Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S
Hanu means decrease jaw / mandible
Graha means tightness, catch, rigidity, lock, arrest
Hanugraha is a situation defined within the context of Vatavyadhi – particular vata problems of ‘solely vata origin’. It’s marked by tightness of the jaw or on the joint of the decrease jaw which makes opening and shutting the mouth troublesome.
It’s also referred to as as ‘Hanustambha’ by some consultants, which additionally means the identical. Stambha additionally means tightness or stiffness or rigidity.
Causative Elements of Hanugraha
Basic etiological elements
Since Hanugraha has been defined within the context of Vatavyadhi, all etiological elements of vatavyadhi and all these elements which trigger aggravation of vata together with meals, actions, behaviours and seasonal modifications would additionally function etiological elements for Hanugraha.
Particular etiological elements
जिह्वानिर्लेखनाच्छुष्कभक्षणादभिघाततः।(वा.नि.अ.१५)
Grasp Vagbhata enlists particular etiological elements for Hanustambha and they’re as talked about under –
Jihva nirlekhana – tongue scraping – Opening the mouth in extra and for extended intervals of time whereas placing the tongue out, for the aim of scraping / cleansing the tongue and tooth with the assistance of tongue cleaners and brushes respectively would put strain on the jaws and extreme associated actions will trigger aggravation of vata.
Shushka Bhakshanat – Extreme consuming of dry and laborious meals. This wants loads of effort for chewing the meals and there’s lot of jaw exercise concerned in it. Dry meals additionally trigger vata aggravation.
Abhighata – Harm to the jaw, joints and different constructions of the jaw is one more essential etiological issue for stiffness to happen within the jaw and trigger hanugraha / hanustambha. Abhighata is a crucial causative issue for aggravation of vata.
Samprapti: Pathogenesis
कुपितोहनुमूलस्थःसंसयित्वाऽनिलोहनुम्।।४९।।(वा.नि.अ.१५)
Based on Grasp Vagbhata –
Because of the above mentioned etiological elements, the vata positioned within the hanumula i.e., root of the jaw will get aggravated and causes looseness and dislocation of the joints of the jaw. This situation known as hanugraha.
हनुमूले स्थितो बन्धात् संस्रयत्यनिलो हनू|
विवृतास्यत्वमथवा कुर्यात् स्तब्धमवेदनम् ||४९||
हनुग्रहं च संस्तभ्य हनुं(नू)संवृत वक्रताम् |५०| च.चि.२८/४९-५०॥
Based on Grasp Charaka –
The aggravated vata positioned on the hanumula i.e. root of the jaw causes loosening of the constructions which maintain the jaw joint in place and causes dislocation of jaw bones. This results in a situation whereby the mouth of the affected person continually stays opened together with stiffness. There can be much less ache. It could additionally trigger lockjaw. This is able to happen due to the stiffness of the joints of the jaw when the mouth stays closed. Right here the affected person would really feel issue in opening the mouth. This situation known as Hanugraha.
Signs of Hanugraha
करोतिविवृतास्यत्वमथवासंवृतास्यताम्।
हनुग्रहःसतेनस्यात्कृच्छाच्चर्वणभाषणम्।।५०।।(वा.नि.अ.१५)
Beneath talked about are the signs of Hanugraha
– The mouth of the particular person would both stay open or closed always
– Because of the mouth being shut or open continually always, it might trigger issue in chewing the meals
– The identical mechanism of pathogenesis would trigger issue in talking
Grasp Charaka too has talked about the identical signs. Aside from mentioning the stiffness of the jaw and tightness of the joints of the jaw, he has additionally talked about that Hanugraha can be related to much less ache. So, stiffness is a predominant criticism in Hanugraha whereas ache shouldn’t be. It is just related to signs that are additionally delicate in nature.
Prognosis of Hanugraha
सन्धि च्युति र्हनुस्तम्भः कुञ्चनं कुब्जताऽर्दितः||७२||
……………………………………………………….
एते स्थानस्य गाम्भीर्याद्यत्नात् सिध्यन्ति वा न वा|
नवान् बलवतस्त्वेतान् साधयेन्निरुपद्रवान्||७४|| च.चि.२८/७२-७४॥
Whereas discussing the prognosis of Vata Vyadhis, some ailments have been talked about which might be cured solely after administering cautious and well timed therapy. If therapy shouldn’t be offered at correct time and if not managed correctly, these ailments can’t be cured in any respect i.e. they might change into incurable due to their deep-seated and persistent nature. They may also be cured when they’re newly manifested and in sturdy sufferers and when not related to issues. Hanustambha too has been talked about amongst these ailments.
So, Hanustambha or Hanugraha might be cured if –
– addressed early with correct interventions, when the illness is acute and newly manifested,
– the affected person is robust sufficient
– correct therapy is given at correct time,
– it isn’t related to issues
Alternatively, if uncared for or if the illness will get persistent or mis-managed, it might change into incurable.
Remedy of Hanustambha / Hanugraha
Basic line of therapy
सर्पिस्तैल वसा मज्ज सेकाभ्यञ्जन बस्तयः ||१०४||
स्निग्धाः स्वेदा निवातं च स्थानं प्रावरणानि च|
रसाः पयांसि भोज्यानि स्वाद्वम्ल लवणानि च||१०५||
बृंहणं यच्च तत् सर्वं प्रशस्तं वात रोगिणाम्|१०६| च.चि.२८/१०४-१०५||
Since Hanugraha is a Vata Vyadhi, common line of therapy of vata vyadhis can even be relevant for treating this situation. This consists of medicines, therapies, way of life modifications, behaviours and weight-reduction plan that are good for vata i.e. which helps in mitigating aggravated vata and balancing it.
They embody –
– Snehana – use of ghee, oil, muscle fats, bone marrow
– Swedana – sudation
– Abhyanga – natural oil therapeutic massage
– Basti / Vasti – medicated enemas – decoction and oil (unctuous) enemas
– Nivatam cha sthanam – dwelling in locations devoid of wind
– Pravarani cha – overlaying the physique with blankets and shielding from chilly
– Rasah – consumption of meat soups
– Payamsi – consumption of various kinds of milk
– Bhojyani svadu amla lavanani cha – consumption of meals that are predominantly candy, bitter and salty / saline in style, that are vata-mitigating and balancing tastes
– Brmhanam yat cha – some other measures that are nourishing in nature
– And all different efficient anti-vata cures like vasti and so forth
Particular line of therapy
व्यात्तानने हनुं स्विन्नामङ्गुष्ठाभ्यां प्रपीड्य च||१०२||
प्रदेशिनीभ्यां चोन्नाभ्य चिबुकोन्नामनं हितम्|
स्रस्तं स्वं गमयेत्स्थानं स्तब्धं स्विन्नं विनामयेत्||१०३||
प्रत्येकं स्थानदूष्यादि क्रिया वैशेष्यमाचरेत् |१०४| च.चि.२८/१०२-१०४
In Hanugraha, if the mouth stays open, swedana – fomentation is given to the jaw and jaw joints (mandibular joints). After giving swedana, the jaw joints are pressed with the assistance of thumbs inserted into the mouth. On the identical time, the decrease jaw (mandible) and chin are elevated with the assistance of index fingers stored outdoors. With this manoeuvre, the jaw bone (mandible) which has been dislocated will slide again into its regular place. If there’s elevated stiffness of the jaw joint, it must be given with fomentation. Following this, it’s pressed downwards to make sure mobility of the joint. However care must be taken to present particular therapies for every affected person relying on the placement of vata, the dhatus affected by vitiated vata and elements like avarana i.e. obstruction or occlusion of vata and so forth.
Vital Therapies
– Abhyanga with Mahamasha Taila or Ksheerabala Taila
– Swedana – with milk processed with Dashamula
– Nasya – with Anu Taila or Mahamasha Taila
– Gandusha – with Ksheerabala Taila or Tila Taila
– Vasti – in difficult situations not responding to traditional therapies and medicines
Vital Formulations
– Pathyakshadhatryadi Kashayam
– Maharasnadi Kashayam
– Balarishta
– Ashwagandharishta
– Triphala Guggulu
– Panchamrita Loha Guggulu
– Vatavidhwamsini Ras
– Ekangavira Ras
Different concerns
Hanugraha shall even be handled on the traces of –
– Ekanga Roga
– Pakshavadha
– Ardita
Trendy perspective
Hanugraha is correlated to a situation referred to as ‘lockjaw’ or ‘jaw stiffness’ or ‘jaw tightness’ defined in trendy medication. The illness has related signs to these of Hanugraha or Hanustambha.
‘Associated Studying – Jaw Tightness or Locked Jaw’
