department of Shareera Rachana, SDMCA, Udupi.
94) ÂeÉÉMüUÉhrÉÎalÉuÉÉrÉÑxÉÉãqÉaÉÑhÉoÉÉWÒûsrÉÉiÉç || (A.xÉÇ.vÉÉ. 7/60)324
95) A¹Éæ MÔücÉï ÍvÉUÉã aÉÑsTü qÉÍhÉoÉlkÉÉ ÂeÉÉMüUÉ : | (A.Wû.vÉÉ. 4/59)415
96) ÂeÉÉMüUÉÍhÉ qÉqÉÉïÍhÉ ¤ÉiÉÉÌlÉ ÌuÉÌuÉkÉÉ ÂeÉ:|
MÑüuÉïlirÉliÉã cÉ uÉæMüsrÉÇ MÑüuÉãïkÉuÉvÉaÉÉã rÉÌS || (xÉÑ.vÉÉ.6/40)376
97) ÂeÉMüUÉhrÉÎalÉuÉÉrÉÑaÉÑhÉpÉÔÌrɸÉÌlÉ, ÌuÉzÉåwÉiÉ¶É iÉÉå ÂeÉMüUÉå; mÉÉgcÉ pÉÉæÌiÉMüÐÇ cÉ ÂeÉÉqÉÉWÒûUåMåü ||
(xÉÑ.zÉÉ.6/16)371
98) ÂeÉÉMüUqÉiÉÏuÉëuÉåSlÉÇ pÉuÉÌiÉ || (xÉÑ.zÉÉ.6/22)372
101) mÉëmÉÉÍhÉ mÉëoÉÉWÒû qÉkrÉå MÔümÉïU: || (A.xÉÇ.zÉÉ 7/16)320
102) MÔümÉïU: MüTüÉåÍhÉ: ‘MÑüWÒûhÉÏ’ CÌiÉ sÉÉåMåü|| (xÉÑ.zÉÉ. 6/24)373
103) MÔümÉïUÉæ – MüTüÉåÍhÉeÉÉæ ²Éæ xÉÎlkÉqÉqÉÉïhÉÏ ²rÉ…ÓûsÉÉæ uÉæMüsrÉMüUÉæ iÉ§É oÉÉWÒûqÉkrÉå xɃûÉå.cÉ: ||
(pÉÉ.mÉë.3/233)70
104) MÔümÉïUÇ eÉÉlÉÑuÉiMüÉæhrÉÇ iÉrÉÉåÌuÉïOûmÉuÉimÉÑlÉ: |
Mü¤ÉɤÉqkrÉå Mü¤ÉÉkÉ×Mçü MÑüÍhÉiuÉÇ iÉ§É eÉÉrÉiÉå || (A.¾û.zÉÉ 4/9)410
105) MÑüÍhÉ: MÑüÎoeÉiÉMüU: || (cÉ.ÍxÉ.2/21)690
106) MÑüÍhÉ: xɃÓû.ÍcÉiÉ oÉÉWÒûqÉkrÉ: || (xÉÑ.zÉÉ.6/24)373
107) MÑüÍhÉiuÉÇ – oÉÉWÒûmÉÉhrÉ…Óû.ÍsÉMÑüoeÉiÉ || (A.¾û.zÉÉ. 4/9)410
108) MÔümÉïUå Ìuɬå iÉjÉÉ MÑüÍhÉiÉÉ ----- MÑüÍhÉ ÌoÉM×üiÉMüU: || (A.xÉÇ.zÉÉ 7/16)320
109) xÉlkrɶÉÉ…û. xÉlkÉÉlÉɬåWåû mÉëÉå£üÉ: MüTüÉÎluÉiÉÉ : || (zÉÉ.mÉë.5/36)52
Shlokas 82
Department of Shareera Rachana, SDMCA, Udupi.
110) iÉ×iÉÏrÉã WûxiÉmÉÉSÍvÉUxÉÉÇ mÉgcÉ ÌmÉhQûMüÉ ÌlÉuÉïiÉïliÉãÅ…û.mÉëirÉ…û. ÌuÉpÉÉaÉ¶É xÉÔ¤qÉÉã pÉuÉÌiÉ ||
( xÉÑ.vÉÉ. 3/18)352
111) AxjlÉÉÇ iÉÑ xÉlkÉrÉÉã WûÉãiÉã MãüuÉsÉÉ: mÉËUMüÐÌiÉïiÉÉ: |
mÉãvÉÏxlÉÉrÉÑÍxÉUÉhÉÉÇ iÉÑ xÉÎlkÉxÉZXûrÉÉ lÉ ÌuɱiÉã || (xÉÑ.vÉÉ. 5/28)367
112) qÉÉÇxÉÉlrÉ§É ÌlÉoÉbSÉÌlÉ ÍxÉUÉÍpÉ: xlÉÉrÉÑÍpÉxiÉjÉÉ |
AxjÉÏlrÉÉsÉqoÉlÉÇ YOíûuÉÉ lÉ vÉÏrÉïliÉã mÉiÉÎliÉ uÉÉ || (xÉÑ.vÉÉ.5/23)366
113) lÉÉærÉïjÉÉ TüsÉMüÉxiÉÏhÉÉï oÉlkÉlÉæoÉïWÒûÍpÉrÉÑïiÉÉ |
pÉÉU¤ÉqÉÉ pÉuÉSãmxÉÑ lÉ×rÉÑ£üÉ xÉÑxÉqÉÉÌWûiÉÉ |
LuÉqÉãuÉ vÉUÏUãÅÎxqÉlÉç rÉÉuÉliÉ: xÉlkÉrÉ: xqÉ×iÉÉ: |
xlÉÉrÉÑÍpÉoÉïWÒûÍpÉoÉïbSÉxiÉãlÉ pÉÉUxÉWûÉ lÉUÉ: || (xÉÑ.vÉÉ. 5/33,34)367
114) MåüzÉzqÉ´ÉÑlÉZÉsÉÉåqÉSliÉÉÎxjÉÍxÉUÉxlÉÉrÉÑkÉqÉlrÉ: zÉÑ¢Çü cÉåÌiÉ (ÌmÉiÉ×eÉÉÌlÉ) || (cÉ.zÉÉ.3/7)390
115) qÉÉiÉ×eÉÉSrÉÉãÅmrÉxrÉ qÉWûÉpÉÔiÉÌuÉMüÉUÉ LuÉ |, uÉÉruÉÉiqÉMüÇ xmÉvÉï:
xmÉvÉïlÉÇ UÉæxrÉÇ mÉëãUhÉÇ kÉÉiÉÑurÉÑWûlÉÇ cÉã¹É¶É vÉÉUÏrÉï: || (cÉ.vÉÉ.4/8)318
116) rÉSÒcduÉÉxÉmÉë´uÉÉxÉÉãlqÉãwÉÌlÉqÉãwÉÉMÑügcÉlÉmÉëxÉÉUhÉaÉqÉlÉmÉëãUhÉkÉÉUhÉÉÌS iÉuSÉrÉuÉÏrÉÇ xmÉvÉï: xmÉvÉïlÉÇ cÉ,||
(cÉç.vÉÉ.7/16)339
117) ´sÉãwqÉÉ ÎxjÉUiuÉÎxlÉakÉiuÉxÉÎlkÉoÉlkɤÉqÉÉÌSÍpÉ: || (A.Wû.xÉÔ. 11/3)182
118) xÉÎlkÉxjÉ: zsÉåwqÉÉ xÉuÉïxÉÎlkÉ xÉÇzsÉåwÉÉiÉç xÉuÉï xÉlkrÉlÉÑaÉëWÇû MüUÉåÌiÉ || (xÉÑ.xÉÔ.29/14)
Shlokas 83
Department of Shareera Rachana, SDMCA, Udupi.
119) mÉYuÉÉzÉrÉ MüÌOû xÉÎYjÉ ´ÉÉå§ÉÉÎxjÉxmÉzÉïlÉåÎlSìrÉqÉç |
xjÉÉlÉÇ uÉÉiÉxrÉ iɧÉÉÌmÉ mÉYuÉÉkÉÉlÉÇ || (A.¾û.xÉÔ.12/1)192
120) M×üvÉSÏbÉÉïM×üiÉrÉ: xÉvÉoSrÉÉiÉÉ: || (A.Wû.zÉÉ. 3/87)402
121) qÉãkÉÉuÉÏ mÉëÍvÉÍjÉsÉxÉÎlkÉoÉlkÉqÉÉÇxÉÉã || (A.Wû.zÉÉ.3/92)403
122) zsÉåwqÉ aÉÔRûÎxlÉakÉÎzsɹ xÉlkrÉÉÎxjÉqÉÉÇxÉ: || (A.Wû.zÉÉ. 3/96)404
123) cÉiÉÑjÉÏï ´sÉãwqÉkÉUÉ xÉuÉïxÉÎlkÉwÉÑ mÉëÉhÉpÉ×iÉÉÇ pÉuÉÌiÉ |
xlÉãWûÉprÉ£ãü rÉjÉÉ WûɤÉã cÉ¢üÇ xÉÉkÉÑ mÉëuÉiÉïiÉã |
xÉlkÉrÉ: xÉÉkÉÑ uÉiÉïliÉã xÉÇδsɹ: ´sÉãwqÉlÉ iÉjÉÉ || (xÉÑ.vÉÉ.4/14-15)356
124) ÂMç mÉuÉïhÉÉÇ pÉëqÉÉã qÉÔcNûÉï SvÉïlÉ iÉqÉxÉxiÉjÉÉ |
AÂwÉÉÇ xjÉÔsÉqÉÔsÉÉlÉÉÇ mÉuÉïeÉÉlÉÉÇ cÉ SvÉïlÉqÉç |
qÉeeÉmÉëSÉãwÉÉiÉç,|| (cÉ.xÉÔ. 28/17)17
125) xÉlkÉrÉxiÉÑ ÎuSÌuÉkÉɶÉã¹ÉuÉliÉ:, ÎxjÉUÉ¶É |
vÉÉZÉÉxÉÑ WûluÉÉã: MüOûrÉÉÇ cÉ cÉã¹ÉuÉliÉxiÉÑ xÉlkÉrÉ: |
vÉãwÉÉxiÉÑ xÉlkÉrÉ: xÉuÉãï ÌuÉ¥ÉãrÉÉ ÌWû ÎxjÉUÉ oÉÑkÉæ: || (xÉÑ.vÉÉ. 5/24,25)366
126) ²å xÉÎlkÉ zÉiÉå।| (cÉ.zÉÉ.7/14)338
127) xÉZXûcÉÉiÉxiÉÑ SvÉÉã¨ÉUã ²å vÉiÉã | iÉãwÉÉÇ vÉÉZÉÉxuɹwÉ̹:,
LMüÉãlÉwÉ̹: MüÉã¸ã, aÉëÏuÉÉÇ mÉëirÉÔkuÉïÇ §rÉvÉÏÌiÉ: || (xÉÑ.vÉÉ. 5/26)366
Shlokas 84
Department of Shareera Rachana, SDMCA, Udupi.
128) iÉ LiÉå xÉlkÉrÉÉåŹÌuÉkÉ: - MüÉåUÉåsÉÔZÉsÉxÉÉqÉѪ mÉëiÉUiÉѳÉxÉåuÉlÉÏuÉÉrÉxÉiÉÑhQûqÉhQûsÉzÉ„û.uÉiÉÉï: |
iÉåwÉÉqÉ…Óû.ÍsÉqÉÍhÉoÉlkÉaÉÑsTüeÉÉlÉÑMÔümÉïUåwÉÑ MüÉåUÉ: xÉlkÉrÉ:, Mü¤ÉÉuÉǤÉhÉSzÉlÉåwÉÑsÉÔZÉsÉÉ:,
AÇxÉmÉÏPûaÉÑSpÉaÉÌlÉiÉqoÉåwÉÑ iÉѳÉxÉåuÉlrÉ:, yluÉÉåÂpÉrÉiÉxiÉÑ uÉÉrÉxÉiÉÑhQûÉ:, MühPû¾ûSrÉlÉå§ÉYsÉÉåqÉlÉÉQûÏwÉÑ qÉhQûsÉÉ:,
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(xÉÑ.zÉÉ.5/27)367
Bibiliography
Department of Shareera Rachana, SDMCA, Udupi.
85
BIBILIOGRAPHY
1. Rishi kumar P.R.S. Sharma &Ram Chandra, editor. Atharvaveda Vol 1 – 8.
Muradabad: Sanatana Dharma Yantralaya; 1988. (7:2/123/1)
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Samshodhana Mandal; Vol 1 to 10 (1:11/61/6)
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Muradabad: Sanatana Dharma Yantralaya; 1988. (1:17/117/24)
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Samshodhana Mandal; Vol 1 to 10 (1:17/16/15)
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Muradabad: Sanatana Dharma Yantralaya; 1988. (8:3/17)
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Muradabad: Sanatana Dharma Yantralaya; 1988. (7:2/123/1)
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Muradabad: Sanatana Dharma Yantralaya; 1988. (7:2/123/1)
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Muradabad: Sanatana Dharma Yantralaya; 1988. (7:2/123/1)
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Muradabad: Sanatana Dharma Yantralaya; 1988. (7:2/123/1)
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Muradabad: Sanatana Dharma Yantralaya; 1988. (7:2/123/1)
Bibiliography
Department of Shareera Rachana, SDMCA, Udupi.
86
11. Rishi kumar P.R.S. Sharma &Ram Chandra, editor. Atharvaveda Vol 1 – 8.
Muradabad: Sanatana Dharma Yantralaya; 1988. (8/3/17)
12. Rishi kumar P.R.S. Sharma &Ram Chandra, editor. Atharvaveda Vol 1 – 8.
Muradabad: Sanatana Dharma Yantralaya; 1988. (8/3/17)
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