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Studies in the Medicine of Ancient India, Part I: Osteology, or the Bones of the Human Body c7.s3.t5: § 65. Facial Bones: Maxillaries

Studies in the Medicine of Ancient India, Part I: Osteology, or the Bones of the Human Body c7.s3.t5

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§ 65. Facial Bones: Maxillaries

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1. *Hanu*, jaw; *hanv-asthi*, jaw-bone, or chin; *hanu-mūla-bandhana*, bond, or tie-bone, at the base, or back, of the jaw; *hanu-citya*, pile or structure of the jaws. The term *hanu* properly means simply a jaw, and ordinarily may indicate both, the upper as well as the lower jaw. But it is in the treatment of these bones, as well as of the other bones of the face which are discussed in the next paragraph, that the second of the most striking differences (for the first, see § 59, cl. 3) between the systems of Ātreya-Charaka and Suśruta discloses itself. The difference, stated briefly and roughly, is that the system of Ātreya-Charaka (§ 4) recognizes the existence of only one jaw, viz. the lower, while the system of Suśruta includes two jaws, the lower and the upper. Accordingly, in the former system, the term *hanv-asthi* signifies the bone (or ‘body’) of the lower jaw, and particularly its more prominent portion, the chin, while the term *hanu-mūla-bandhana* signifies the two attachments (or ‘rami’) at the base, or back, of the lower jaw. In the list of Vāgbhaṭa I (§ 37) there occurs only the term *hanu-bandhana*, jaw-attachment, which is used in a loose way as synonymous with simple *hanu*, jaw (see § 38, cl. 6). The term *hanu-citya* is peculiar to the Atharva Veda (§ 43).

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2. Suśruta’s way of counting the jaw-bones agrees generally with that of modern Anatomy. The two maxillaries really consist each of two bones, but their two lateral halves are so intimately united by harmonic sutures that they are counted each as a single bone. In the same way Suśruta counts two *hanu* or jaw-bones, which, therefore, practically correspond to the maxillaries. Ātreya-Charaka, on the other hand, does not recognize the existence of a maxillary as a single bone. He divides either of them horizontally into a number of separate bones (Figs. 31 and 32). The superior maxillary (Fig. 30) consists of two parts, the body and certain processes. The chief of the latter are, (1)

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the palatine process which forms the hard palate (*tālu* or *tālūṣaka*), and which is counted by both Ātreya-Charaka and Suśruta as a separate bone (§ 67); and (2) the alveolar process which contains sockets of the teeth. This alveolar process, too, is counted as a separate bone, but by Ātreya-Charaka alone, who calls it *dant-olūkhala*, or tooth-socket bone. As to the ‘body’ of the superior maxillary, it would appear that Ātreya-Charaka looked upon it as being continuous with and forming part of the malar bones (§ 66). In the system of Ātreya-Charaka, therefore, there

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FIG. 30.

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SUPERIOR MAXILLARY, *Hanu*. From below. *a, a.* Palatine process, or hard palate, *Tālūṣaka*. *b, b.* Alveolar process, *Dant-olūkhala*. *c, c.* Body of maxillary.

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is practically no superior maxillary. It is replaced by three bones, (1) the hard palate (*tālūṣaka*, § 67); (2) superior alveolar process, or tooth-socket bone (*dant-olūkhala*, § 68);¹ (3) the malar bone, of which the ‘body’ of the maxillary forms a part (Fig. 32). On the other hand, the system of Suśruta, consequent on its recognizing a superior maxillary bone (*hanu*), does not admit any separate tooth-socket bone. At the same time Suśruta’s *hanu*, or upper jaw-bone, does not fully correspond to the superior maxillary, because of its excluding the palatine process, which Suśruta (equally with Ātreya-Charaka) counts as a separate bone (*tālu*, § 67).

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¹ That is, strictly, the set of thirty-two superior tooth-socket bones.

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3. The inferior maxillary (Fig. 31) is a large, strong, horse-shoe-shaped bone, which consists of a nearly horizontal body, and two posterior vertical portions, or rami. The body itself consists of three portions, the alveolar process above, the base beneath, and the mental protuberance, or chin, in front. The whole of this inferior maxillary is counted as a single bone by Suśruta, and constitutes his other *hanu*, or jaw-bone. Ātreya-Charaka, on the other hand, treats it as consisting of four bones: (1) the alveolar process (*dant-olūkhala*); (2) the base with the chin, which he calls *hanv-asthi*, or jaw-bone (chin-bone); (3) and

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FIG. 31. INFERIOR MAXILLARY, *Hanu*. Seen from the left. Showing—*a*. The base of the body, *Hanv-asthi*. *b, b*. The rami, *Hanu-mūla-bandhana*. *c*. Alveolar process, *Dant-olūkhala*. *d*. Mental protuberance, or chin, *Hanv-asthi*.

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(4) the two rami, which he calls *hanu-mūla-bandhana*, bonds at the root, or back, of the jaw-bone. He calls the rami by this name on account of their being the bones by which the ‘body’ of the lower jaw is attached to the rest of the skull.

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4. To sum up: irrespective of the hard palate, which both Ātreya-Charaka and Suśruta count separately, the list of Suśruta represents the two maxillaries by two *hanu*, or jaw-bones, while the list of Charaka breaks them up into—(1) two alveolar processes (*ulūkhala*), (2) one (lower) jaw-bone (*hanv-asthi*), (3) two rami (*hanu-mūla-bandhana*), and (4) probably a portion of his peculiar central facial bone (§ 66). This is shown in the subjoined tabular statement:

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| Modern Anatomy. | Ātreya-Charaka. | Suśruta. | Vāgbhaṭa II. |
| Sup. Max. { 1. palatal process 2. alveolar process 3. body | *tālūṣaka* *ulūkhala* facial bone (K, fig. 32) | *tālu* 1st *hanu* | *tālu* *ulūkhala* 1st *hanu-bandhana* |
| Inf. Max. { 1. alveolar process 2. base 3. chin 4. rami | *ulūkhala* *hanvasthi* *hanu-mūla-bandhana* | 2nd *hanu* | *ulūkhala* 2nd *hanu-bandhana* |

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5. The system of Vāgbhaṭa I represents, as usual, a compromise between the two systems of Ātreya-Charaka and Suśruta. From the latter he adopts the two *hanu* or jaw-bones, and from the former the two *dant-olūkhala*, or tooth-sockets. In the main, therefore, inasmuch as he holds not one, but two jaw-bones or maxillaries, he is a follower of Suśruta; but as a concession to the doctrine of Ātreya-Charaka, he divides each maxillary into two separate bones, viz. its alveolar process (*dant-olūkhala*) and its body (*hanu-bandhana*), the latter including, in the case of the inferior maxillary, its two rami. Another concession to that system appears to be Vāgbhaṭa’s use of the term *hanu-bandhana*, instead of the simpler Suśrutiyan term *hanu*. It seems probable that Vāgbhaṭa I failed to understand the significance of the word *mūla* in the Charakiyan term *hanu-mūla-bandhana*, bond at the base, or back, of the jaw. That word renders the term applicable only to the lower jaw-bone, and signifies its two rami, by which it is attached to the rest of the skull. The omission of the word *mūla* shows that Vāgbhaṭa I understood the term *hanu-bandhana* to be applicable to both jaw-bones, and to indicate that the jaw-bones were attachments of the skull. In his system, therefore, the term *hanu-bandhana* is a mere descriptive synonym of the simpler term *hanu* (§ 38, cl. 6).

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6. The system of the Atharva Veda (§ 43) appears to be essentially the same as that of Ātreya-Charaka. This seems to be indicated by its term hanvoḥ citya, or structure (pile) of the two jaws, inasmuch as that term points to the view of the jaw being a composite organ built up, as Ātreya-Charaka holds, of the separate bones which he calls dant-olūkhala, alveolar process, hanv-asthi, jaw-bone, and hanu-mūla-bandhana, two rami.

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