EFFECT OF SWARNAPRASHANA ON CHILD HEALTH: A REVIEW

EFFECT OF SWARNAPRASHANA ON CHILD HEALTH: A REVIEW

Sahadat Khan * and Nisha Kumari Ojha

Department of Kaumarbhritya, National Institute of Ayurveda, Deemed To Be University (De Novo), Jaipur, Rajasthan, India.

ABSTRACT: Introduction: Gold preparations are highly prized and often utilized for their tonic and revitalizing effects in Indian systems of medicine. Gold has both preventive and curative medicinal properties. The Kashyap Samhita, under the name Swarnaprashana, describes the usage of gold internally in children via the oral route. After birth, it is indicated in Lehan karma (supplementary feeding to improve nutrition, immunity and intelligence) and Jatkarma (newborn care). Now a day Swarnaprashana in children is getting huge publicity, and many trials are being conducted to evidence its use in children. Material and Methods: This review is in a narrative format and consists of all publications relevant to Swarnaprashana or Swarnabinduprashana, Suvarnabindu prashan, Suvarnavachayog, or Swarnavachayog that the authors identified through a systematic search of major computerized medical databases; no statistical pooling of results or evaluation of the quality of the studies was performed due to the widely different methods employed by each study. Result and Discussion: The present review of the studies proves the role of Swarnaprashana in enhancing cognition and protection against diseases by enhancing immunity. Swarnaprashana acts on multiple levels and can be given for better growth and development in children. Swarnaprashana is safe for children. Conclusion: Clinical and pharmacological studies show immunomodulatory, nootropic, and therapeutic effects of Swarnaprashan as therapy.

Keywords: Ayurveda, Suvarnabinduprashana, children, Suvarnaprashana, Swarnaprashana, Swarnabhasma

INTRODUCTION: Gold preparations are highly prized and often utilized for their tonic and revitalizing effects in Indian systems of medicine. Gold has both preventive and curative medicinal properties. In various forms, administration of Swarnabhasma has been indicated in Ayurveda in infants and children.

Gold is utilized in the Ayurveda system of medicine in the form of refined metallic fine powder (perhaps as nanoparticles) or red colloidal solution, both of which are made through a complex process that includes the use of herbal extracts and even other metals ¹.

The Kashyap Samhita, under the name Swarnaprashana, describes the usage of gold internally in children via the oral route. The benefits of Swarnaprashana are categorized into three categories: intelligence, immunity, and nutrition. Furthermore, it has been stated that by administering Swarnaprashana for one month, the child becomes Param Medhavi (Incredibly intelligent) and Vyadhi Bhishch Na Ghrishyate (Disease-free), by administering Swarnaprashana for six months, the child becomes Shrutdhara (May recall anything he or she hears) ². After birth, it is indicated in Lehan karma ³ (Supplementary feeding to improve the nutrition, immunity, and intelligence) and Jatkarma ⁴ (Newborn care). As the child grows, gold is indicated to get Agni (Digestive powers), Bala (Strength and immunity), Medha (Intellectual power), Varna (Complexion), and Ayu (Life span) ⁵. When Arishta Lakshana (Fatal signs) is observed on the deathbed, gold is administered for therapeutic action ⁶. Thus, gold is a noble metal used from conception until death. According to Ayurveda texts, gold should be used after adequate purification because incorrectly purified gold can deplete strength and induce diseases and even death ⁷. Acharya Sushruta mentioned the administration of Swarna (gold) along with honey and Ghee in one of the procedures of Jatakarma Sanskara (Birth ritual) ⁸. The medicine is used as a single dose at the time of birth in the procedure of newborn care. Acharya Vagbhatta 9 and other Acharyas also mention Swarnaprashana (Gold licking) immediately after the birth as a part of Jatkarma Sanskara (Birth ritual).  Rather than focusing on the sickness, the ancient Ayurvedic Acharya emphasized the development of the body's defensive mechanism against disease. Regarding pediatric situations, Acharya took extra precautions to enhance the infant's immune system from the moment he was born. It is one of the oldest applications of gold nanomedicine. Clinical and pharmacological studies show immunomodulatory, nootropics and therapeutic effects of Swarnaprashana as therapy.

Aims and Objectives: To review the use of Swarnabhasma in children and the safety and efficacy of Swarnabhasma in children.

MATERIAL AND METHODS: This review is in a narrative format and consists of all publications relevant to Swarnaprashana or Swarnabindu prashana, Suvarnabindu prashan, Suvarnavachayog or Swarnavachayog that the authors identified through a systematic search of major computerized medical databases; no statistical pooling of results or evaluation of the quality of the studies was performed due to the widely different methods employed by each study.

Pharmacological Properties of Swarnabhasma: Pharmacological Properties of SwarnaBhasma.

TABLE 1: THERAPEUTIC EFFECT OF GOLD (SWARNABHASMA) AS DESCRIBED IN AYURVEDA CLASSICS

Pharmacological Actions:

Immunomodulatory Effect of Swarnaprashana: Research was carried out to study the immunomodulatory activity of Swarnaprashana in albino rats where both the test drug and vehicle were administered for 10 days. The study revealed that there was a significant increase in platelet count compared with SRBC (humoral immunity) group in the test drug group, whereas a non-significant increase in paw edema (cell-mediated immunity) after 24 hours and after 48 hours compared to the control group. Histopathological studies revealed that Swarnaprashana increased the cellularity in the spleen and lymph node, indicating that Swarnaprashana produces humoral immune response ²¹.

The effects of the Ayurvedic gold preparation SwarnaBhasma (SB) - auranofin (AN) and the Unani preparation KushtaTilaKalan (KTK) on non-specific immunity were investigated in a study where the incremental doses of these medicines were given orally to male mice for ten days. Both test medications (KTK and SB) significantly (P<0.001) raised peritoneal macrophage numbers and enhanced macrophage phagocytic index, whereas AN had a suppressive effect on these parameters ²².

The study described the possible mechanism of Swarna Bindu Prashana (SBP) in dendritic cell maturation and subsequent T cell activation. The study concluded that SBP is an immune booster for newborns against any viral disease, and comprehensive scientific research is needed to confirm its safety and efficacy ²³.

In a study, the effect of Swarnaprashana and Swarna-vacha-prashana on anthropometry, biochemical, immunological, hematological and infant toddler quality of life (ITQOL) parameters were assessed in newborns in 3 groups as Group A-Ghrita and Madhu, Group B-SwarnaBhasma, Ghrita and Madhu and Group C: SwarnaBhasma, Ghrita, Madhu and Vacha Churna. In this trial, all three groups demonstrated a statistically significant (P < 0.001) increase in all anthropometrical metrics, no influence on the infant’s normal growth, no significant differences in hematological and biochemical markers in the groups as well as no significant difference in Immunological indicators with the exception of Group C, which had higher levels of immunoglobulin G (IgG), IgM, albumin, globulin & all ITQOL metrics. This also proved the safety of the drugs in newborns ²⁴.

Swarna Bhasma mixed with Ghrita and Madhu (Suvarna BinduPrashana) were given in 12 healthy children 4 drops of Swarna Bhasma suspended Ghrita (4 mg gold/dose) followed by four drops of honey once every month for 6 months. The study showed an increase in mean levels of immunoglobulins (IgG, IgM, IgA) after 6 months significant reduction in duration, severity, and frequency of illness ²⁵.

In one clinical study, Suvarna Vacha was found to have immunomodulatory effects in neonates without causing toxicity; however, more research on standardization of the technique and therapy and toxicity studies on appropriate animal models are needed to establish the therapy's safety and efficacy ²⁶.

In a case study of a 1 year and 05 months old female child with complaints of recurrent common cold and cough since birth, Swarna prashan maintained general health of the body and decreased recurrent common cold and cough in the child. The result indicates that Swarnaprashan is assumed to possess an immunomodulatory function ²⁷. A randomized, controlled, single-blind study was conducted to assess the safety and efficacy of Swarna Bhasma (calcined powder), Madhu (honey) and Ghrita in infants concerning anthropometrical, hematological and immunological parameters. 102 healthy infants were allocated into trial and control groups.

The trial group received a mixture of Swarna Bhasma, honey and Ghrita, while the control group received a mixture of honey and Ghrita, both in drop form, for a period of 4 weeks with 8 weeks follow-up. Safety was assessed based on biochemical parameters, and efficacy was based on the values of IgG before and after the treatment. Anthropometrical and biochemical parameters did not show any statistically significant difference between the effect of trial and control drugs, which suggested that the trial drugs did not hamper the normal growth of the infants and were safe to be administered in infants. Both trial and control drugs showed statistically significant changes in IgG levels individually before and after the treatment; however, when compared between the groups, there were no significant differences.

However, the number needed to treat (NNT) to assess the normalization of immunoglobulins, which is suggestive of its immunomodulatory activity, was 1 out of every 4.535 infants who received Swarnarashana was significant. As evident by NNT, it showed immunomodulatory activity and was tolerated by the infants with no adverse effects during the trial or follow-up period ²⁸. A randomized, open-label study was conducted on 60 children of 06 months to 5 years of age and was randomly divided into two groups (30 in each).

Effect on Growth, Development and Behavior: In Ayurveda Swarnaprashana (SP) is stated to be effective in increasing intelligence, strength and potency to longevity. A study investigated the effect of SP on physical growth parameter weight and height. Total 120 children were selected randomly from outpatient department (OPD) with age group ranging from 0 to 12 years. SP as trial drug and Madhujala as placebo was administered in children of trial group and control group, respectively, for 14 times in the duration of 1 year (on every Pushyanakshatra days). Growth parameter weight and height was assessed on every visit of children. It is found that SP has significant (p<0.05) effect on height in male and female children as compared with standard group ³⁰.

Nootropic Activity: A study, aimed to prepare and evaluate the traditional formulation, Swarnaprashana for its nootropic efficacy on the learning and memory by employing exteroceptive and interoceptive behavioral models in young and aged mice. Swarnaprashana (30 mg/kg, p.o.) was administered to young and aged Swiss albino mice for 15 days. The elevated plus-maze and Morris water maze were used as exteroceptive behavior models. Swarnaprashana was prepared by mixing Swarnabhasma (gold) with honey and Ghee was used as vehicle. Scopolamine and naturally ageing-induced amnesic models were used as interoceptive behavior models.

Biochemical parameter such as whole brain acetylcholinesterase (AChE) activity is used to quantify the nootropic activity. Piracetam (200 mg/kg, p.o.) was used as a standard nootropic agent. The pretreatment of Swarnaprashana (30 mg/kg, p.o.) exhibited significant improvement in learning and memory (P < 0.01) and also showed significant (P < 0.001) decrease in whole brain AChE activity and hence, it can be employed in enhancing the memory of the child ³¹. The efficacy of the formulation SuvarnaBinduPrashan in twenty apparently healthy male and female In Group A, trial drug (Swarnaprashan) was given, and in Group B, there was regarded as ‘No concurrent treatment control’. In group A where trial drug (Swarnaprashan) was given, improvement in morbidity features were found whereas in group B which was ‘No treatment concurrent control’, ‘not significant’ results were obtained. Present research reveals that Swarnaprashan works as an immune-modulator which decreased the morbidity rate and therefore can be a simple remedy to bring down the morbidity rate in children. Post-treatment follow-up showed sustained effect of the trial drug ²⁹.

children aged 3 to 4 years was studied. Subjects in Group A received SuvarnaBinduPrashan (Suvarna Bhasma, Ghrita and Madhu) whereas Group B (Control group) did not receive any treatment. Both the groups were observed for six months. Children in SuvarnaBinduPrashan group showed significant reduction in the scores of eating habits, behavior, mood, temperament and scores of events of illness. However, there was no significant difference in the score of sleeping habit. There was significant increase in IQ percentage ³². Administration of gold in children is a popular practice in Ayurveda. It is stated that pure gold if administered along with honey and Ghee for a period of 6 months will enable the infant to remember things which are just heard. Study was conducted to evaluate the effect of SwarnaBhasma on memory and learning against hyoscine/ scopolamine induced amnesia in albino mice. Young Swiss albino mice of either sex divided into three groups. The trial drug contained SwarnaBhasma, honey and Ghee whereas adjuvant drug contained only Ghee and honey which were made into drops from and directly administered in 2 groups of mice and the other group was kept as the normal control. Elevated plus maze was used to assess the effect of test drugs on transfer latency which is interpreted as effect on learning and memory. The trial drug showed significant decrease in transfer latency (p<0.05) both on 2^ndand 3^rdday of the study when compared with initial values and the control group. SwarnaBhasma exhibited significant therapeutic effects on memory and learning in albino mice ³³.

Effect on Nocturnal Enuresis: 40 patients of Shayyamutra (Nocturnal enuresis) satisfying diagnostic criteria and age 6-16 years were selected. Among them, 20 patients were treated with Swarnamritaprashana capsule daily once for two months along with Satvavajaya Chikitsa in study group. The other 20 patients were treated with Ghritabharjita Godhuma capsule (placebo) daily once for two months along with Satvavajaya Chikitsa in control group. The patients were assessed on the completion first month, second month and followed again after third month. It was open labeled standard control non-randomized prospective clinical trial from August 2016 to Feb 2017. Statistically significant effect (p<0.05) of Swarnamritaprashana capsule along with Satvavajaya Chikitsa in reduction of all signs and symptoms of nocturnal enuresis after treatment were observed ³⁴.

Safety of Swarnaprashana: The safety parameters of Swarna Bindu Prashan (SBP) and its vehicle’s effect on chronic administration were investigated. The groups of Wistar strain male albino rats were identified as control, vehicle group of Ghee, honey and both ghee-honey and group of SBP, respectively. In the SBP group, Swarna Bhasma was administered at a dose of 5.625 mg/ kg body wt. along with 0.4 mL of each Ghee and honey. The vehicles group also received the same dose of 0.4 mL/kg of each substance in graded quantities by oral route for 90 days. No mortality, as well as no significant behavioral changes, was noticed in any group studied during the study. The effect on food and water consumption and fecal and urine output remained unaffected. No major alterations were observed in hematology and serum biochemistry. Histopathology of vital organs also supported the non-toxic effect of SBP. It is concluded that the chronic use of SBP is safe and non-toxic at this tested dose level compared to other vehicle groups ³⁵.

DISCUSSION: Infancy or childhood is the growing period of life and is the most crucial period. Proper growth, psychosocial development, and a disease-free state of health in this period provide a strong foundation to the future building of life. Ayurveda science is more concerned with a better life by preventive and promotive measures for pediatric age group.

Kashyap stated that the health and illness of a child depend on the Lehana ³⁶. Lehana is an ancient process of administering Swarna and other useful medicines through oral route in children for better health and prevention of many diseases. Acharyas have mentioned four Swarnayogas (formulations) for the proper growth and development of child. In all the four Yogas Swarnabhasma (gold), Ghee and honey are present ³⁷. As Swarna is the main ingredient of this Lehana, it is named Swarnaprashana ³⁸. Acharyas have mentioned the benefits of Swarnaprashana. They have stated that regular use of Swarnaprashana helps to sharpen the memory to its extreme level, helps in proper growth and development, and prevents diseases ³⁹. Swarnaprashana also improves digestion and metabolism, which keeps the Tridoshas in a balanced state. Thus the child remains free from seasonal variances and helps in effective growth. The present review reveals that Swarnaprashana increases the body's immunity level and thereby may help in proper growth and development. Modern research shows that gold particles have anti-oxidant properties and T-lymphocyte activation and thus regulate antigen-specific immune response ⁴⁰. The Madhu-Ghrita-Swarna-Vacha combination had a significant impact on humoral anti-body growth in neonates. It also showed an increase in total proteins and serum IgG levels, activating the immune system's response ⁴¹. This effect of Swarna may decrease the frequency of illness in children and helps to grow healthily. It also shows cognitive effects, which may increase Dhi (intellect), Dhriti (restrain) and Smriti (memory or recalling capacity) ^42-44. In a study, colloidal gold was found to improve cognitive performance, measured by IQ scores of ⁴⁵. The study also reported the free radical scavenging effect of Swarnabhasma ⁴⁶ which justifies its use as Jatakarma at the time of birth. During birth, there may be oxidative damage to the newborn, which the administration of Swarnaprashana may correct. Honey and ghee act as a vehicle for the Swarnaprashana ⁴⁷. A toxicity study provides evidence of the safety of Swarnaprashana ⁴⁸.

CONCLUSION: The present review of the studies proves the role of Swarnaprashana in enhancing cognition and protection against diseases by enhancing immunity. Swarnaprashana acts on multiple levels and can be given to for better growth and development and protection from diseases by improving immunity and during brain growth for proper brain growth and improving cognition. Swarnaprashana is safe for children.

ACKNOWLEDGEMENT: The authors are thankful to the national institute of Ayurveda for providing the necessary facilities.

CONFLICTS OF INTEREST: The authors declare no conflicts of interest.

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    Khan S and Ojha NK: Effect of Swarnaprashana on child health: a review. Int J Pharm Sci & Res 2023; 14(2): 654-60. doi: 10.13040/IJPSR.0975-8232.14(2). 654-60.

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