Marma Bandhana for Wrist Drop - A method under clinical evaluation

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                                 Dr.Bhat.A.Rangaprasad -Sarve janah Sukhino Bhavanthu || Sarve santhu Niramayah ||

Constant research on creating new modules of treatment in influencing and clearing the blockage of the pranic energy at the sites of marmas, I have come up with a new idea of bandhana/ plastering, having an impact over the marmas afflicted by the stagnant doshas.
The concept explained in this ppt is under evolution and further evaluations.
As of now, the clinical pattern of improvement observed with this technique is quite satisfactory.
And further such pattern of bandhanas are being tried for certain ailments.

More PowerPoint presentations from DrBhatRangaprasad

MARMA CHIKITSA IN GRDHRASI aka SCIATICA

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                                 Dr.Bhat.A.Rangaprasad -Sarve janah Sukhino Bhavanthu || Sarve santhu Niramayah ||

Sciatic pain is referred as Grdhrasi in Ayurveda, where in, the pain originating from the region of Kati (waist) gets referred or travels down to the Sakthi (Thighs), Janu (Knees), Gulpha Ankles) and to the Pada (foot) gradually, causing much agony to the patient.

The causes for the occurrence of sciatic pain are many. But the commonest causes are Lumbar Spondilitis or Spondilolisthesis, Lumbar Strain, Sacro ilitis etc.

The following marmas are afflicted with the stagnation {Aavarana} of doshas in case of Grdhrasi. Katikataruna – Nitamba – Kukundara – Lohitaksha ­– Urvi – Ani – Janu – Indrabasti – Gulpha – Kurcha – Talahrdaya – Ksipra. In my experience either all the marmas (very rare phenomenon) or a certain group of marmas (common phenomenon) are found to be involved.

METHOD OF PALPATING & CONFIRMING  MARMAS. 


Katikataruna marma: - this category of Asthi marma measuring half angula (1 cm) is present near the margins of pelvic bone, a few centimeters away from the Lumbo-sacral joint. Best posture to palpate this marma, would be prone or standing posture. Structures beneath this tenderful point approximate to the sacro-iliac joint ligaments, iliac bone, & iliac artery.


Nitamba marma:-
The hip region is referred as by the word Nitamba. It is located on the 2 pelvic bones on either side. Its length is half angula (1 cm) and falls under the category of Asthi marma. Make the patient lie down in prone posture. By drawing an imaginary line from scrotum to femoral joint, probe your fingers along that line until you find the highest point of tenderness, somewhere around the mid of this line which can be justified to be the  Nitamba  marma. Underneath this point, the entry of Sciatic nerve into the femoral region exists.


Lohitaksha: - Injury to this marma as per Sushruta leads to profuse bleeding (lohita) there by giving an appearance of red colored round or oval spot in this point on getting injured, resembling the appearance of red shot eye ball (as seen in case of opthalmitis), hence should’ve been named Lohita (red colored) Aksha (eye).It is Sira marma of ½ angula (1cm approx.) in length. It is present near the crease of the thigh. Start probing with the index finger, downwards from the crease, somewhere near the inguinal canal, the highest point of tenderness could be elicited. It is @ this point the femoral vessels exit to the lower limbs. One can hence understand the impact of injury to this spot leading to massive haemorrhage. Position of patient should be standing erect or supine.


Urvi marma: - The very presence of this marma in the region of thigh (Uru) becomes the reason for its nomenclature as Urvi. This Sira marma measuring 1 angula (1 1/2cm approx.) in length is present in the medial aspect of the thigh, nearly somewhere @ the mid of knee & groin. Make the patient sleep in supine posture. Make sure that the leg is flexed little bit so as to relax the thigh muscles, such that poking of the thigh muscles with the fingers would be possible. Then starting from the medial aspect of knee, over the medial compartment of the thigh,   probe your fingers slowly along the margins of biceps femoris, & locate the tenderness caused by the Urvi marma @ the middle of the thigh. Structures assumed to be beneath this vital point is the femoral artery. Most of the times, this artery becomes palpable in lean persons.

Ani marma: - The 3 angula (3 to 4 ½ cm approx.) length, Snayu marma lies above the janu marma on the medial side, falling near the medial border of Poppliteal fossa. Structures beneath this spot are the tendons of biceps femoris & other flexor muscles along with femoral artery and nerve. This marma plays an important role in persons of severe sciatica who complain that their knees are giving out, when manipulated properly makes the patient stand straight & walk steadily as firmness around the knee joint is restored.


Indrabasti marma: - This falls under the category of mamsa marma, measuring 2 angulas in length. It is present in the posterior compartment of leg, somewhere near the mid-point of Janu & Gulpha. As with my experience it most of the time gets elicited @ the end portion of calf muscle. Patient may be positioned in prone or sitting posture with crossed leg. Structures beneath this vulnerable point are etc Gastrocnemius muscle, Sciatic nerve, Tibial artery.

Gulpha marma: - Gulpha falls under the category of Sandhi marma and measures 2 angula in length. It is better palpable on the medial and lateral aspects of the ankle joint, where the tarsal ligaments are attached to the bone.

Kurcha marma: - The 4 angula Snayu marma is situated in the dorsal aspect of the foot, just 2 angulas above the Kshipra marma vertically. Interosseous muscles, ligaments & a branch of Tibial artery are the structures approximate to it. Posture of patient is either supine or sitting.

Talahrdaya: - In the hrdaya bhaga (central portion) of tala (sole) this talahrdaya marma is present. It is a marma measuring ½ angula (1 cm approx) in length. Due to the presence rigid plantar aponeurosis, pressing with one finger or thumb mayn’t be helpful in the proper determination of this marma. Hence, one has to press with both the thumbs approximating with each other, slowly from the heels, towards the region of fingers along the mid-line of the sole. Position of patient should be supine. The tenderness would be elicited best @ the centre of sole. Structures beneath this Talahrdaya marma are - Lumbrical muscles, plantar aponeurosis, Arch of anastomosis of veins etc.

Ksipra marma: - Kshipra is one of the most sensitive & useful marma used in the marma healing procedure for many diseases, other than Sciatica. As of my rough study it has got some viable connection with the Cardiac plexus too. It is a Snayu marma of ½ angula (approx. 1cm) in length, located between the thumb & 2nd toe. To palpate this marma adduct the above two fingers & carefully probe the space from its lower end, moving upwards to find the most tenderful spot. Best posture to elicit this is supine posture.


Concept of Marma chikitsa :
Due to the stagnation of doshas around any 1 or 3 or almost all of the above marmas, the flow of cosmic energy (Pranic energy or Prana vayu) from Shat chakras to the destinated part (over here the leg) will be affected or blocked. On manipulating the marma point, we are actually trying to displace or disperse the doshas, blocking the pathway of the cosmic energy. On having displaced either partially or completely, the symptoms of (Sciatic pain) starts receding gradually or immediately respectively. Based on the concept of energy, and as per my view, the energy actually starts flowing from Agna chakra to Muladhara chakra (Sacral plexus) in downward direction (i.e. from a region of higher concentration to a region of lower concentration). For this reason, manipulation of proximal marmas (hitherto-- katikataruna) followed by other marmas in the downward direction reaching the distally affected marma (hitherto­­--Kshipra marma). When done in the above manner the patient gets a faster relief from the pain. Whereas, if distal marmas are manipulated first, followed by the marmas present proximally ending in Katikataruna, it is observed that—{a}either the pain gets relieved very slowly or {b} the pain gets localized in any of the marmas present in the middle, causing severe agony to the patient. On having displaced either partially or completely, the symptoms ( Sciatic pain) starts receding gradually or immediately respectively.

Marmas to be manipulated with utmost care: --
                                                                  
1.Lohitaksha 

2.Indrabasti 

3.Kurcha 

4.Kshipra



Undue or much pressure exerted on these marmas may result in, as from my experience severe localised pain & tenderness, increased vascularity (if a patient with an h/o thrombosis in leg, any cardiac or valvular impediments etc., this may pose a danger to the quality of life or even may endanger his life), ligamental sprain, limping gait, shock etc., respectively.

Conclusion: -- 
To conclude, when the above marma points are manipulated by a technically sound physician, who has mastered the knowledge of the anatomical position of the structures involved; who has the ability to implicate and analyze the physiology or patho-physiology of the diseased portion of the body, will be the blessed person in the earth to humbly give relief to his patients suffering from Sciatica. My vast experience in treating the patients of sciatica is one of the contributing and inspiring factors for having written this article, for the sole purpose of spreading the awareness and benefit of Marma chikitsa. Sarve Janah Sukhinoh Bhavanthu (Let the humanity live in peace and health).

The above article had been written by the author in Articlesbase.com at the following link http://www.articlesbase.com/alternative-medicine-articles/synopsis-of-management-of-grdhrasi-sciatica-with-marma-chikitsa-895610.html

Obesity Management With Ayurveda Combination Sthoulyahara

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                                 Dr.Bhat.A.Rangaprasad -Sarve janah Sukhino Bhavanthu || Sarve santhu Niramayah ||

Treatment of Obesity as per the siddhanta of Ayurveda has to be planned taking into the consideration of the following factors the Kapha,Pitta & Vata doshas; the bala / physical strength of the person; the rasa, rakta,mamsa & medo dhatus.
Treating obesity successfully is a challenging job for physicians of any system of practice of medicines.
It had been said in one context of explanation of obesity that कार्श्यमेव  वरं  स्थौल्यं ॥(Karshyameva varam sthoulyam ||). Which means Being lean is better than being obese,specifically when it comes with tretaing them.Obesity will hereby from now on be referred with the term Sthoulya in this draft.
Sthoulya is possible to control but with difficulty. It is because  santarpana / excess nutrition (calories) will lead to further medodhatu vruddhi / accumulation of adipose or fat tissues and apatarpana (Starvation or Extreme Dieting) will not conquer tikshna agni bala / profound digestive activity . More over, sthoulya persons will naturally be durbala / depleted in energy due to improper nourishment of the Saptadhatus, hence the obese or sthoulya perons may not be able to withstand the extremity of depletion of nourishment caused by the extereme dieting.
P.S:-It is believed in Ayurveda that the sapta dhatus / 7 tissue elements are complimentary to each other and that each of the tissues has the quality of their predecessor tissues.

We too had our difficulties in treating obese persons, not until when I happened to stumble up on certain specific references while researching the vast repertory available in various samhitas related Ayurveda.
Based up on those fine tuned research for the herbs, we started providing the "Sthoulyahara" which is a combination of two preparations.One in the form of kvatha churna to which some fruit pulp are to be added, while preparing the kashayam and other in the form of Capsules.

This specific combination, the "sthoulyahara",might give an impression to you that it drastically reduces the weight, since the discussion is about obesity. Any expectations of loosing 5 kgs to 12 kgs in a month may not and will not get fulfilled with this combination. We are not claiming tall regarding the Sthoulyahara with regards to the perpective of weight loss.To the most you can expect 1 to 3 kgs of weight loss per month that's it.

The result we get from the feedback of our clients are encouraging.

But, the Sthoulyahara do have a profound inclination in reducing and controlling the LDL / Low density lipids & the Triglycerides.

One must understand that it is the low density lipids, which is the culprit, which gives the sensation of heaviness and pendulous appearence of the body parts like the abdomen,buttocks, thighs and the arms accumulated with the adiposity.
When once the LDL starts getting reduced, the subjective feeling of heaviness of body parts gets reduced initially, and there by one's girth of the body too gets shrunken gradually.

As of our clinical & physical observation there has always been a particular pattern of losings one's cumulative fat deposit. The face is the first index representing the action of the medicines consumed. It starts losing its excess fat deposit. If no fat present in face already, then it's contour remains the same as it was, even, before taking the medicines. Following the face, one will start feeling the lightness and loss of excessive fat in the following areas the buttocks,then the abdomen along with the thighs followed by the chest & the arms.

The above sequence of loss of fat has been observed in almost 60 to 70 % of the patients who took the medicines religiously and followed the diet and exercise regimen adviced appropriately.

WBC,RBC & Hb Aberrations - A brief clinical input

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                                 Dr.Bhat.A.Rangaprasad -Sarve janah Sukhino Bhavanthu || Sarve santhu Niramayah ||

 A patient with the following symptoms approached our clinic for appropriate treatment.

 1.Reduced WBC & RBC counts and Hb%
2.Splenomegaly
3.Fatty liver
4.Mild ascites with Anasarca
5.Loss of appetite with nausea and vomiting
6.Constipated bowels with dysuria

On careful analysis based on the Ayurveda siddhantas, and after thorough search in the repertories of samhitas for medicinal combination just the following two medicines were selected and given to the patient after preparing with the specifications mentioned in the classical text.

1.Dasamulapancakoladi kvath churn
2.Punarnavadi churn, Care was taken to include all the ingredients mentioned in the reference.

Mode of action for which the above medicines selected..
1.Appetiser
2. Digestive
3. Carminative
4.Tonic to Spleen and Liver
5.Indicated in Ascites
6.Mild diuretic
7.Laxative
8.Rejuvenative
9.Acts on Pitta,Kapha and Vata respectively.
10.Negates the aberrated ap,teja&vayu maha bhuta
11.Influences the rasa,rakta,mamsa and medo dhatus.

Observation post medication:


Observation after one month medication, partaken by the patient is as follows.

1.The counts of WBC & RBC along with Hb% increased.
2.Colicky Pain over splenic area nil.
3.Appetite improved; gained 3 kgs of lost weight
4.Clarity of face improved with disappearance of the erst while sunken face.
5.Pedal oedema completely null.
6.Nausea, vomiting, dysuria relieved.
7.Bowels loose and regular.

We in our clinic always prefer and advice the patients to prepare fresh kashayam by themselves and try to avoid the readymade kashayam available in the market, since we believe that the potency of the alkaloids in the fresh kashayam gets preserved in its fullest extent.

The immense joy felt by the patient, on getting relievd of the problems and returning to his normal life could not be expressed in words over here,but only be felt in one's presence.

Our belief that Ayurveda is not a slow acting system of medicine has enhanced further with the rate of success in the above case.

The entire credit goes to the blessings of the almighty showered up on him and us in ensuing proper selection & treatment in the above case.

MANAGEMENT OF CERVICAL DISC HERNIATION WITH MARMA CHIKITSA

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                                 Dr.Bhat.A.Rangaprasad -Sarve janah Sukhino Bhavanthu || Sarve santhu Niramayah ||

What is Vertebral Disc? :

The disc (or intervetebral disc) is a structure that is found in between the spinal vertebral bodies from the neck to the sacrum (tailbone). It serves as a cushion and helps the spine to move.

Each disc is composed of two parts, the nucleus pulposus (the central part) and the annulus fibrosis (the outer part). The nucleus pulposus provides the padding and it is surrounded by the annulus fibrosis which forms a ring around the nucleus pulposus. This pulposus also attaches to the vertebral bodies above and below.

The diseases frequently associated with the disc :
The diseases frequently associated with the disc are usually 2 in number, disc herniations (abnormal protrusions of a portion of the disc material) and disc degeneration (changes in the disc seen in normal aging and also in injury) respectively.

The sites usually affected by disc herniation in neck :

The most common levels for disc problems are in descending order C6-C7 (C refers to cervical and the number refers to the number of the vertebral body counting from the top), C5-C6, C7-T1 (here the T refers to the thoracic spine, the part that the ribs attach to), C4-C5 and very rarely C3-C4.

Why and how disc protrusions cause pain? :
Herniation of the contents of the disc into the spinal canal often occurs when the front side (stomach side) of the disc is compressed while sitting or bending forward, and the contents (nucleus pulposus) get pressed against the tightly stretched and thinned membrane (annulus fibrosis) on the rear (back side) of the disc. The combination of membrane thinning from stretching and increased internal pressure (200 to 300 psi) results in the rupture of the confining membrane. The jelly-like contents of the disc then move into the spinal canal, pressing against the spinal nerves, thus producing intense and usually disabling pain and other symptoms.

Symptoms caused by the herniation :
Pressure on a nerve root is referred to as cervical radiculopathy.Cervical disc herniations can press on the spinal cord and cause a problem called cervical myelopathyThe most common symptom of a cervical disc herniation is neck pain that radiates (spreads) down to the arm in various locations. The specific location of the arm pain depends on which disc is involved. There can also be associated paresthesias (pain as if pricked with pins and needles) and in some cases weakness of some of the arm muscles. Patients find that turning their head away from the painful side helps. Extending the head makes the pain worse so that looking up is avoided. Bending the head down usually gives some relief.
Severe neck pain radiating to the back of head and down between the shoulder blades may be present with an acute disc prolapse. There may also be an associated muscle spasm aimed at limiting the movement and relieving the pain. How ever in certain occasions the spasm itself may cause generalised neck pain.

Cervical Disc Herniation Treatment :

The treatment of cervical disc herniation can be divided into two categories, conservative and Pancha karma with Marma Chikitsa.
In general, conservative management consists of maneuvers to reduce pressure on the nerve root. Immobilization with the neck in a flexed forward position may be helpful. Straining should be avoided. Medication in the form of anti vatic or anti vata-kaphaik like Maha Rasnadi, Prasaranyadi, Gulgulu thiktam etc., may be prescribed. As these medications are selected based on the Prakruti (Constitution) of the patient, patients should consult their doctor if taking any medications for longer than a few days. Ayurveda medicines of course do not cause any side effects, only when proper medicine is selected for proper Prakruti. Other wise it may aggravate the agony, there by giving an impression like that of a side effect. Say for example a person with Pitta Prakruti suffering from Bleeding Piles if consumes a preparation with Bhallataka (Semecarpus ancardium) as it’s ingredient, he can be rest assured that his symptoms are going to get worsened, sometime leading to hospitalization. It is because Bhallataka increases the Pitta and hence will drastically increase the flow of already existing venous blood loss in the bleeding piles. Physical therapy may be prescribed. This can consist of traction, mild stretching, exercise, heat, massage etc.

vrikshayurveda of Acharya Surapala - A boon to the Ayurveda & Horticulture

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                                 Dr.Bhat.A.Rangaprasad -Sarve janah Sukhino Bhavanthu || Sarve santhu Niramayah ||


The treatise Vrikshayurveda indeed is a master piece in itself, and certainly each and every Ayu physician should be proud of possessing one.
The availability of book can be checked with this link ...http://bit.ly/hUED33, whose paper edition is priced at INR 350/-

The Vrkshayurveda also deals in detail regarding the following concepts.,.,

How to procure a plant
Construction of pit on earth for sapling
Nature of soil and it's relation with plants
natural form of fertilzers, watering method,
lay out of the garden based on vastu principles etc.,

Acharya Surapala is referred to be a prominentt physician of is time (vaidya vidyavarenya), whose period of time seems to be in between 7th to 10th century A.D.


For better understanding of the books utmost important usage the following foot notes with the authentic verse numbers will be appropriate to view.

Animated explanation of Kurpara sandhi manipulation

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                                 Dr.Bhat.A.Rangaprasad -Sarve janah Sukhino Bhavanthu || Sarve santhu Niramayah ||

Anatomy Of Kurpara Sandhi or Elbow Joint 

Medical conditions involving pain in the region of Elbow :-

Sinusitis / நீர்க்கோவை in Ayurveda

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                                 Dr.Bhat.A.Rangaprasad -Sarve janah Sukhino Bhavanthu || Sarve santhu Niramayah ||

முகப்புரை (Introduction) :- 

தலை குகரம் (Sinus Cavity) என்பவை மண்டை ஓட்டினுள்ளே அமையப்பெற்ற, காற்றினால் நிரப்பபெற்ற குகைப் போன்ற ஒரு அறை.(The sinuses are air-filled spaces in the skull.They are present behind the forehead, nasal bones, cheeks, and eyes) 

அவ்வாறான அமைப்புகள் பின் வரும் நான்கு பகுதிகளின் பின்னே ஒளிந்துக்கிடக்கும்- அவையானவை 

(அ) நெற்றி(Frontal Sinus- நெற்றிக்குகரம் ); 

(ஆ) நாசிகை (Nasal Sinus - நாசிக்குகரம்); 

(இ) கன்னங்கள் (Maxillary Sinus -கன்னக்குகரம் ); 

(ஈ) கண்கள் (Sphenoidal Sinus - ஆப்பு குகரம்; Sphenoidal = wedge shaped = ஆப்பு (படம் காண்) = முக்கோண வடிவிலான கருவி
 

மேற்க்கூரிய 4 அமைப்புகளின் அகத்தே உட்புற  சவ்வு chavvu - (Mucous membrane -  மூடுதோல்) ஒட்டிக்கொண்டிருக்கும். இத்திசையின் பரப்பிலிருந்து தான் சளிப்போன்ற நீர் (Mucous secretion) சுரக்கும்.

That are lined with mucus membranes, which secretes the mucus.

Groin pain due to irritation of Ilio-inguinal Nerve As A Result Of Wearing A Parallel Pant

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                                 Dr.Bhat.A.Rangaprasad -Sarve janah Sukhino Bhavanthu || Sarve santhu Niramayah ||


 Brief excerpt of the ppt presented (Details of which can be viewed in the ppt):- 

Name	Mr. Xyz
Age	32 yrs
Sex	Male
Occupation	IT related (Desk work job)
Date of consultation	12th of march 2012
Chief complaints	1.       Pain in left groin Radiates to left scrotum 2.       & To lower abdomen, almost near the the pubic symphysis 3.        Feeling of stretching in the left flank 4.       Tightness / stretching along upper medial compartment of left thigh 5.       Pain occasional in left Knee.

Analytical Study Of Anatomy Of Shrngataka Marma – Sira Predominant variety.

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                                 Dr.Bhat.A.Rangaprasad -Sarve janah Sukhino Bhavanthu || Sarve santhu Niramayah ||

Abstract of the ppt presented:-

• Shrngataka marma is a sira predominant & Sadhyo Marana variety of marma .
  
• It is 4 angulas of circumference. It is a conglomeration of 4 veins draining from the region of nose, eyes,ear & oral cavity respectively.
  
• Hence is 4 in number on each side of the face.
  
• Angular, Nasal, Superior Labial Vein & Inferior Palpebral veins are the structures present adjacent to the area of manipulation of Shrngatak marma .

Katikataruna Marma - Bone predominant Kalantarapranahara variety of Marma

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                                 Dr.Bhat.A.Rangaprasad -Sarve janah Sukhino Bhavanthu || Sarve santhu Niramayah ||


The Katikataruna marma, has helped in giving relief in many diseases related to the prstha pradesha & the adho udara bhaga related pathologies.

The details of the Katikataruna, as per the classical textual reference of Sushrutha & it’s interpretation as of my understanding with the modern anatomy is being discussed henceforth.

Katikataruna location:-

On either side of the vertebral column at the place where in each of the component (i.e the Ileum & Ischium) of the shroni kandam (hip bone) join together to form the Katikataruna marma.

Bahvi - Oorvi - Lohitaksha Marmas of Upper & Lower Limbs (Vaikalya kara varieties of Sira Marmas)

CONTENTS	BAHVI MARMA IN UPPER LIMB	OORVI MARMA IN LOWER LIMB	LOHITAKSHA MARMA IN UPPER LIMB	LOHITAKSHA MARMA IN LOWER LIMB
General	Middle of the arm [1]	Middle of the thighs  [2]	Infra-clavicular near shoulder	@ Femoral triangle  [3]
Number	TWO (One in each upper limb) Refer foot note 4	TWO (One in each lower limb) Refer foot note 5	TWO Refer foot note 6	TWO Refer foot note 6
Measurement	1 angula	1 angula	1/2 angula	1/2 angula
Classification based on structural predominance	Sira marma [4]	Sira marma[5]	Sira marma Refer foot note 6	Sira marma[6]

---

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                                 Dr.Bhat.A.Rangaprasad -Sarve janah Sukhino Bhavanthu || Sarve santhu Niramayah ||

[1]  उर्व्या ऊर्ध्वमधो वङ्क्षणसन्धे || su.sha.6/24 ||

[2]  उर्व्या ऊर्ध्वमधो वङ्क्षणसन्धे  || su.sha.6/24 ||

[3] ऊरुमूले लोहिताक्षं  || su.sha.6/24 ||

[4] एकचत्वारिंशदिति चतस्रो धमन्यः, अष्टौ मातृकाः, चत्वारि शृङ्गाटकानि, द्वे अपाङ्गे, एका स्थपनी, द्वे फणे  , द्वे स्तनमूले, द्वावपस्तम्भौ , द्वावपलापौ, एकं हृदयं, एका नाभिः, द्वौ पार्श्वसन्धी, द्वे बृहत्यौ, चत्वारि लोहिताक्षाणि, चतस्र उर्व्यः, एवमेकचत्वारिंशत् सिरामर्माणि| The 4 Oorvi mentioned over here includes (2 Bahvi + 2 oorvi) || Dalhana commenting over su.sha.6/4 ||

[5] एकचत्वारिंशदिति चतस्रो धमन्यः, अष्टौ मातृकाः, चत्वारि शृङ्गाटकानि, द्वे अपाङ्गे, एका स्थपनी, द्वे फणे  , द्वे स्तनमूले, द्वावपस्तम्भौ , द्वावपलापौ, एकं हृदयं, एका नाभिः, द्वौ पार्श्वसन्धी, द्वे बृहत्यौ, चत्वारि लोहिताक्षाणि, चतस्र उर्व्यः, एवमेकचत्वारिंशत् सिरामर्माणि| The 4 Oorvi mentioned over here includes (2 oorvi + 2 Bahvi) || Dalhana commenting over su.sha.6/4 ||

[6] एकचत्वारिंशदिति चतस्रो धमन्यः, अष्टौ मातृकाः, चत्वारि शृङ्गाटकानि, द्वे अपाङ्गे, एका स्थपनी, द्वे फणे  , द्वे स्तनमूले, द्वावपस्तम्भौ , द्वावपलापौ, एकं हृदयं, एका नाभिः, द्वौ पार्श्वसन्धी, द्वे बृहत्यौ, चत्वारि लोहिताक्षाणि, चतस्र उर्व्यः, एवमेकचत्वारिंशत् सिरामर्माणि| || Dalhana commenting over su.sha.6/4 ||

Role of posture in the manifestation of Occipital pain/neuralgia & its management with Marma chikitsa:-

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                                 Dr.Bhat.A.Rangaprasad -Sarve janah Sukhino Bhavanthu || Sarve santhu Niramayah ||



This clinical case is about evaluation of the effect of incorrect posture causing certain distress in the neck & head region, portraying the features of Migraine Head ache and there by arising a suspicion in the mind of a clinician as a clinical migraine..

The following phenomenon of neck pain associated with radiation of the same to the occipital; vertex & temporal or pre-auricular area has been observed in quite a number of clients of mine, especially in people who are prone to sleep in prone posture ( Upside down posture of sleeping ).

I am here by discussing a recent & interesting case dealt with recently.

Name of the patient:- Mrs.Xyz

Age:- 36 yrs

Occupation: - House wife

Nature of jobs done in a day: - House hold activities by herself (no house maid); teaching her child by sitting in floor (where in her neck will always be in flexion)