A History of Indian Medical Literature v1.c25.617

Language: English

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The subjects discussed are: the number of marmans is 107; forty-four are found in the extremities, twenty-six in the trunk, thirty-seven in the part above (the trunk) (7.2); descriptions of the marmans in the leg up to the knee and the disorders resulting from injuries to them: the talahṛdaya,³⁴⁵ kṣipra,³⁴⁶ kūrca,³⁴⁷ kūrcaśiras,³⁴⁸ gulpha,³⁴⁹ indrabasti,³⁵⁰ and jānu³⁵¹ (knee) (7.3); the marmans in the thigh: the āṇi,³⁵² urvī,³⁵³ lohitākṣa,³⁵⁴ and viṭapa;³⁵⁵ the marmans in the arms correspond to those of the legs; the gulpha corresponds to the maṇibandha (wrist), the jānu to the kūrpara (elbow), the viṭapa to the kakṣādhara;³⁵⁶ injury to these leads to kuṇitā (crookedness)³⁵⁷ (7.4); the marmans of the trunk: guda (ano-rectal region),³⁵⁸ basti (urinary bladder),³⁵⁹ nābhi (navel)³⁶⁰ (7.5), hṛdaya (heart),³⁶¹ two stanamūlas,³⁶² two stanarohitas,³⁶³ two apastambhas,³⁶⁴ two apālāpas³⁶⁵ (7.6),³⁶⁶ two kaṭīkataruṇas,³⁶⁷ two kukuṇḍaras,³⁶⁸ two nitambas³⁶⁹ (buttocks),³⁷⁰ two pārśvasandhis³⁷⁰ (7.7), two bṛhatīs,³⁷¹ two aṃsaphalakas,³⁷² two aṃsas³⁷³ (7.8);³⁷⁴ the marmans above the trunk: four dhamanīs³⁷⁵ in the neck: two called nīlā and two called manyā,³⁷⁶ the four sirāmātṛkās,³⁷⁷ two kṛkāṭikās,³⁷⁸ two vidhuras,³⁷⁹ two phaṇas,³⁸⁰ two apāṅgas,³⁸¹ two śaṅkhas,³⁸² two āvartas ³⁸³ (7.9), two utkṣepas,³⁸⁴ the sthapanī,³⁸⁵ five sīmantas,³⁸⁶ four śṛṅgāṭakas,³⁸⁷ and the adhipati³⁸⁸ (7.10); the general characteristics of injury to a marman (7.11); the disorders arising (7.12);

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marmans are called thus because (injury to them) leads to death (maraṇakāritva); marmans are aggregates (sannipāta) of muscular tissue, sirās, snāvas, bones and joints;³⁹⁰ injury results in damage (ābādha) to the prāṇas; the marmans are classified according to the type of structure prevailing (7.13);³⁹¹ the eleven māṃsamarmans,³⁹² forty-one sirāmarmans,³⁹³ twenty-seven snāvamarmans,³⁹⁴ eight asthimarmans,³⁹⁵ and twenty sandhimarmans³⁹⁶ (7.14); the nineteen marmans of the sadyahprāṇahara group; injury to them leads to death within a week (7.15);³⁹⁷ the thirty-three marmans of the kālāntaraprāṇahara group; injury will have its effects within half a lunar month;³⁹⁸ injury to a kṣipra may quickly be fatal (7.16); the three marmans of the viśalyaghna group:³⁹⁹ someone with an injury to one of these will remain alive as long as air does not escape from the wound (7.17);⁴⁰⁰ the forty-four marmans of the vaikalyakara group; injury is sometimes fatal (7.18);⁴⁰¹ the eight marmans of the rujākara group (7.19);⁴⁰² some authorities assert that injuries which affect all five structures forming part of a marman are sadyahprāṇahara, while those affecting four of them are kālāntaraprāṇahara, etc. (7.20);⁴⁰³ others again do not accept the usual classifications of the marmans, insisting that svabhāva is the only determining factor with regard to the effects of an injury;

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in favour of this view they point to the fact that amputation of (part of) a limb, in spite of the presence of many marmans in it, is not fatal (7.21); still others explain this fact by arguing that, after amputation of a hand or foot, the sirās contract, thus leading to an only slight loss of blood and the preservation of life; injury to a marman, however, leads to much loss of blood, resulting in disorders of vāta, and, finally, death;⁴⁰⁴ therefore, when a marman in a particular limb is injured, this limb should be amputated at the nearest (proximal) joint;⁴⁰⁵ serious injury to a marman of a particular type necessitates placing this marman in a higher group; the reverse holds good in slight injuries (7.22);⁴⁰⁶ marmans are also divided into five groups by another criterion, namely their dimensions; urvī, kūrcaśiras, viṭapa and kakṣādhara measure one aṅgula,⁴⁰⁷ gulpha, maṇibandha and stanamūla two aṅgula, jānu and kūrpara three aṅgula; kūrca, guda, basti, nābhi, hṛdaya, the nīlās, manyās and mātṛkās, the sīmantas and śṛṅgāṭakas are as large as the palm of the hand; the remaining ones have the extent of an aṅguladala;⁴⁰⁸ other authorities hold that the kṣipras have the size of a grain of vrīhi rice, the stanarohitas and utkṣepas the size of a kalāya, and others the size of a sesamum grain⁴⁰⁹ (7.23).