The Treatment of Marmas

In Ayurveda, there are many different treatments of marmas or the lethal zones of which Sushruta explains there are 107 marmas. One of these treatments is what we call today acupressure. This is where we can use a finger to apply pressure to one of these marmas to cause a therapeutic effect. Acupressure is called Mardana (मर्दन) in Ayurveda and may involve deep tissue pressure massage.

As Ayurvedic experts Ranade, Frawley and Lele explain:
“Mardana- Acupressure"
Mardana is another method of Ayurvedic massage meaning ‘applying pressure’. We can also call it ‘acupressure’.”(p.72).

Mardana can be done with a circular massage motion on the marmas in a clockwise directive motion (+) in order to increase the flow of prana or in an anticlockwise motion (-) in order to reduce the flow of prana either in the marma or in the part of the body where the marma is located.

Marma Massage

For massage [mardana], two important rules should be remembered.
1.Perform the massage motion in a a clockwise motion when tonification or strengthening the internal organs and tissues is the aim.
2.Perform the massage in a counterclockwise manner when the goal is to reduce excess doshas or excess tissues growth or for detoxification purposes.” 1 (pp 66-67)

Each finger has a different effect when they’re used for Ayurvedic acupressure. These effects may be important in the treatment of ailments, symptoms and derangements of the Five Elements and the Three Doshas (Vata, Pitta, Kapha).

“ Acupressure done with the thumb strengthens Prana overall [Pranavayu]. Acupressure done with the index finger projects the upwards moving energy of Udana. That done with the middle finger projects the outward moving energy of Vyana. That done with the ring finger projects the contracting and consolidating energy of Samana. That done with the little finger projects the downward moving energy of Apana.” 1 (p.74)

Normally it is recommended to apply pressure on a marma for a limited period. This period is usually between 3 and 5 minutes or until the pain sensation on the marma has ameliorated.
“ The duration of massage for marma points should be at least three to five minutes. ” 1 (p.66).
Equally, this method can also be applied in the application of needles (suchi) in the method called siravedhana or piercing of siras1 (pg 212). Sushruta explains that there are 700 siras or acupoints in the body which can be pierced for treatment 2.

The application of the needles should always be done gently and carefully in order not to aggravate the doshas, specifically Vata. A formula of acupoints, similar to a formula of herbs can be developed in order to treat the disease with needling. Usually, somewhere between 5 to 20 needles could be used in one treatment but this number may also depend on the patient’s dosha. There is an ancient Asian saying that an extrovert practitioner uses many needles while the true master uses a few, in well chosen locations.

“For balancing the doshas, Sushruta advised puncturing the channels (sira) by using instruments as small as half a grain of rice. These are needle numbers 26, 27 & 28 in size.” 1 (pg 212).

We can stimulate or sedate prana by rotating the needle which is already piercing the skin and at the appropriate depth, either clockwise or anticlockwise with the fingers.

Additionally, if we use the thumb and the index finger together to rotate the needle when it is inserted in the acupoint, this may stimulate the entry and general diffusion of prana (pranavayu) in the body while at the same time encouraging the ascending pranic flow (udana). To cause a centrifugal effect of prana (vyana), we can use the thumb and the middle finger.
The thumb and the ring finger can be used which will cause the return to the torso of pranic flow (centripetal) from the limbs (samana). When it is desired for the pranic energy to descend (apana), then the thumb and the little finger can be used to rotate the needle. For instance, use of the thumb and little finger may be desirable for easier defecation, urination and even child-birth, especially at a sira or acupoint which relates to Apana vayu. Prana diffuses from the practitioner’s fingers through the needle to the patient’s body at the sira, like an antenna or conductor from the macrocosm to the microcosm.

When we use these methods, that also cause subtle (sukshma) as well as physical (sthula) effects, therefore the therapist should possess a calm, balanced and positive disposition when applying the therapy.

Dr. Frank Ros, Author Ayurveda and Acupuncture. www.marmapuncture.net

1.Ayurveda and Marma Therapy. Drs. S. Ranade, D. Frawley, A. Lele. Lotus Press, Wi, USA.2003.
2 Vedic Health Care System (Clinical Practice of Sushrutokta Marma Chikitsa and Siravedhana-highlighting Acupuncture) Drs.R.L.Shah,B.K.Joshi, G.Joshi. New Age Books New Delhi. 2002.