Brihati Marma: Components, Location, Effect Of Injury

Article by Dr Raghuram Y.S. MD (Ay) and Dr Manasa, B.A.M.S
Brihati is an important Marma i.e. vital or delicate point of the body. They are 2 in number and are located one on either side of the spine, at the level of Sthana mula Marmas (located in the chest, below the nipples). 

Bruhati Marma
स्तनमूलात् ऋजुः उभयतः पृष्ठवंशस्य बृहत्यौ नाम, तत्र शोणित अतिप्रवृत्ति निमित्तैः उपद्रवैः म्रियते।(सु.शा.६)

Location

Bruhati Marmas are located in the mid back. They are 2 in number, located one on either side of the thoracic spine. They are located at the level of and in line with Sthana Moola Marmas (Marmas of the chest). Sthana Moola Marmas are located at the base of the sthanas or breasts in the chest. From these Marmas when we extend towards the back in the same line, we can find Bruhati Marmas, in the back.
The Right Bruhati Marma falls in line with Liver and the Left Bruhati Marma falls in line of Spleen.

Categories

Categories in which the Bruhati Marma is included
Bruhati Marma is classified into various categories. They are as below mentioned –

i) Prushta Gata Marma (Prushta = Back)
ii) Siraa Marma – Bruhati Marma is predominantly made up of Sira i.e. veins, which form the structural component of this Marma. Therefore it is classified under Siraa Marma. The other elements namely Snayu (ligaments), Asthi (bone), Sandhi (joints) and Mamsa (muscles) are also present but in a lesser proportion.

iii) Kaalantara Praanahara Marma – (Kaalantara – Gradual, Pranahara – life taking) Bruhati Marma is said to produce death over a period of time, gradually.

Measurement

Pramana (measurement of Brihati Marma) –
Bruhati Marma occupies a space of ½ angula dimension (approximately equal to the horizontal dimension or breadth of middle segment of one’s own middle finger). Each Bruhati Marma (right and left) has same dimensions.

Effect of Injury

तत्र शोणित अतिप्रवृत्ति निमित्तैः उपद्रवैः म्रियते।(सु.शा.६)
Injury of Bruhati Marma causes gradual death.

When Bruhati Marma gets injured it leads to Shonita Atipravrutti (excessive bleeding). Excessive bleeding leads to many upadravas (complications). These complications of severe hemorrhage eventually lead to gradual death.

Modern perspective

Modern Perspective (Practical anatomy) of Brihati Marma
Structures falling in the area of Bruhati Marma –
Porta Hepatis – Opening on the inferior surface of the Liver with its contents i.e. Hepatic Vein, Hepatic arteries, Portal Vein, Hepatic Ducts and Bile Duct.
Hilum of the Spleen – Opening in the spleen through which the blood vessels gain entry and exit from Spleen

Though all the elements which comprise a marma i.e. snayu (ligaments), mamsa (muscles) asthi (bones) and sandhi (joints) are all present in the site of this Marma, it is predominant in the Sira or blood vessels vis-à-vis veins making up the Bruhati Marma, therefore it is a Sira Marma.

When Bruhati marma gets damaged, the effect of injury will chiefly involve the important veins located in the vicinity of and within the Bruhati Marma in comparison to the extent of damage caused to other tissues.

Just Before Finishing
Bruhati Marmas fall in line with Porta Hepatis and Spleen hilum. Yakrit (Liver) and Pleeha (Spleen) form the Raktavaha Srotas (blood forming and transporting units) in the body. When Bruhati Marma is injured, severe bleeding occurs along with many complications related to hemorrhage. The blood formation and dispensing activities will be hampered. As a result there will be multiple organ failure ultimately leading to gradual death. Therefore any injury to the mid back especially at the sites of Bruhati Marma should not be neglected.
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