Article by Dr Raghuram Y.S. MD (Ay) and Dr Manasa, B.A.M.S
Apalapa is an important Marma i.e. vital or delicate point in the body. It is located in the upper back, in the scapular region. Apalapa Marmas are predominantly made up of Siras (blood vessels).
अंसकूटयोः अधस्ताद् पार्श्व उपरि भागयोः अपलापौ नाम, तत्र रक्तेन पूयभावं गतेन मरणम्।(सु.शा.६)
Apalapa Marmas are located on the upper back. They are located below the amsa kuta (acromion process of scapula, a bony projection which connects the scapula i.e. a wing shaped bone on your upper back with the color bone i.e. clavicle) and above the parshwa (sides of chest cavity).
They are 2 in number and are located one on either side of the spine (backbone) in the positions mentioned above. They are Madhya Shareeragata Marma and Prishta Gata Marmas (marmas located in the back)
Categories in which the Apalapa Marma is included
- i) Madhya Shareera Gata Marma, Uro Gata Marma, Prishta Gata Marma (Madhya Shareera = Middle portion of the body, trunk, Uro = chest, Prishta = back)
- ii) Siraa Marma – Apalapa marma is predominantly made up of Sira i.e. veins, which form the structural component of this 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) Apalapa Marma is said to produce death over a period of time, gradually.
Pramana (measurement of Apalapa Marma) –
Apalapa 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)
Effect of Injury
तत्र रक्तेन पूयभावं गतेन मरणम्।(सु.शा.६)
Injury of Apalapa Marma causes gradual death.
Injury of Apalapa Marma causes Rakta Pooyatwa (blood getting infected and getting converted to pus, septicaemia) eventually leading to gradual death of the person.
Cause of gradual death:
- Bleeding in the region of the upper back or scapular region
- Accumulation (pooling) of blood in the axillary (arm pit) region
- Infection in the region of blood pooling
- Spread of infection throughout the body
- Spreading septicaemia leading to shock and gradual death
Modern Perspective (Practical anatomy) of Apalapa Marma
Structures falling in the area of Apalapa Marma –
- Upper back
- Scapular region
- Axilla and its contents
- Brachial plexus of nerves
- Axillary blood vessels
- Axillary lymphatics
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 Aplapa Marma, therefore it is a Sira Marma.
When Apalapa marma gets damaged, the effect of injury will chiefly involve the important veins located in the vicinity of Apalapa in comparison to the extent of damage caused to other tissues.
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