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 issues 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 tough.
It is usually referred to as as ‘Hanustambha’ by some consultants, which additionally means the identical. Stambha additionally means tightness or stiffness or rigidity.
Causative Components of Hanugraha
Basic etiological components
Since Hanugraha has been defined within the context of Vatavyadhi, all etiological components of vatavyadhi and all these components which trigger aggravation of vata together with meals, actions, behaviours and seasonal adjustments would additionally function etiological components for Hanugraha.
Particular etiological components
जिह्वानिर्लेखनाच्छुष्कभक्षणादभिघाततः।(वा.नि.अ.१५)
Grasp Vagbhata enlists particular etiological components for Hanustambha and they’re as talked about beneath –
Jihva nirlekhana – tongue scraping – Opening the mouth in extra and for extended durations of time whereas placing the tongue out, for the aim of scraping / cleansing the tongue and enamel with the assistance of tongue cleaners and brushes respectively would put stress on the jaws and extreme associated actions will trigger aggravation of vata.
Shushka Bhakshanat – Extreme consuming of dry and arduous meals. This wants a number 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 buildings of the jaw is yet one more necessary 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 –
As a result of above stated etiological components, 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 is 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 buildings 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 continuously stays opened together with stiffness. There might be much less ache. It might additionally trigger lockjaw. This might happen due to the stiffness of the joints of the jaw when the mouth stays closed. Right here the affected person would really feel problem in opening the mouth. This situation is 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 individual would both stay open or closed always
– As a result of mouth being shut or open continuously always, it could trigger problem in chewing the meals
– The identical mechanism of pathogenesis would trigger problem 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 might be related to much less ache. So, stiffness is a predominant grievance in Hanugraha whereas ache will not be. It’s only related to signs that are additionally gentle 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 will be cured solely after administering cautious and well timed remedy. If remedy will not be supplied 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 continual nature. They will also be cured when they’re newly manifested and in robust sufferers and when not related to problems. Hanustambha too has been talked about amongst these ailments.
So, Hanustambha or Hanugraha will be cured if –
– addressed early with correct interventions, when the illness is acute and newly manifested,
– the affected person is powerful sufficient
– correct remedy is given at correct time,
– it’s not related to problems
Alternatively, if uncared for or if the illness will get continual or mis-managed, it could change into incurable.
Therapy of Hanustambha / Hanugraha
Basic line of remedy
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, normal line of remedy of vata vyadhis may also be relevant for treating this situation. This contains medicines, therapies, life-style adjustments, behaviours and food regimen that are good for vata i.e. which helps in mitigating aggravated vata and balancing it.
They embrace –
– 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 treatments like vasti and so forth
Particular line of remedy
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 similar time, the decrease jaw (mandible) and chin are elevated with the assistance of index fingers saved exterior. 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 needs to be given with fomentation. Following this, it’s pressed downwards to make sure mobility of the joint. However care needs to be taken to provide particular therapies for every affected person relying on the situation of vata, the dhatus affected by vitiated vata and components 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 issues
Hanugraha shall even be handled on the strains of –
– Ekanga Roga
– Pakshavadha
– Ardita
Fashionable perspective
Hanugraha is correlated to a situation referred to as ‘lockjaw’ or ‘jaw stiffness’ or ‘jaw tightness’ defined in fashionable medication. The illness has comparable signs to these of Hanugraha or Hanustambha.
‘Associated Studying – Jaw Tightness or Locked Jaw’
