Marma chikitsa is a related more to kalarippayattu, the martial art form of Kerala. Marma, literally means a key point. According to Kalari payattu knowledge, there are 108 Marmas on human body. Twelve among them are extremely critical and are called Padumarma. Immediate death will be the result if any of these points are injured. There are 96 others marmas, collectively known as Thodu marmas, not as serious as padumarmas.

A shock to a marma (thattu in Malayalam) can be overcome by applying controlled negative shocks (maruthattu in Malayalam). In marma treatment, the injuries to marmas are treated. Ayurvedic medicines are used for massaging and treatments. Marma chikitsa also addresses dislocation of bones, out-of-shape bones, etc.

Marma massaging involves massaging the body while applying sufficient pressure over the marmas. Different medicinal oils are used in the massaging.

Though marma chikitsa is primarily associated with Kalari payattu, (martial art form of Kerala), Kathakali, the divine dance form of Kerala also benefits from marma chikitsa. It gives the body flexibility to perform different maneuvers.

Apart from giving flexibility to body muscles, the marma massage also enables the persons to attain a sharp mind, mental alertness, better composure, and natural resistance to almost all common diseases.

Marma massage is primarily called Thirummu chikitsa or Thirummal. Chavittithirumal is a special thirummal, in which the person is left bathed in medicated oil on floor. Then the masseur massages the body with his or her feet. A rope hanging from the roof keeps the masseur in balance.

Ayurvedic training in Kerala, especially in the salya tantra (surgery) division, marma tantra is an important item.

Marma Chikitsa is followed only in Kerala and in the southern parts of Tamil Nadu.

According to Vagbhata Samhita, there are 94 different diseases that attack eyes, Susrutha talks about 67 ophthalmologic diseases.

Nimi, the sage is considered to be the acharya of Netra Chikitsa (ophthalmologic treatment) and Sun the God of Eye. The different treatment options involved in Netra Chikitsa are Anjana (eye liner), Aschodana, Netra Tarpan, Pindi, Pudapakam, etc.

Keeping the lifestyle activities can help one keep his or her eyes healthy. The different reasons for most common diseases that affect the eyes are spending excess time in the sun, excess physical exertion, quickly moving to a cold place from a hot environment – like jumping into a swimming pool while sweating, stare an object for long, sleeping at daytime, sleeplessness at night, etc.

There are different kinds of Thimira (cataract), which has treatments other than surgery in its initial stages. However in advanced stages, surgery is the only option. Night blindness and infectious diseases also have different treatment options.

There are also six classes of optic diseases classified based on tridoshas -Vataja, Pittaja, Kaphaja, samsargaja, sannipathaja, and rakthaja. The treatment is suggested after considering the physical peculiarities of a person. Shirovasti and Nasya are also administered for treating diseases that affect the eyes.

Prasoothi Tantra refers to the care given to pregnant woman. Prasoothi literally means an expecting woman. Prasoothi tantra refers to the health conditions, diseases and their treatments, and special treatment food and lifestyle modification that lead to the birth of a healthy child.

Prasoothi Tantra has three divisions
Garbhini Paricharanam (Garbhini Paricharya) or Ante-natal phase which denotes to diagnosis of pregnancy and the care for a garbhini (pregnant woman).

Prasava Kaala Paricharanam (Prasava Kaala Paricharya) or natal phase starts with labour pains and ends with delivery of placenta.

Soothika Paricharanam (Soothika Paricharya) or Post Natal Phase – deals with the care of the newborn baby and the nursing mother.
Identification of Pregnancy
There are signs to look for immediately after union, within a week or a month.

Sadhyogruheeta or Sadyogruheeta garbha lakshana (probable signs of Pregnancy)
The woman will experience drowsiness, uneasiness, feeling of something pulled into the body, repeated spitting, pain in chest, more semen remains in the vagina without flowing out – etc are symptoms that show very low probability of pregnancy.

Vyaktha Garbhalakshana/Dowhrudya Lakshana (Positive signs of Pregnancy)
These are clear indications of pregnancy – they are missing periods, vomiting without any reason, newfound fondness towards sour food items, darkening of lips and areola, milk secretion in breast etc. Repeated drooping of eyes, aversion to good smells, tiredness, etc are the other symptoms. Acharyas like Sushrutha, Bhaavamisra, Vagbhata, etc suggests that the nutrients that the mother takes are diverted to the development of embryo, hence the signs of drowsiness and tiredness.

Garbhini Parcharya
Garbhini Parcharya insists good ahara (food), vihara (daily routine – lifestyle) and vichara (thoughts). All the three will have effect on the expected child.

Wholesome diet has prime concern in garbhini paricharya as the development of the baby depends solely on the nourishment that the woman takes. The first three months of pregnancy and the months after seventh one are considered to be extremely important.

First three months mark the formation of foetus (or fetus). The expecting woman wants to take lot of fruits or juice, coconut water, milk, and food items in liquid or easily digestible form. Apart from the healthy diet, certain medicinal preparations are also recommended. One example is sukhaprasava ghritam (medicated ghee that facilitates easy delivery).

Surgery has longer history than treatment using medicines in Ayurveda. Salya Tantra or the technique of surgery is one of the eight branches of (asthanga) Ayurveda. Ayurvedic surgeons are traditionally known as Dhanwantareeyas (after Dhanwantary).

Lord DhanwantaryÂ’s image has in his one hand a pot of Amrit (the divine nectar of immortality) and in the other a leech, suggesting surgery. Dhanwantary has once taken incarnation as a human, as the son of the king of Kashy. (Human) DhanwantaryÂ’s great grandson, Divodasa was an expert in Salya Tantra or surgery. Sushrutha, Ouradra, Pushkalavada and Oupadhenan had their education under Divodasa.

Dhanwantary and Jeevaka did surgery for brain, while Nimi specialized in ophthalmologic surgery. Bhoja was an expert to treat wounds occurred from weapons (sword, arrow, etc) and Sushruta specialized in cosmetic plastic surgery. Westerners got the idea of plastic surgery, when a local Ayurvedic surgeon re-created the nose of a British soldier named Kovaski, which he lost in a battle with Tipu Sultan of Mysore in 1792. Now Sushrutha is regarded as the father of modern plastic surgery.

There are surgical methods for treating bodily pimples, cancer, cataract, bones and diseases that affect urinary bladder, liver, intestine, etc. Surgical methods were also practiced on ear, nose and throat. Dental surgery too was not rare.

Surgery had three main phases, poorva karma (pre-surgery), Sashtrakriya (surgery) and paschath karma (post-surgical treatment). Poorva karma involves diagnosing the disease and the part of the body that affects the health of the person and pashchath karma refers to post surgical care.

Sasthrakriya is the Sanskrit word of surgery. Sasthra means a weapon and kriya means and action. Thus sasthrakriya or surgery is an action with a weapon or tool. There are about 108 different tools used in surgery, all of them have striking similarities with the surgical instruments that allopathic surgeons use.

In Kerala (and India) dealing with blood was considered an inferior thing. The surgeon also was responsible for the health of the patient. If any serious damage happens to the patient, the surgeon had full responsibility. He even got death sentence. All these have led to the extinction of surgery in India.