Interpretation of Lohitaksha marma of lower limb as described in Ayurveda

1. Lohitaksha Marma of Adho Shakha
GuidedBy
Dr. Sunil Kumar Yadav
AssistantProfessor
PresentedBy
Nishi Jain
Ph.D.Scholar
PG Dept. Of Sharira Rachana
NIA, Jaipur.

2. Introduction
 Marma science is part of vedic science.
 107 Marma are described in per view of
traumatology.
 Marma is the seat of Prana and is constituted by
confluence of Mamsa, Sira, Snayu, Asthi, and
Sandhi.
 Injury lead to various effects from death to
permanent deformity.

3. मममाणि नमम
ममांसससरमस्नमय्वस्स्िसस्धिसस्धनपमतमाः; तेषु
स्वभमवत एव ववशेषेि प्रमिमस्स्तष्ठस्धत|
Conglomeration
of Marma
mamsa
sandhi
asthi
sira
snayu
All of them are considered to be seat of Prana.

4. 1. Literary meaning= Red eye, Indian
cuckoo, kind of snake, epiphet of vishnu.
2. Vaikalyakara Marma (Soumya)
3. Sira Marma, ½ Angula Pramana
5. Definition= उर्व्मा ऊर्धवामिो वङ्क्षिसधिेरूरुमूले
लोहितमषां, तत्र लोहितष्ेि मरिां पषमघातमतो वम|
proximal to Urvi Marma distal to Vamkshana Sandhi
near root of Uru in lower limb.
6. Lohitakshayena Marana/ Pakshaghata.
Lohitaksha....

5. 7. A.H.Sa.4
ऊरुमूले लोहितमषां िस्धत पषमसृक्क्ष्मत ्||७||
सवमाङ्क्गसुधदरी र्व्मख््म ( कृ त)
ऊरुमूले- उर्व्मास्तूर्धवं वङ्क्षिसधिेरिस्तमल्लोहितमषां नमम
ममा| तद्ववद्िां पषां ित््सृक्क्ष्मत ् र्व्िे सत््वप|
8. A.S.Sa.7
ऊर्व्मास्तूर्धवामिो वांषिसधिेरूरुमूले लोहितमषम्|
तत्र रक्क्तष्मत ् पषमघातमताः||१३||
र्व्मख््म (इधदु कृ त)
ऊरोमूाले वांषिसधिेरिस्तमत ् लोहितमषम्| तत्र रक्क्तष्मत ्
पषमघातमतो भवतत|

6. Assessment
 Surface anatomy
By classical description, definition
 Regional anatomy
By literature study
Identify location, structural composition
 Traumatology
From contemporary views
 Applied importance
From published articles

7. Surface anatomy
 According to classical description in gross, it is seen in area
around midinguinal point.
 Urvi= Uru Madhya
 Vamkshana Sandhi = hip joint
 Hip joint 1.2cm below inguinal ligament and just below joint
there is angulation between neck and shaft of femur.
 Uru Moola= inguinal fold or angle between neck and shaft of
femur because head is involved in articulation of hip joint.
Location of Marma may be between hip joint and neck shaft angle
of femur.

8. Lohitaksha marma

9. Regional anatomy
 Anterior aspect of proximal part of thigh.
 Femoral triangle
Roof= skin, superficial fascia, femoral branch of genito
femoral nerve, superficial branches of femoral artery
with accompanying veins, upper part of great saphenous
vein, deep fascia with saphenous opening.
Floor= medially adductor longus, pectineus
laterally iliacus, psoas major
Contents= Femoral artery and branches,
Femoral vein and tributaries ,
Femoral sheath encloses upper 4cm of femoral vessels,
Femoral nerve and branches.

11. Cont...
 Profunda femoris branching at distance of 3-4.5cm
from midinguinal point.
 Superficial and deep branches of femoral artery are
found just below inguinal ligament and above
branching of profunda femoris artery.
 great saphenous vein draining in femoral vein in this
area.
 Division of Femoral nerve is also in this area.
As it it Sira Marma, it is revealed to be composed of
these three.

12. Cont...
 ½ Angula (circumference, depth)= emerging point
of profunda femoris artery (crucial role in
formation of anastomoses in the surrounding area
to maintain blood supply)
Injury/ pathology
Blood supply hampers
Lohitaksha Sira= profunda femoris vein is in
vicinity of this.

13. Traumatology
 Marana or Pakshaghata due to Rakta Kshaya.
 Sira injury= excessive blood loss Kshaya of
Dhatu Vata increase severe pain
 Vascular injuries is main cause of limb amputation and
death if not treated early and properly.
 Severe haemorrhage= haemorrhagic shock,
hypovolemic shock
 Femoral vessels are among most commonly injured ,
comprises 70% of all arterial traumas. Result of
Penetrating injuries (gunshot wounds)

14. Marana meaning
1. Localized ischaemia
Amputation rate increase in lower limb arterial injury, risk factor is
failed revascularization
2. Death of person
Severe haemoorrhage hypovolemic shock death.
Veins injured air entry into venous circulation air
embolism death, pulmonary embolism
Vessels are large in size, pressure in artery high, blood flow towards
gravity. gunshot injury fatal haemorrhage
3. Marana Sadrishya Dukha
Ischaemia= severe pain
Thrombosis= excruciating pain
Pakshaghata= paralysed part, monoplegia due to haemorrhage.
due to acute ischaemia there will pain, pallor, pulseless, parasthesia,
paralysis

15. Air embolism in lung
tissue
Acute embolism to right femoral artery
resulting in ischaemia

16. Applied importance
1. Penetrating injury massive haemorrhage
death.
Death Cause is rapid blood loss oxygen decrease
to brain and other vital part suddenly.
2. Vascular injuries more involvement of femoral
artery more
3. lower extremity artery serious limb loss death.
3. Death because of air entry through femoral vein.
4. Death from extremity vascular injuries, femoral
artery >70%death, causes exsanguinations.
Post traumatic effect of Lohitaksha is rationalized.

17. Conclusion
 Uru Moola= between hip joint and neck shaft
angle of femur.
 ½ Angula= origin of profunda femoris from
femoral artey and entry of great saphenous vein to
femoral vein.(Lohitaksha Marma)
 Pakshaghata= monoplegia (ischaemia,
surrounding nerves)
 Marana= localized ischaemic death, death,
Marana Sadrishya Dukha.

18. References of applied importance
1. Senn N. An experimental and clinical study of air
embolism. Annuals of surgery 1885;2(7):22-50.
http://dx.doi.org/10.1097/00000658-188507000-
00002.
2. KauvarDS etal. National trauma databank analysis
of mortality and limb loss in isolated lower
extremity vascular trauma. Journal of vascular
surgery 2011;53:1598-603.
http://dx.doi.org/10.1016/j.jvs.2011.01.056.
3. Debakey ME, Simeone FA. Battle injuries of arteries
in world war II. Annuals of surgery 1946;123(4):
534-79. http://dx.doi.org/10.1097/00000658-
194604000-00005.

19. References
 Su.Sa.6/16
 Su.Sa.6/13
 Su.Sa.6/7
 Su.Sa.6/25
 Su.Sa.6/30.
 Su.Su.7/22