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Line 25: − + − ''Marma'' (vital points) are collection of muscle, tendons, ligaments, bone tissue, joints, blood vessels and nerves, nervous tissue, which forms the seat of life5 and it is also said that they are the seat for ''tridosha, triguna'' and the ''atma'', hence any injury to these can be life threatening and can cause death.6 + − + + + + + + − #''Sira'' is the brain along with the spinal cord comprising the body's central nervous system which is control network for all the body activities, conscious communication and automatic operation of organs such as breathing, maintaining blood pressure, and releasing hormones etc.+ − #''Hridaya'' is the heart which is the head of the circulatory system, which supplies oxygen and nutrients to the tissues. The body tissues need constant nutrition supply to be active, if there is lack of blood supply to the organs, the tissues may die.10 − #''Basti'' is renal system which plays an important role in elimination of body waste and regulate blood volume, help to regulate blood pressure, pH, and maintains electrolyte balance in the body. − The loss of substance/ body (''asraya'') leads to the loss of the substrate/ life (''ashrayee'') 11 hence, these ''trimarma'' should be especially protected against external injury and ''vatadi dosha''.+ + + +
→Introduction
=== Introduction ===
=== Introduction ===
Morbidity and mortality from cardiovascular (including cerebrovascular) diseases and renal diseases are the leading cause of morbidity and mortality today. According to the Center for Disease Control and Prevention (CDC), Cerebrovascular diseases are the fifth leading cause of death. Cardiovascular diseases (CVDs), per the Media Centre Fact Sheet of the World Health Organization (WHO), are the “number 1 cause of death globally” with an estimated 17.7 million people dying of it in 2015 (31% of global deaths). Last but not the least, renal diseases (or chronic kidney diseases (CKDs) afflict 14% of the general population in the US and are one of the major causes of death worldwide .
Morbidity and mortality from cardiovascular, cerebrovascular, and renal diseases are leading among global burden to the society. According to the Center for Disease Control and Prevention (CDC), Cerebrovascular diseases are the fifth leading cause of death.
Cardiovascular diseases (CVDs), per the Media Center Fact Sheet of the World Health Organization (WHO), are the “number one cause of death globally” with an estimated 17.7 million people dying of it in 2015 (31% of global deaths). Last but not least, renal diseases (or chronic kidney diseases (CKDs) afflict 14% of the general population in the US and are one of the major causes of death worldwide .
The word ''marma'' is derived from the ''mru marane dhatu'' of Sanskrit7 which states that, the ''marma'' are so vital that any trauma to them may lead to ''marana'' (death). In practical sense, ''marana'' here may not mean the death but can be considered as the pain and deformity which is so severe (''marana tulya peeda'') which may further lead to death.8 The ''adhisthana'' (location) of these diseases of ''marma'' can be assessed by the physiological changes in the body which can be detected considering the type of ''rogamarga'' (pathway of pathogenesis). ''Marma'' comes under ''madhyama'' (middle) ''rogamarga''9 so understanding of the ''rogamarga'' is essential to analyze the characters of the diseases, related with ''dushti'' (pathogenesis).
''Marma'' (vital points) are junctures of muscle, tendons, ligaments, bone tissue, joints, blood vessels and nerves, nervous tissue, which forms the seat of life and it is also said that they are the seat for ''tridosha, triguna'' and the ''atma'', hence any injury can be life threatening leading to death.
The word ''marma'' is derived from the ''mru marane dhatu'' (Sanskrit) which states that any trauma to ''marma'' may lead to ''marana'' (death) or dysfunction of that particular site. The ''adhisthana'' (location) of diseases of ''marma'' can be assessed by changes in physiological functions in the body and through type of ''rogamarga'' (pathway of pathogenesis). ''Marma'' comes under ''madhyama'' (middle) ''rogamarga''. Therefore understanding of the ''rogamarga'' is essential to analyze the characters of the diseases, related with ''dushti'' (pathogenesis).
Following are the sites of three most important ''marma'':
Following are the sites of three most important ''marma'':
#''Shira marma'' relates with the brain with the spinal cord comprising the body's central nervous system. This controls all the body activities, conscious communication and automatic operation of organs such as breathing, maintaining blood pressure, and releasing hormones etc.
#''Hridaya marma'' relates with heart and circulatory system, which supplies oxygen and nutrients to the tissues. The body tissues need constant nutrition supply to be active, if there is lack of blood supply to the organs, the tissues may die.
#''Basti marma'' relates with the urinary bladder and renal system plays an important role in elimination of body wastes and regulate blood volume, help to regulate blood pressure, pH and maintains electrolyte balance in the body.
The loss of substance/ body (''ashraya'') leads to the loss of the substrate/ life (''ashrayee'') hence, these ''trimarma'' should be especially protected against external injury and ''vatadi dosha''. The clinical features of diseases of head as per ''dosha'' dominance have already been described in [[Kiyanta Shiraseeya Adhyaya]]. In the present context, ''dosha'' dominant features observed in diseases of three ''marma'', of eyes, nose, ears and oral cavity are described. The diseases of scalp and hair are also described.
Later, in[[Trimarmiya Siddhi]], the importance of three ''marma'', consequences of their injury and management with [[Panchakarma]] procedures is described in detail. In the present chapter, however, management of disorders with medicines only has been described.
''Udavarta'' literally means upward and opposite frequent movement of ''vata dosha''. The term itself suggests pathology of aggravation of ''vata'' either due to its own causes or due to obstruction to its movement due to other dosha. If the aggravated vata affects vital marma like heart, brain and urinary bladder, then it can cause serious disorders. The chapter details about the diseases of these three regions with etiological factors, clinical features and management.
There are thirteen types of udavarta based upon suppression of natural urges described in navegandharaniya adhyaya. The diseases vary depending upon vitiation of vata due to respective urges and so is the management of udavarta. In the present chapter, the diseases due to apana vaigunaya (impairment of apana) in the pelvis region due to suppression of urge of flatus, defecation and urination are described. Though, udavarta is dealt in the initial part of the chapter and three marma in latter part, the name of the chapter is given as ‘Trimarmiya chikitsa’, because it emphasizes the management of diseases of three marma. Udavarta can be considered as cause for the diseases of three marma.
=== Sanskrit Text, Transliteration and English Translation ===
=== Sanskrit Text, Transliteration and English Translation ===