A REVIEW ARTICLE ON NEELAA AND MANYA MARMA WITH RESPECT TO INTERNAL CAROTID ARTERIAL DEFICITS

Abstract

Introduction: Mookata (Complete loss of voice), Swaravaikrita (Defective voice) and Arasagrahita (Loss of taste sensation) are Abhighata Lakshanas (symptoms of injury) of Neelaa Manya marma. They are mentioned as Vaikalyakara Marmas (deformity) of the head & neck region. They are also included as avedya sira (vessels to be avoided during surgical procedure), as injury will lead to either deformities or death. In a comprehensive study done on Shiromarma Abhinaya Lakshanas in 100 patients with intracranial neurological disorders at SDMACH, Udupi, Karnataka (2014-2017), eight individuals were observed with the incidence of Mookata, Swaravaikrita and Arasagrahita having notable pathological changes in the calibre and patency in the Doppler study of the carotid arteries1,2. Aims and objectives: To understand Neelaa Manya Marma Abhinaya Lakshanas and to localise the structures involved in the lesions of neurological origin from the CT, MRI scan of the brain & Doppler imaging study of the carotid artery in the marma region. Materials and methods: Concerned Literary works, books, journals, and CT MRI scans and Doppler imaging studies collected from patients suffering from intracranial diseases were reviewed, and related information was collected and analyzed scientifically. Results and Discussion: In the pathogenic sequel of injury to any Marma sthana, aggravated vayu diffuses into the surrounding areas and spreads throughout the body via siras (vessels). Both Neela and many are included among the Vaikalyakara Marmas as well as they come under the category of Madhya siras (vessels supplying to trunk area). Here the vitiation of Dhamanis (vessels) such as Vatavaha (vessel carrying life force), Rasanagrahana (vessels responsible for taste sensation), Bhashya (vessel accountable for speech), Gosh (vessel responsible for voice artriculation) located in the neck region near the Marma Sthana, may be one of the reasons for the symptoms such as Mookata, Swaravaikrita and Arasagrahita. The branches of the internal carotid artery supply to the cortical, sub-cortical, as well as the thalamic & sub-thalamic areas of the brain. Any occlusion of these vessels will undoubtedly result in the ischemia or infarct of the areas of its supply, causing functional deficits such as Aphasia, dysphonia, dysphagia, etc. Conclusion: This was a review article based on the observational study representing the fact that it was possible to clinically assess the Neelaa Manya marma abhinaya lakshanas on patients diagnosed with intracranial lesions with internal carotid arterial deficit, especially notable pathological changes in the calibre and patency in the Doppler study of the carotid arteries.