Marma Cikitsā - Ayurvedic Energy Work

​Marma Cikitsā

There are subtle channels running in and around the energetic body called nāḍīs. These nāḍīs correspond to the different parts of the physical anatomy. When these nāḍīs become blocked by the three doṣas, energy becomes stagnant and disease arises. Clearing blockages in these subtle channels can help to alleviate all sorts of mental and physical conditions in the body. There are certain vital points described by the ancient Āyurvedic texts where these nāḍīs pass close to the skin. These points are referred to as marman (plural marmāni). So the word “marma” refers to certain vital points and “cikitsā” means treatment. In Kerala, marma is often referred to as varman. Marma means “that which is secret.” Varman means the place where the vital breath and the five elements join to give vitality (va = air or vāyu; ru = five; and aman = joining point).   

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My Experience of Marmāni ​

I have practiced and taught Āyurveda for many years. My teacher originally studied at the Āyurvedic Institute but learned most of what he knew about Āyurvedic body work directly with Āyurvedic doctors in Kerala and later in Rishikesh. I have not generally practiced marma cikitsā because I have not specifically studied all the various points. But I have commonly used more than 27 of the marmāni in both diagnosis and body work. My student, Mochani Devi. has been studying marma cikitsā and is beginning to offer marma cikitsā here at the Soma Matha Center and at Oversoul Healing Center in Charlottesville. 

I am generally not practicing Āyurveda any more, though I teach some when I can find time amidst my very busy schedule. I am writing this article to help increase awareness of this mystical Vedic form of energy healing which has been largely lost throughout India, but which has been preserved by the siddhas of Kerala in particular. The marmāni are mentioned in several of the major extant texts on Āyurveda and there are many people working to revive this ancient system throughout India. The siddhas of Kerala have preserved and passed down this ancient tradition, teacher to disciple for generations.  

My experience of the marmāni is mainly energetic. Since I was a young child I could feel the different nāḍīs of the subtle body. As a child, I recall speaking to my physician about the sensation of the nāḍīs in the body. He, of course, was unaware of these subtle energies and suggested that I speak to a psychiatrist about what I was feeling. Later, when talking to Yogis, they confirmed my experiences of these subtle channels. Most people who want to work with such energetic channels for healing must do a lot of spiritual practice to begin to gain awareness of these channels. I was blessed with this awareness at a young age so working with nāḍīs and marma points came naturally to me. Though it will be possible to find the points in relation to the physical anatomy without being able to feel the subtle energy, it may not be possible to accomplish much healing through these points without some subtle awareness. 
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Marma cikitsā is traditionally considered a mantric science or prāṇic science. Traditionally, marma work involved the recitation of Sanskrit mantras to bring awareness to the energy channels and to help to clear blockages and stimulate a healthy flow of energy. The prāṇa of the practitioner is used to influence the flow of prāṇa for the client. Marma cikitsā cannot be practiced by just anyone. The practice requires a heightened awareness of the subtle energy of the body which in most cases requires spiritual initiation to develop. Beyond this, a person must clear the veil of the subconscious through many months or years of disciplined spiritual practice designed to reveal the unconscious patterns of one’s own mind, offering the attachments of egoism into the sacred agni of transformation. When working with spiritual students I often focus awareness upon the blockages in the nāḍīs to help facilitate the release of granthis (spiritual knots) hindering awareness. This is the same as marma cikitsā which is commonly practiced by gurus when having darshan (sight) of their students. This is similar to the practice of nokku varmam in Kerala, by which martial artists disable, injure, or kill a person through sight of the marmāni.  

​Marma and Massage

Marma cikitsā is not at all like massage. Whereas massage works on the physical body by applying pressure or otherwise manipulating the soft tissue of the body, marma cikitsā works instead upon the energetic body. For a person trained in marma work, it is not necessary to touch a person’s physical body at all. In marma work, it is possible to accomplish healing through the use of sound, awareness, breath, sight, or intention. Unlike massage, marma cikitsā can be conducted distantly. A competent marma practitioner in Chennai could easily work on the marmāni of a person in Philadelphia. In marma work, it is important not only to be able to locate certain points on the skin where the nāḍīs pass close to the surface of the body. These points are merely points of access or points of focus for our meditation. What is more important is to trace the energy flowing within the nāḍīs to locate blockages. The use of mantra is the most common technique which allows the awareness of the practitioner to enter into the body of the client to identify certain blockages within the channels. This cannot be accomplished by use of the five senses of the physical body but must be done using the higher perceptions which are developed in a dedicated spiritual practice. 
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With awareness of one’s own prāṇic body, it is possible to take awareness out of one’s own body and to go into the body of a client. The prāṇic body is not bound by space and time like the physical body. The same cosmic prāṇa which enlivens one person’s body is in the body of all other living beings also. With awareness of prāṇa, we can literally enter the body of a client and bring a higher meditative awareness into the subtle channels to facilitate the release of stagnant energies contributing to disease. In many cases certain physical techniques will be used also like the application of gentle pressure or herbal substances, but the intention and effect remain the same.  

History of Marma Cikitsā ​

The history of marma cikitsā in India is ancient and fascinating. The knowledge of nāḍīs for healing in Āyurveda is connected to the use of nāḍīs in Yoga to carry awareness into higher realms. One of the earliest texts which describes the marmāni in detail is the Suśruta Saṁhitā. This text refers to these vital points mainly in connection to the peril arising when the points are injured and the specific protocol involved in treatment of injuries to specific marmāni. The earliest texts on marmāni, refer to 107 marmāni with the mind as a 108th. In practice in Kerala today, there are over 250 marmāni commonly used, with countless others used occasionally. In some cases, these points correspond to the points used in the Chinese system of acupuncture. In other cases, these points are distinct and unique to the Āyurvedic system. It is said that the system of acupuncture was in fact first brought to China along with the martial arts from India by the Buddhist monk, Bodhidharma. There is a 3,000 year old Sanskrit text on the Āyurvedic system of acupuncture called Sūcī Veda. The practice of acupuncture has been all but lost in India now. But the use of herbs and mantras for treatment of the marmāni is much more common. 

In the times that the Buddhists were invading India and forcefully converting people to their faith, the surgical traditions of Āyurveda were seen by the Buddhists as bad. Since Buddhism valued ahimsa (non-violence) so highly, the surgical system of Āyurveda, along with the needling techniques of sūcīveda, gained disapproval from Buddhist invaders because they caused harm in order to heal. At this time, many texts were burned by the Buddhists and many surgeons and acupuncturists were sentenced to death. The hypocrisy of killing surgeons to prevent harm is hard to overlook, but this is the unfortunate nature of fundamentalism which turns well-intentioned people into brutes and causes much harm to society. Unfortunately, most of the texts on Āyurvedic surgery and Marma cikitsā were lost at this time. 
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Later, the system of marma cikitsā faced further scrutiny and repression under the British Raja in India. The physicians trained in marma could touch a point on a person’s body and make them unconscious or revive them from a state of unconsciousness. They could touch a point and paralyze a person. They could touch certain points and impair a person’s speech or vision. Certain points could be touched to inflict injury or death. This knowledge was seen as a great threat by the British rulers and the practitioners of marma cikitsā were executed or their fingers were cut off to prevent their practice. A few martial artists went into hiding and preserved the knowledge of marmāni, along with a few physicians in Kerala who were granted protection by Indian Rajas. After British rule ended, a few of these people who had preserved the ancient secrets came out of hiding and began teaching others. The knowledge of marmāni is still carefully guarded due to its great potential for inflicting harm and few really know the practice in its most authentic forms.

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​The Application of Marma cikitsā in India and Abroad

Today in Kerala, where knowledge of marma has been preserved the best, marma work is typically accomplished with the use of mantra and other techniques of meditation to center consciousness along with pressure and the application of special herbal pastes (kalkas) in addition to traditional herbal oils (tailams). These substances are applied topically along with gentle pressure and awareness. For the best results, herbs and other substances should be empowered using mantras. The spirit of the plants should also be contacted and supplicated for help with the healing work being done. 

Many teachers of marma in the West are recommending more commonly available substances for marma work like gemstones, tuning forks, or essential oils. Though it is possible to affect the marmāni with these things in addition to colors and other sounds and other minerals and objects, each of these techniques carries with it certain drawbacks compared to the use of herbs prevalent in Kerala. 

Like herbs, gemstones possess powerful specific energies which can be used for healing specific conditions. There are certain stones which are most suitable for each doṣa and for specific organs, tissues, and conditions in the body. Though there is some description of the rasa, vīrya and other healing effects of a few gems and minerals in the Rasaśāstras (texts on alchemical medicines), the specific healing effects of most of the thousands of gemstones available today remain mysterious to most people. There are accounts of the healing properties of gemstones in many Western new age books, but accounts are conflicting and few provide the depth of understanding needed to apply gems for the treatment of specific conditions. With herbs, it is possible to tailor treatments to the specific needs of an individual according to the properties of herbs described in detail in the various texts on Āyurvedic pharmacology. 

Tuning forks and singing bowls possess the drawback that one sound frequency emitted by any implement will have specific effects upon the doṣas which will be very difficult for all but the most intuitive healers to determine. A tuning fork which makes one note, will treat one specific type of condition quite effectively while remaining ineffective in other conditions, or even worsening these conditions. Essential oils also present the drawback that they are not doṣa specific. Though many people use essential oils according to the specified effects of the herbs from which they were produced, this is a flawed approach. Because essential oils are a concentration of the most volatile and fragrant portion of an herb, they all possess similar properties to the fragrant herbs of the eladi gana. Despite what various modern sources may state, it has been our experience that all essential oils will tend to aggravate vāta and pitta in excess.       

Some people in India today who have not been trained in the traditional ways, are also working to revive the science of marma. In the absence of many good texts on marma published in India, many of these Āyurvedic doctors have been heavily influenced by Western authors. This provides the advantage that new ways of working with the marmāni are being developed which could help to expand the scope of marma cikitsā. This also provides the drawback that it leaves out the ancient wisdom of the Sages inherent in the traditional ways which have been passed down for generations. 

In practice, many various techniques have been used through the generations in India to work on marma points. In addition to the use of needles and kalkas and tailams, herbal steams have commonly been applied to the marmāni. Calamus, turmeric, and other herbs have been burned close to the points as well, similar to the use of mugwort and ginger in the Chinese practice of moxibustion. Beyond this, certain  mantra, tantras and meditations are commonly employed to effect the flow of prāṇa through the nāḍīs. Many practitioners of marma know techniques to use their prāṇa (breath) to stimulate the flow of prāṇa through the nāḍīs of people they work with. With mantra and puja and prayer always being performed before marma work begins, it is not uncommon for the Devas to assist the practitioner of marma from the inner realms as well. It is certainly possible to work on the marmāni in many different ways, and no particular modality is wrong. Many practitioners are doing good work with essential oils and tuning forks despite the potential drawbacks of these methods. It is most important to do effective marma work that a person has a strong and clear vital force within themselves and an awareness of the blockages in their clients. In this case, any substance used becomes like amrita for healing, and any point on the body which is focused upon becomes a marma point.

​Marma Cikitsā and Accupressure

Many people liken marma cikitsā to acupressure or reflexology. This is understandable because both systems accomplish healing through specific points and both systems do not use needles as in acupuncture. The similarities end here. In reflexology, intense pressure is applied to certain points on the feet or hands in particular. Though it is safe in certain cases to apply firm pressure to the marmāni, in many cases, the application of firm pressure to the marmāni can lead to injury or death. A detailed description of the harm which can be inflicted with too much pressure to each of the 108 marmāni can be found in the Suśruta Saṁhitā. In marma cikitsā, we must be much more careful. Typically gentle pressure is used, with the specific amount of gentle pressure being determined by the doṣa affecting the nāḍī. In reflexology, the maintenance of pressure leads to a release of energy which can be noticed by a relaxing of the soft tissue at that spot. In marma cikitsā, physical touch is used more to direct energy within the inner channels. Reflexologists are trained to identify points requiring attention due to muscular tension around that particular point. In marma cikitsā, the muscles around a point may or may not be sensitive to the touch because these points are used to grant access to certain distant blockages along the same nāḍīs. 

Chakras and Marmāni

Many people wrongly associate the marmāni with the chakras. The system of chakras was originally revealed to help facilitate the flow of awareness into higher realms of consciousness. The system of marma was revealed to aid in healing the physical body. Most of the marmāni are contained within the astral body (sūkṣma śarīra) - though they are located with reference to the physical body, but the chakras are within the causal body (kāraṇa śarīra). The chakras do not relate to any part of the physical anatomy and it is perfectly possible for the kundalini to remain dormant and the chakras inactive and for a person to have excellent health. The use of chakras for healing was imagined by the Western scholars who struggled to understand the true spiritual application of the chakra system. This was never the intention of the Sages, but an addition of the Western thinkers. None of the traditional texts on Āyurveda make any mention of the use of chakras for healing. For healing of the energetic body, instead the system of nāḍīs and marmāni is used in Āyurveda. This system is much more complex than the Western system of seven chakras, but its complexity allows for precise healing work to be done.  

There are certain marmāni which people commonly relate to the seven chakras most prevalent in the West today. It should be noted that gurus in India have been aware of and used 100’s of chakras throughout the body in spiritual practice. The system of seven chakras was popularized by Western scholars in the late 19th century. Most of the marmāni which are related to the 7 Western chakras are located on the front of the body and are wrongly associated with the chakras located at a similar place within the spine. Many people have developed the misconception that the manipura chakra is located at the naval. This chakra is located within the spine around the height of the naval. This misconception has likely been inspired by diagrams of the location of the chakras which depict a sitting person from the front. From this misconception, it has been deduced that nābhi marma (located at the navel) is connected to the manipura chakra. Many practitioners wrongly assume that this point can be used to cure any condition the manipura chakra is claimed to treat. We must remember that chakras were never intended by the Sages to treat any condition, but instead to grant us access into spiritual realms of awareness. These healing attributes of chakras come not from the enlightened awareness of the Sages, but the imagination of Western mystics struggling to understand the true application of the chakras. There are many specific uses for the nābhi marma described by the traditional Āyurvedic literature. The tradition of healing with marmāni, unlike the tradition of healing with chakras, is reliable, having its origins in the enlightened awareness of the Sages. 

​The Application of Marma Cikitsā

Even if a person does not have knowledge of the Āyurvedic techniques of nāḍīnidāna (pulse diagnosis), sparśana (palpitation), darśana (physical inspection), and praśna (questioning), one who is trained in marma cikitsā can determine the doṣas contributing to a condition through the marmāni themselves. Touch of certain marmāni with knowledge can aid in the diagnosis of specific conditions. A tenderness will be noticed around specific marmāni in certain conditions; like hṛd marma cardiac problems, the yakṛt marma for liver problems, plīha marma for the spleen, spṛkka marma for the kidneys, or indrabasti for chronic constipation. Āyurvedic doctors in India often use palpitation of the marma to confirm diagnoses.         

To properly treat any marma, it is useful to know where there is a blockage of energy along the connected nāḍī. For this, great awareness of the subtle body is required. Even without this awareness, it is possible with mindfulness and practice to determine which doṣa is causing obstruction to that nāḍī by touch of the marma itself. This technique also requires some subtle awareness of energy because unlike the practice of acupressure which feels for tension in the soft tissue of the physical body, this technique requires awareness of tension within the prāṇic body of a person. This is subtler and may or may not be accompanied by corresponding tension in the soft tissues of the physical body. Generally it is necessary to study directly with a teacher to be able to effectively employ these methods. 

With practice, we can bring awareness to the prāṇa flowing through a nāḍī. Tension in the flow of prāṇa through the nāḍī will be noticed when there is a need for treatment of that nāḍī. Even without knowing what condition a person is affected by, it is possible to know which marmāni require treatment by bringing awareness to the nāḍīs. When we gently touch a marma, pressure is felt within the nāḍī. If this pressure is released upon very gentle pressure, it is understood that the obstruction is caused by vāta doṣa. If tension is released with slightly firmer pressure, it is understood that pitta is the cause of imbalance within the nāḍī. If deep pressure is required to feel a release of tension in the nāḍī, it is understood that kapha doṣa is the cause. Of course, even this “deep” pressure must be relatively gentle for the safety of the person. Very deep pressure is never required when working with marmāni because we are working on the energetic body and not the physical body.   

With knowledge of the doṣa causing obstruction to the nāḍī, it is possible to devise an effective treatment. doṣa specific herbs are used to pacify the doṣa / doṣas in question. If there is knowledge of the specific disease conditions, or the organs or tissues or channels affected, herbs with specific properties to alleviate these conditions can be employed for the best result. Mantras used should be specific for the doṣa and condition in question also. The pressure and duration of treatment also should be tailored to the specific requirement of the doṣa giving rise to imbalance. vāta requires the most gentle pressure and shortest duration of treatment. The light and airy and changeable nature of vāta is easily influenced and benefits from gentle and short treatments but is aggravated by firm touch and long treatment times. Pitta benefits from a moderate pressure and duration of treatment. Kapha, which is very slow and heavy, requires the firmest pressure and longest duration of treatment. This is required to achieve the needed stimulation to break through the dull stagnation of that particular doṣa. vāta requires the least amount of herbs and large amounts of oils to counter its dryness. Pitta benefits from a moderate amount of herbs and oils. Kapha requires the stimulating effect of large quantities of herbs and very little oil.          

The touch in many types of body work is designed to achieve a certain effect upon the tissues of the physical body. Touch is different in marma work. We must remember that marma cikitsā is designed to stimulate the flow of energies in the subtle body and that physical touch is not required at all. There are martial artists in Kerala who can kill a person by gazing at a marma. There are healers there who can heal disease by looking at the marmāni as well. When therapeutic touch is used in marma treatments, it is designed to stimulate the flow of prāṇa. In abhyanga, the motions of the hands are designed to help apply herbal oils and open the pores so that those oils can penetrate deep into the muscles and tissues of the body. In this case, it is the herbs and oils which do the work; not the practitioner. In the case of marma cikitsā, touch is designed to stimulate a healthy flow of prāṇa through the nāḍīs. 

Beyond the differences in pressure described above, different types of touch are used to accomplish different effects to the flow of energy in the body. Upward movements stimulate udana vayu whereas downward movements stimulate apana vayu. Circular motions can be used to increase vyāna vāyu. Upward movement can increase alertness and bring awareness into higher spiritual states. Downward movements are calming and grounding. Clockwise movements are used to increase strength and nourishment. Counter clockwise movements help to facilitate release and purification. Movements from the extremities toward the heart are tonic whereas outward movements are cleansing. Movements from the right toward the left are more cooling whereas movements from the left toward the right are heating. These and other such motions are done to influence the flow of energy in the subtle body. Knowledge of the specific type of motions most useful can be discerned by knowledge of a person’s doṣas and conditions. 

However, we can also feel the movements of energy within the subtle body. Those who can feel the subtle spiraling and pulsation of energy in the subtle body can follow these movements with their awareness in order to facilitate release. This technique is even more powerful because it follows the energetic body’s natural process of healing. In this case, the energy in the body will often be noticed initially to move in the opposite directions than those specified for healing above. By following these movements within the body, pressure builds which facilitates release. After this, the energy of the body will naturally move in the appropriate ways for the desired healing effect. For example, if a person has skeletal degeneration of the patella caused by vāta doṣa, clockwise motions would help ease that condition. However, if we bring awareness to the flow of energy at the jānu marma, it would often be noticed that energy is spiraling in a counterclockwise direction. By following the flow of energy with our awareness in a counterclockwise direction, we will observe a pulsation at the area of the knee. As pressure builds and the subtle pulsation intensifies, energy will be released through the body of the client and through the body of the practitioner. This process may need to be practiced repeatedly until certain resistances are released. Once sufficient release is facilitated, it would be noticed that energies start to move naturally in a clockwise direction as would be desired for the needed healing effects. This approach is more gentle and facilitates deeper healing, but it requires greater awareness of subtle energy and much more practice. It is an advanced technique utilized by the siddhas who have great awareness of the subtle energies within the body. 

Really all that is required to facilitate the release of blockages in the nāḍīs is to bring higher awareness to those obstructions. Whether we utilize higher states of awareness accessed through meditative practices or rely upon the heightened awareness of the herb plants for healing, the effect is the same. It is a normalization of the flow of prāṇa in the body which improves vitality. With practice, we can see these obstructions in our own energetic body and within the bodies of others. With detached awareness, all obstructions are cleared.    

- Gananathamritananda Giri