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Introduction

Since the beginning of time, mankind has been familiar with the use of metals and minerals. Gold has been designated as the most valuable metal and has been used to create statues of the gods, jewellery, coinage, and other items all over the world. One of the oldest metals, it is even utilised for therapeutic and preventative purposes. Regarding its early awareness among Indians, the first mention is from the prehistoric era and is given as Hiranya (also known as Swarna) in Vedic writings.1 Manusmriti, the firstAccording to the ancient Indian literature on rectitude, a Dwija (brahmin) must go through Samskara (purificatory rites) like Jatakarma (procedures at birth) and Chudakarana (ceremony of tonsure) to remove impurities that may be present in the Bija (sperm and ovum) as well as due to the stay inside the womb as Garbha (fetus).

As a means of purification, Jatakarma Samskara (newborn care) is described heremethod whereby the infant is made to sip a mixture of gold, honey, and ghee shortly after the umbilical cord is severed while reciting a mantra (spiritual hymns)2. It is evidently mentioned in the texts of Ayurveda that any form of gold should be used internally only after proper purification failing to do, which may result in complications that may be even life?threatening.[3,4] The type of gold to be used, mode of administration of different forms, theirs benefits and therapeutic indications are also clearly explained.[3]

Methods

A methodical collection of data from classical texts of Ayurveda as well as related pharmaco?clinical research articles and dissertation works published in between May 1977 to November 2011 have been collected using PubMed and manual search of bibliographies as the sources.

Swarnaprashana

 Lehana depicts administration various herbal drugs, ghee preparations, and gold alone as supplementary feeds wherein precise indications are stated. Acharya Kashyapa coined the term Swarnaprashana for administration of gold.

This unique formula has been explained wherein gold should be triturated along with water, honey, and ghee on a clean stone facing eastern direction and made the Shishu (infant)[11] lick the same.

The specific benefits ascribed to Swarnaprashana are as follows:[7]

 • Medha Agni Bala Vardhanam (improvement of intellect, digestion, metabolism, immunity, and physical strength)

 • Ayushyam (promoting lifespan)

 • Mangalam (auspicious)

 • Punyam (righteous)

• Vrushyam (aphrodisiac)

 • Varnyam (enhancement of color and complexion)

• Grahapaham (protection from evil spirits and microorganisms).

The specific benefits of Swarnaprashana according to the duration of administration have been mentioned such as:

• If administered for 1 month, the baby will become Parama Medhavi (highly intelligent) and Vyadhibhir Na Cha Drusyate (will not be affected by any disease)

• If administered for 6 months, the baby will become Srutadhara (will be able to remember the things, which are just heard).[7]

 All the above said benefits are indicating the enhancement of all favorable factors required for proper growth and development of a child, which is considered to be rapid during Shaishavavastha (infancy).

In Jatakarma Samskara Acharya Sushruta cite administration of Swarna along with honey and ghee in one among the procedures of Jatakarma Samskara that is, as a single dose at birth in the procedure of new born care. He provided the rationale behind this practice that there will be no adequate secretion of breast milk for the first 4 days after delivery and so as to support the baby with respect to preventive and nutritive aspects such practices are indispensable.[8] Acharya Vagbhata advises to give a combination of herbal drugs in a specific shaped spoon as that of the leaf of holy banyan tree, made up of gold to the newborn for increasing Medha (intellect).[9] Administration of Swarna along with other herbs is also mentioned by Acharya Vagbhata in Jatakarma Samskara. [10]

Administration In Jatakarma Samskara, it is told that Swarna should be administered soon after birth as one of the procedures of new born care. In Lehana it should be administered in Shishu. Acharya Sushruta suggests administration of Swarna along with other herbs like Shankhapushpi (Convolvulus pluricaulis Choisy), Kushtha (Saussurea lapa Clarke), Vacha (Acorus calamus L.), etc., with honey and ghee for a period of one year.[12] The term Kumara is also used in the same context that can be considered as a child of the age group in whom development of reproductive system is not yet complete.[13] In all above references, it is said that Swarna should be administered along with honey and ghee.

 Acharya Vagbhata gives specific combinations of gold and herbal drugs as those who desire Ayu, Medha, Lakshmi (wealth), and Kama (sensual enjoyment) should consume it along with Shankhapushpi (Convolvulus pluricaulis Choisy), Vacha (Acorus calamus Linn.), Padma Kinjalka (stamen of Nelumbo nucifera Gaertn.), and Vidari (Pueraria tuberose DC.) respectively.[10] A glimpse of administration of Swarna in newborn is also found in the text Rasaratna Samuchaya,[4] which is very similar to above references. There is no reference of any specific day or time for Swarnaprashana in children. Dosage Acharya Kashyapa has not mentioned the dosage for Swarnaprashana in specific. However, he has given general dosage of children according to age in the same context from birth.The same can be followed to fix the dosage of Swarnaprashana.

A few other available references regarding per day dose of Swarna Bhasma from various texts are as listed below:

• 1/4th–1/8th Ratti (15–30 mg) Swarna Bhasma[3]
• 2 Gunja (250 mg)[4]
• 1 Gunja (125 mg)/As
• age[8]
• 1 Harenu[9]
• 1/32 Ratti (3.9 mg)[14]
• 15.5–62.5 mg of Swarna Bhasma. [15] By taking these adult dosages as reference standards, dosage in children can be calculated.[16]

 Forms of Swarna

Classics of Ayurveda mention specific forms of Swarna for internal administration such as Patala/Mandala (leaf/foil), Churna (powder), Bhasma (ash).[3]

 Safety measures

Acharya were perceptive of all the serious adverse effects if gold is administered in impure form which is evident from the explanation of Shodhana (purification) of Swarna in specific. It is cited that if Swarna is administered without appropriate processing, it will destroy the happiness, potency, and strength of the individual and it will lead to manifestation of a group of diseases.[4] If Swarna is administered in impure form, it can also cause mental disturbances and even death.[3]

Discussion

Discussion

By considering various references it can be said that the term Swarnaprashana signifies the administration of gold alone or along with other herbs in a Leha/Prasha form. He describes Swarnaprashana in the context of Lehana. Lehana has been indicated for those children who are healthy, but have compromised breastfeeding and are having minor functional problems of metabolism. It is contraindicated in seriously ill children and also on daily basis.[7]

Swarnaprashana can be administered in all children as it acts at the level of nutrition, metabolism, growth and development, physical strength, and immunity. It is the only type of gold preparation described with its specific benefits according to the duration of administration. Even though Lehana is contraindicated on a daily basis, Swarnaprashana alone can be continued for a period of 1 or 6 months to get its specific benefits in children as stated by Acharya.

Further research studies could reestablish the above said benefits of Swarnaprashana with respect to its duration.

Lehadhyaya of Kashyapa Samhitha, the first mentioned formulation is Swarnaprashana. By considering the indication it can be said that Shaishava Avastha is the right period from which it can be commenced. The role of gold as a physiologically important element might have been understood by Acharya Kashyapa, thousands of years back, which made him to include gold as an important metal to be used in therapeutics. This precise mention may also be due to some specific action of gold in that age group of children, which is observed in the following studies. In a study, trace elements including gold were measured in human placenta and newborn liver at birth.[17] A trace elements like zinc, copper and gold were measured in the hair of newborn infants.[18] In a pharmco?clinical study on neonates Madhu?Ghrita?Swarna?Vacha combination showed a significant effect of humoral anti?body formation and it acted on immunological system, which was evident by triggering the response of immunological system by a rise in the total proteins and serum IgG levels.[19]

Basically, childhood is the period of growth spurts, which is considered to be until 16 years of age, as per Ayurvedic classics. Acharya Charaka mentions a period "Vivardhamana Dhatu Avastha" from 16 to 30 years of age in which growth and development is observed. According to him, this period comes under Balyavastha (childhood).[20] Administration of gold is suggested in new born care (Jatakarma Samskara), up to one year of age and in Kumara. This wide range of age is suggested for administration of gold always arise queries regarding the cited benefits of Swarnaprashana in children. It can be said that the benefits of Swarnaprashana can be attained from infancy to adulthood with a wide range of actions influencing the growth and development of a child. The age at which it can be administered should be dependent upon the expected effect in the body.

Considering all the above cited references it can be said that the action of this noble metal might be at multiple levels like as a general health promoter or in specific to enhancement of intelligence, metabolism, immunity, physical strength, fertility, complexion, etc. As a general tonic, it can be administered in any age group. For the benefit as an immuno?modulator, it can be administered in children in early ages as this period until one year is considered to be the most vulnerable time for infections due to immature immune system. It can be even administered in case of immunodeficiency states provided that there is no serious illness associated with. The action of gold in the immune system can be justified from the following study reports. Pharmacological studies showed specific and nonspecific immune responses, which were modified in a positive manner in Swarna Bhasma?treated mice. It also had a stimulatory effect on peritoneal macrophages, which may be helpful to fight against infections.[21,22]

 In adolescence, there is the appearance of secondary sexual characters, which signify the development of the reproductive system. This could be the right period to get the benefit of Swarnaprashana as a fertility enhancer.

In a study measuring trace elements in endometrium and decidua, looking for cyclic variations, including those during pregnancy, gold was found in human endometrium and decidua. The reported levels of gold were slightly lower around mid?cycle than at other stages of the cycle.[23]

In male reproductive system, gold was measured in semen and reported that it is the richest source of gold reported in biological materials.[24]

Another study suggests a significant stimulatory effect of gold chloride on female reproductive activity in immature rats.[25]

 To get benefited as an enhancer of intelligence, Swarnaprashana can be given from birth and specifically for a period of 1 or 6 months continuously as mentioned in the classic. In a study colloidal gold was found to improve cognitive functioning, which was measured by IQ scores.[26]

As there are a number of forms of Swarna mentioned, picking the apt form is a major chore. Acharya Kashyapa has mentioned Kanaka[7] (a synonym of gold) triturated along with water, honey, and ghee. The idea behind this may be that as per the availability at that time in its pure form, gold could be administered directly and by rubbing on a stone micro particles of gold might be procured effortlessly. Later, other forms of Swarna were mentioned especially Bhasma which may be due to the advancement of pharmaceutical methods in Ayurveda like Rasasastra (metallurgy) as a separate branch of Ayurveda. Any form of gold, which is having better bioavailability should be the first choice for internal administration. The bioavailability of all the forms of gold is yet to be established. A few related study reports are cited below. Swarna Bhasma is said to have nanoparticles of gold which comprises gold?containing particles that are globular and have an average size of 56–57 nm. In blood compatibility study, it was found that Swarna Bhasma contained gold nanoparticles with crystallite size 28–35 nm and was 90% pure gold. Another study found that colloidal gold uptake in gastrointestinal tract is dependent on particle size that is, smaller particles cross the gastrointestinal tract more readily.

 It is very obvious in children that even slight negligence in the administered drug can cause serious adverse effects due to their highly sensitive body systems, which are still under rapid growth and development. Acharya had a very lucid idea regarding the significance of refinement of Swarna before internal administration. This is the reason that they have specifically pointed out the adverse effects of gold if administered without proper processing. Depending upon the form to be used, suitable processing should be adopted; that is, proper purification has to be performed if pure gold has to be administered and if Bhasma after proper purification and incineration. The particles of Swarna Bhasma were reported as non?cytotoxic. In a study of chronic toxicity of Swarnabindu prashana no cytotoxicity was observed.

 There is no any specific day or time for administration of Swarnaprashana. Acharya Kashyapa mentions east direction to which one should face, while preparing Swarnaprashana. In the context of Rasayana[5] and Pumsavana Karma,[6] Acharya Susrutha and Charaka, respectively mention the usage of Swarna on Pushya Nakshatra (a star in Hindu calendar).

The current popular practice of Swarnaprashana only on the day of Pushya Nakshatra may be due to the belief that it is an auspicious start to administer any medication due to its nourishing effect However, such administration once in a month in every age group of children without proper dosage fixation may not yield any benefit as mentioned in classics. Scientific studies in this direction maybe helpful to make this practice unambiguous.

Conclusion

Swarnaprashana does not signify administration of any specific form of gold on a specific day or time. Rather it is the administration of pure gold alone or different forms of gold along with various herbs where this specific word solely means the administration of gold. The selection of the form of gold should be based upon the factors such as better bioavailability, no adverse reactions, easier in preparation, and administration, which should be standardized by scientific studies. Imprecise usage in terms of dose, duration, and condition will definitely generate adverse effects in the body, especially in children. The benefits of Swarnaprashana in children as told by Acharya Kashyapa and others are to be studied with the help of various experimental models and also at clinical levels so as to re?establish the unaccepted facts due to lack of scientific support. The benefits of Swarnaprashana in children are multidimensional. In a nut shell, Swarnaprashana can be named as a positive health care program for children.