Ayurvedic management of Hanugrah-A case study

Abstract

Hanu means Jaw and Grah means fixed or locked hence it can be correlated with locked jaw. Hanugrah can be a symptom in particular disease or presented as individual disease. While explaining pathology of hanugrah Acharya Charak said, when vayu is located at the root of jaw, it causes the jaws to slip down from their bonds and consequent opening of mouth or by stiffening the jaws it causes closing of mouth. It is characterized by stiffness and absence of pain. In this case study a male patient 20 years old visited our opd with difficulty in opening his mouth to its full extent, pain over temporomandibular joint while opening his mouth to its full extent, difficulty in chewing hard substances.1 year back he was diagnosed with ankylosing spondylitis and having lower back pain then started suffering from restriction in opening his mouth to its full extent. In anklyosing spondylitis pradhanlakshan is sandhigrah and chestahani which is related to mamsadhatukathinya and mamsadhaturukshata leading to loss of elasticity of joint causing Grah lakshan. Mamsadhaturukshata, Mamsarukshata, Shoth are the causes for grah lakshan. In view of sampraptibhang, amapachan, dushtsanchit dosh pachan and shothghna treatment was planned. In this treatment plan Simhanad guggul and Dashmool kwath was given internally. Anu tail nasya is advised along with Prasarani tail for local application over temporomandibular joint and followed by sthaniksankar swed that is valukapottali swed over painful area of temporomandibular joint. This line of treatment was given for 1 month. After 1 month treatment, patient got significant relief. Pain at temporomandibular joint while opening mouth got reduced and range of movement of TMJ joint improved.