Article by Dr Raghuram Y.S. MD (Ay) and Dr Manasa, B.A.M.S
Apastambha is an important Marma i.e. vital or delicate point in the body. It is located in the front of the chest, one on either side of the mid-line. Apastambha Marmas are predominantly made up of Siras (blood vessels).
उभयत्र उरसो नाड्यौ वातवहे अपस्तम्भौ नाम, तत्र वातपूर्ण कोष्ठतया कास श्वासाभ्यां च मरणम्।(सु.शा.६)
Apastambha Marmas are in the form of 2 Vata Vaha Naadis (air carrying channels or ducts).
Apastambha Marmas are located in the Madhya Shareera, one on either side of the midline (sterna line) of the chest. Therefore it is a Madhya Shareeragata Marma and also Uro (chest) gata Marmas.
Categories in which the Apastambha Marma is included
Apastambha Marma is classified into various categories. They are as below mentioned –
i) Madhya Shareera Gata Marma, Uro Gata Marma, (Madhya Shareera = Middle portion of the body, trunk, Uro = chest)
ii) Siraa Marma – Apastamba 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) Apastambha Marma is said to produce death over a period of time, gradually.
Pramana (measurement of Apastambha Marma) –
Apastambha 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 वातपूर्ण कोष्ठतया कास श्वासाभ्यां च मरणम्।(सु.शा.६)
Injury of Apasthambha Marma causes gradual death.
Injury of Apastamba Marma causes Vata Purna Koshtata (chest cavity or thoracic cavity filled with Vata or excessive air), Kasa (cough) and Shwasa (dyspnoea, breathlessness) eventually leading to death.
Cause for gradual death:
- Injury to the trachea or wind pipe
- Collection of air in the lungs and chest cavity
- Pressure of accumulated air over the lungs and heart
- Pressure on breathing and circulation
- Deficit supply of oxygen and nutrients to the cells and organs of the body
- Hypoxia in all parts of the body leading to functional failure of more than one organs
- Gradual death
Modern Perspective (Practical anatomy) of Apastambha Marma
Structures falling in the area of Apastambha Marma –
- Trachea (wind pipes)
- Right Bronchus
- Left Bronchus
- Phrenic nerve
- Vagus nerve
- Common carotid artery
- Subclavian vein
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 Apastambha Marma, therefore it is a Sira Marma.
When Apastambha marma gets damaged, the effect of injury will chiefly involve the important veins located in the vicinity of Apastambha in comparison to the extent of damage caused to other tissues.
Just Before Finishing
Apastambha Marmas which are located in the front of the chest correspond with the bronchus, the divisions of the wind pipe which enter the lungs. When these sections of wind pipe get damaged there is leakage of air into the chest cavity which builds up pressure on chest organs, chiefly on lungs and heart. This in turn exerts pressure on the circulation and breathing mechanism leading to hypoxia and gradual death.
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