Critical study on the role of stimulation of talahridaya marma in vama urdhwa shakha on blood pressure with special reference to its regional anatomy

Marma shareera is an important concept described in Ayurveda. It is a subject of interest because of its applied aspect. References of marma can be traced way back in vedas to present modern literature.

Marma is the seat of prana and is constituted by confluence of mamsa, sira, snayu, asthi and sandhi .They are known as vital points because any injury to these points are fatal .According to Ayurveda 107 Marmas are present in the body. Acharya charaka mentioned in detail about trimarmas ie; hridaya, shiras and vasthi.

Talahridayamarma is one among shakha marma , seen as one in each limb thus total number is 4  .Location is at the center of padatala (sole)or hastatala(palm),in line with madhyama anguli( middle finger or middle toe) .It is a type of mamsa marma with size of half anguli . Talahridayamarma comes under the group of kalantarapranahara marma  (delayed death). Any injury to this point causes death due to pain . While enumerating parts of body of kaliyuga person, kasyapa samhita mentioned that there are 5 hridaya ; One is hridaya which is situated in uras , remaining 4 are talahridayamarma which are situated in padatala or hastatala. This emphasizes the importance of this marma.

Blood pressure is the hydrostatic pressure exerted by blood on walls of a blood vessel .The main factors affecting blood pressure are cardiac output, blood volume, and vascular resistance. Several interconnected negative feedback systems control blood pressure by adjusting heart rate, stroke volume, systemic vascular resistance, and blood volume. Cardiovascular center which regulate heart rate and stroke volume is located in the medulla oblongata . It receives input both from higher brain regions and from sensory receptors. Blood pressure is usually measured in the brachial artery using sphygmomanometer. Normal blood pressure of an adult is less than 120 mmHg systolic and less than 80 mm Hg diastolic. Persistent elevation of blood pressure is referred to as hypertension and it is a major reason of premature death worldwide.

Marma therapy is more acceptable among society as it is safe, cost effective and non-invasive. In susrutha samhitha, for treatment of diseases of internal organs, certain points have mentioned for siravyadha. Marma therapy has been developed taking these references into account  . Clinicians who are practicing marma therapy observed that stimulation of Talahridaya marma has an effect on cardiovascular system especially on blood pressure .This can be utilized to control blood pressure. But clinical data supporting this statement is very few. Hence this study is an attempt to find the change in blood pressure by stimulation of Talahridaya marma in urdhwashakha and to critically explore the anatomical aspect of Talahridaya marma in urdhwashakha .