Suvarnaprashana (सुवर्णप्राशनम्)

Suvarnaprashana (Samskrit: सुवर्णप्राशनम्) is one of the exclusive preventive healthcare therapies advised specifically for children in Ayurveda. 'Suvarna' (सुवर्णम्)means 'gold' and 'prashana' (प्राशनम्)refers to feeding, tasting or licking. Thus literally, Suvarnaprashana indicates feeding gold to the children. However, it should not be taken in literal terms. Ayurveda has a very well developed art and science of preparing medicinal formulations from not just herbs but also minerals and metals. These elemental substances like gold are not used in the form as they are found in the nature but, are systematically processed with specific herbs with the help of fire in furnaces and then only the transformed substances are used in medicinal formulations. The medicines prepared in this classical way are time tested, safe, effective and easy to use. The branch of Ayurveda dealing with all these types of processes is known as Rasashastra (रसशास्त्रम्) which is also popularly known as Alchemy in Ayurveda. Specifically 'gold' and no other metal is selected for suvarnaprashana because of its gunas (गुणाः) and karmas (कर्माः) as per Ayurveda. Suvarnaprashana is a comprehensive Rasayana (रसायन) Chikitsa, administered for strengthening the the physical, mental and intellectual faculties of the children.

परिचयः ॥ Introduction

Acharya Kashyapa (आचार्य काश्यपः), in Kashyapa Samhita first coined the term 'Suvarnaprashana' and provided the unique formula for it thousands of years back. Other Ayurveda scholars like Acharya Sushruta and Vagbhata have also advised use of gold in an infant or neonate especially under Jatakarma Samskara (जातकर्म संस्कारः). Suvarnaprashana advised by these acharyas was of quite a primitive form. Over the years of practice and development of Rasashastra branch of Ayurveda, now-a-days, the practice and method of Suvarnaprashana is slightly modified. Suvarnaprashana described in Kashyapa Samhita is intended to boost memory, intelligence, agni (अग्निः here, growth & metabolism) and immunity in infants. It is considered as one of the oldest applications of gold nano medicine. Although originally Ayurveda acharyas had advised this therapy either on the day of birth or over a period of 6 months to 1 year of age, today it is given to all children upto 12 years of age. It is specifically given on the Pushya nakshatra (पुष्य नक्षत्रम् constellation) of every month in Ayurveda clinics across India. Clinical and pharmacological studies show immunomodulatory, nootropic as well as therapeutic effects of Suvarnaprashana therapy. Thus it can be administered in all children as it acts at the level of nutrition, metabolism, growth and development, physical strength, and immunity.

षोडशसंस्कारे सुवर्णप्राशनम् ॥ Suvarnaprashana as a part of Childhood Samskara

Samskaras (संस्काराः) in Sanatana dharma are known as the rites of passage performed for purification of a human being or to generate or to infuse particular qualities in a person to prepare him for the new stages of life. Among 16 samskaras described in Grhyasutras Jatakarma (जातकर्म ceremony at birth) and Chudakarma (चुडाकर्म tonsure ceremony) are the 2 childhood samskaras which are performed to get rid of the impurities, which may be present in the Bija (बीजाः sperm and ovum) and also due to the stay inside the womb as Garbha (गर्भः fetus). Here, Jatakarma Samskara (जातकर्म संस्कारः newborn care) is told as a purification procedure, in which soon after cutting the umbilical cord the baby is made to lick the mixture of gold, honey, and ghee by chanting Mantra (मन्त्राः spiritual hymns). Therefore Suvarnaprashana has been the integral part of jatakarma samskara since long time in Bharata. A newly born baby has a very weak and immature immune system. Owing to this, utmost care must be taken to protect the baby and implement measures that would boost the baby's immunity till the baby develops it by self. For this, now-a-days we give various different vaccines to the child to provide immunity against multiple diseases. In ancient India, the same purpose was served with the use of Suvarnaprashana. Thus Suvarnaprashana is also popularly known as the Ayurvedic vaccination method. However, the scope of Suvarnaprashana is far beyond that.

जातकर्मसंस्कारांतर्गतम् सुवर्णप्राशनम् ॥ Suvarnaprashana in Jatakarma Samskara

Immediately after delivery of a baby, for first 4 days, there is mostly no adequate secretion of the breast milk. Thus newborn baby might not get sufficient breastmilk for growth and nourishment. Along with this there could arise some situations were the mother of the baby is not available to breast feed the baby due to any possible cause. In such crucial scenarios, there is a necessity to search for certain feeds which can provide nourishment as well as essential nutrients to support baby's growth and development. Ayurveda acharyas have recommended 'lehana' (लेहनम्) in such instances. Lehana indicates certain supplementary feeds in linctus (semisolid/fluid) form that facilitate nourishment, growth, protection and development of the baby with or without breastmilk. Acharya Sushruta and Vagbhata have suggested use of gold in such lehanas. Under Jatakarma samskara, Acharya Sushruta suggests, administration of Suvarna (gold) along with honey and ghee as a single dose at birth in the procedure of new born care. Acharya Vagbhata also provides formula that includes suvarna (gold) along with the combination of other herbs under Jatakarma samskara.

सुवर्णस्य महात्म्यम् ॥ Why Gold?

Suvarna (Gold) is one of the most precious metals known to the man since long time. It has been used in ornaments, currency etc widely in India. At the same time gold has secured place as a therapeutically effective medicinal substance in Ayurveda medicine since thousands of years. In various Ayurveda texts, the types of gold to be used, mode of administration of different forms, theirs benefits and therapeutic indications are clearly explained. According to Ayurveda literature, gold is one of the 7 dhatus (धातवः metals) and also one of the pure metals used in medicines. It is known to show Rasayana (रसायन rejuvenation, immunomodulator, adaptogenic) and Vajikarana (वाजीकरणम् aphrodisiac, invigorating, vitalizing) activity when consumed orally in different formulations.

Various modern research studies have validated the role of Gold in maintenance of health and wellbeing.

• The action of gold in the immune system is supported by an experimental study conducted using suvarna bhasma (सुवर्णभस्म calcinated ash) on mice. This pharmacological Study 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.
• One experimental study of suvarna bhasma conducted on immature rats showed that there is a significant stimulatory effect of gold chloride on female reproductive activity. The traces of gold have been found in endometrium and decidua of uterus in females and highest percentage of gold has been found in the semen fluid of males.
• One more study reports state that, colloidal gold colloidal is found to improve cognitive functioning, which was measured in that study by IQ scores.
• The advantages of biodegradable gold particles are utilization in the vaccinated organism, high loading efficiency for the target substance, enhanced ability to cross various physiological barriers, and low systemic side effects. In all likelihood, the immune actions of biodegradable nanoparticles and gold nanoparticles as corpuscular carriers are similar. The recent data indicating low toxicity of gold nanoparticles makes it being used in the development of next-generation vaccines.

Forms of Suvarna used in Ayurveda medicine

Classics of Ayurveda mention specific forms of Swarna for internal administration such as Patala/Mandala (पटल/ मण्डल leaf/foil), Churna (चूर्णम् powder), Bhasma (भस्मम् ash).

सद्यकाले सुवर्णप्राशनपद्धतिः ॥ Present day Suvarnaprashana

Original classical descriptions on Suvarna prashana in Kashyapa samhita and even other texts use metallic gold for the therapy. The gold in metallic form rubbed on a clean rubbing stone with water releases fine gold particles on the surface. These fine particles were then mixed with ghee and honey and then used as a linctus in Suvarnaprashana therapy. One more form of metallic gold use din this therapy is popular as Suvarna vacha yoga (सुवर्णवचा योगम्). In this method, purified gold wire is inserted into processed underground stem (dry or fresh) of herb named Vacha (वचा Acorus calomus). Later when the herb grows upto a certain level, the part of herb inserted with gold wire is removed. This golden part of herb is rubbed on a clean rubbing stone (5-6 rotations) with milk or water, so as to get fine gold particles along with a paste of the herb vacha. The released gold along with the herbal powder is then mixed with honey-ghee and then it is used for suvarna prashana. These are the classical methods of Suvarnaprashana described in Ayurveda literature. However along with time and advances in Rasashastra branch of Ayurveda which entirely deals with making of safe and effective medicinal formulations from metals and minerals, Suvarnaprashana therapy has also evolved. Considering bhasma form of gold safer than the mere metallic form, now-a-days, at most of the places, Suvarnaprashana is done using bhasma (purified calcinated) form of gold. The present day Suvarnaprashana practice is described below,

सुवर्णप्राशनम् ॥ Practice of Suvarna Prashana

In multiple clinics and institutional setups across Bharata, Suvarnaprashana is conducted regularly. The methods, medicines used and duration of therapy may vary slightly on the basis of the practitioner Vaidya's knowledge and experience.

भेषजम् ॥ Medicine used

Suvarnabindu (सुवर्णबिन्दु) is the popular form of Suvarnaprashana medicine. Purified and calcinated form of gold i.e Suvarna bhasma is used in therapeutic dose as per age, along with ghee and honey. Combination of ghee and honey is considered as the best carrier or vehicle for gold medicine. The combination of ghee and honey is also believed to trigger immune responses which helps to strengthen a child’s immunity for toxins and allergens. In some formulations, the ghee used in the combination is first fortified with some known immunomodulatory and nootropic herbs like Yashtimadhu(यष्टीमधु Glycerrhiza glabra), Shankhpushpi (शंखपुष्पी Convolvulus pluricaulis), Vacha (वचा Acorus calamus), Brahmi (ब्राह्मी Bacopa monnieri), Mandookaparni (मण्डूकपर्णी Centella asiatica) and Guduchi (गुडूची Tinospora cordifolia). This can give enhanced intellect/memory boosting, immunity boosting effects with suvarnaprashana.

मात्रा ॥ Dosage

The dose may vary slightly from place to place however, the gold in the therapy is approximately from 5 to 10ml per single dose. The rest of the part of dose includes mixture of ghee and honey. The entire dose is fed to the baby either with spoon or through a syringe or a small bowl.

वयम् ॥ Age group

Suvarnaprashana is offered to all children upto 12 years of age. As mentioned earlier it has its root is Jatakarma samskara. It indicates that Suvarnaprashan can also be given or ideally should be started in a newborn child. In one opinion it can be offered to all children upto 16 years of age. Clinically, a minimum therapy of 6 months, 1 year to two years is recommended in order to get considerable results.

कालम् ॥ Time

It is offered on every Pushya nakshatra (Constellation) of the month. For newborns, suvarnaprashan is recommended daily upto 1 year of age to get optimum benefits. Various clinical studies have been conducted till now to understand the age related effects of Suvarnaprashana and the results show that this therapy can benefit all children upto 15 years of age even if it is given only on pushya nakshatra time or on daily basis.

पुष्यनक्षत्रकालस्य प्रयोजनम् ॥ Why on Pushya Nakshatra

Pushya is one of the 27 nakshatra (constellations) as per Hindu calendar. Among these nakshatras, Pushya when in the sky is believed to facilitate positive growth, nourishment, and strength in the universe. The Suvarnaprashana therapy is offered to enhance the similar attributes in a child like growth, development and nourishment. Therefore to get maximum benefits from this therapy one can make use of the energies in the universe which can facilitate, support and boost the effects on Suvarnaprashana. Moreover, according to Ayurveda the results this therapy gives, are called as Rasayana karma in Ayurveda. Acharya Charaka and Sushruta in their classical work have specifically advised use of gold on Pushya nakshatra when to be given for Rasayana karma. Thus the current day practice of Suvarnaprashana is done on pushya nakshatra time of the month.

सुवर्णप्राशनलाभाः ॥ Benefits of Suvarnaprashana

Suvarnaprashana is given to the children to improve multiple aspects of their health and wellbeing like physical growth, psychological growth, intellect, immunity etc. Ancient Ayurveda scholars had included it right under the Jatakarma samskara (जातकर्म संस्कारः) owing to which the child will be fed with this from birth itself allowing maximum possible administration and effects. The benefit of Suvarnaprashana discussed by ancient Ayurveda scholars have been described below.

आयुर्वेदशास्त्रोक्ताः लाभाः ॥ As per classics or Ayurveda literature

The clean and pure gold in metallic form was used earlier to rub on a clean surface and get the particles of gold from it. These particles mixed with ghee and honey were given in the linctus form as a suvarnaprashana dose. The benefits of such suvarnaprashana are stated by Acharya Kashyapa as below,

सुवर्णप्राशनम् ह्येतत् मेधाग्निबलवर्धनम् |

आयुष्य मङ्गल पुण्यं वृष्य वर्ण्यं ग्रहापहम् ॥ मासात् परसमेधावी व्याधिभिर्न च धृष्यते |

षड्‍ भिः मासैः श्रुतधरः सुवर्णप्राशनाद्भवेत्॥ (Kash. Samh. Sutra 18.26-27)

Meaning: It increases Medha (मेधा intellectual power), Agni (अग्निः digestive fire), balam (बलम् strength). It acts as a potion which enhances longevity, auspiciousness, virtue and vitality. It improves complexion, removes infliction of mind by evil forces.

The benefits of Suvarnaprashana can thus be listed as below,

• Improves intellect and sharpen mental faculties
• Enhances power of Agni (digestive and metabolic functions)
• Increases physical strength, energy and immunity
• Promotes longevity
• It is auspicious and pious too(positively affects body-mind-energy complex in a human)
• Enhances vitality, vigor and strengthens Shukra dhatu (शुक्रधातुः)
• Improves skin colour and complexion
• Eliminates grahas (ग्रहाः) which indicates protection from disease causing microorganisms and evil energies affecting mind. Which means Suvarnaprashana can strengthen and protect physical as well as mental components of health
• The one special benefit of suvarnavacha type of Suvarnaprashana is improvement of speech. Practitioners advise administration of suvarnavacha in infants after 3 months of age till 5-6 years or 12 years. There is one clinical study which reports immunomodulatory effects of suvarna vacha in neonates without any toxicity.

Along with this, Ayurveda scholars have also studied the effects of Suvarnaprashana given for a specific duration. Based on that, what results its shows when taken for a specific duration of time have been stated as below,

मासात् परसमेधावी व्याधिभिर्न च धृष्यते |

षड्‍ भिः मासैः श्रुतधरः सुवर्णप्राशनाद्भवेत्॥ (Kash. Samh. Sutra 18.26-27)

• If administered for 1 month, the child will become Parama Medhavi (परम मेधावी highly intelligent) and will not be affected by any disease (Immune)
• If administered for 6 months, the baby will become Shrutadhara (श्रुतधरः will be able to remember the things, which are just heard).

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).

Role of Suvarnaprashana validated by scientific studies

Various scientific research studies have been conducted to evaluate the safety and efficacy of Suvarna (Gold) bhasma and and Suvarnabindu (सुवर्णबिन्दुः Medicinal formulation used for Suvarnaprashana) used in in Ayurveda. The reports of the studies show that,

• Suvarna bhasma possesses antioxidant, antidepressant, anti-cancerous, antibacterial, and anti-rheumatoid property and acts as a nerve stimulant.
• Immunomodulatory activity of Gold has been proved in some studies because of gold's antibacterial action against different organisms. But when the gold is mixed with honey and clarified butter or ghee as in Suvarnaprashana, it is found to widen the spectrum of its action to stimulate body immune cells.
• Suvarna prashana is believed to activate non-specific immunity by activating both cellular and humoral immunity. This activity of SP is supposed to be as a result of the chemical structure of gold in SP. Due to the combination of purified calcinated gold, ghee and honey, The gold nanoparticles become encapsulated and develop into particles of various size, shape, charges, and composition. This activity helps to train immune system to identify and defend human system from many different types of antigens having different forms and develop immunity against wide range of pathogens along with their mutated forms. It is evident that gold nanoparticles are efficiently interacting with the target cells in terms of immunological responses and cytotoxicity

Efficacy and safety of Suvarnaprashana seen in clinical research studies

Multiple studies have been conducted on Suvarnaprashana done using suvarna bhasma. Most of the studies have assessed the effects of Suvarnaprashana on growth, development, disease characteristics, intelligence quotient, quality of life, hematological, biochemical or immunological parameters in children upto 12 to 15 years of age. Newborns including preterm infants have also been included in some studies.

Efficacy

1. A comparative pharmaco-clinical study on Suvarnaprashana medicine and just ghee-honey combination in full term newborns given once daily 4 weeks, showed that, Weight, MUAC, head circumference had significant increase in SP group than control group. Episodes of recurrent Upper respiratory tract infections, diarrhoeal episodes were absent or infrequent in SP group than control group. Significant increase in WBC and lymphocyte count, IgG levels also showed significant rise. [Gaikwad AS et al. 2011]
2. A randomized controlled clinical trial on Suvarna prashana to assess its immunomodulatory activity in neonates where dose was given once daily 6 weeks showed that, significant increase in weight of the children treated with SP is observed as compared to control group. Moreover infrequent or absence of other illnesses during follow up episodes was also observed in SP treated group [Singh P et al 2016]
3. A comparative pilot study conducted to assess efficacy of Suvarnaprashana in Preterm born infants upto 3 years age, suggested that, SP leads to healthy weight gain in children significantly moreover these children are less likely to fall sick due to frequent illnesses during the course. Here the dose was given once every Pushya constellation for 6 months [Rathi R et al 2017]
4. One comparative clinical study was conducted to assess role of suvarnaprashana on recurrent illness in children from 3 to 10 years age showed that SP treatment lead to significant improvement in appetite in children. Moreover these children did not show recurrent cold, cough, loose stools, vomitting etc as compared to the children in the other group. Significant improvement in Total WBC count and Hb % was observed in children treated with SP compared to the other group. Here the dose was given once daily for 30 days [Joshi K et 2019]
5. One study was conducted to evaluate role of Suvarnaprashana on growth and development in Indian toddlers. Suvarnaprashana was given once every pushya nakshatra for 9 months. The reports showed that, along with the positive improvement in physical parameters like height, weight etc, the developmental quotient for mental age of SP treated group was highly significant than the non-treated group. [Kannan S et al 2018]
6. The effect of Suvarnaprashana (SP) on physical growth parameters like weight and height in children upto 12 years age was evaluated in one study by giving doses of SP every Pushya nakshatra for 1 year. It showed that the effect on weight is significant but not statistically significant effect on height in SP treated group is observed. [Ramteke RD et al 2014]
7. Effects of Suvarnaprashana on multiple parameters in children were assessed in one more study. SP was orally administered for 6 months once every pushya or 27th day. The study reports showed that not just the height and weight but also improvement in IQ scores of SP treated group is significant. Moreover, increase in mean levels of immunoglobins like IgG, IgM, IgA were observed among SP treated children group after 6 months of SP. [Patil A et al 2017]
8. Effect of Suvarnprashana on physical growth as well as its immunomodulatory activity was assessed in children upto 14 years age in a study. SP was given once every 27th day for 1 year. The reports showed that SP therapy significantly improves weight, height and head circumference of children. [Khawale D et al 2017]
9. Other few studies evaluated the effects of Suvarnaprashana as a preventive healthcare measure in children upto 8 years age and its clinical effects. Highly significant decrease in occurence of illnesses like cough, dyspnoea, sleep problems and pharyngitis is observed in SP treated group highlighting its preventive role. Improvement in weight and height was seen in these studies as well by giving SP once daily for 30 days [Rao NP et al 2012] and once every pushya nakshatra for 12 months [Somaji LD et al 2014].
10. A survey study of Suvarnaprashana in healthy children was conducted where the age specific dose was given on every Pushya constellation for 12 months to the children from 0-10 years of age. The assessment of the treatment was done after 12 months to check changes in weight, concentration, appetite, activity (Chapalata), mental stability, immunity, and memory power. The results showed that, 116.13 (88.65%) parents found overall improvement in all parameters, 9.37 (7.16%) parents could not judge any change and only 5.5 (419%) parents found their children deteriorate. Parameter wise percentage improvement due to suvarnaprashana is listed below,

Effect of Suvarnaprashana on various aspects of child growth and development

	Parameter	Percentage Improvement
1	Weight	87%
2	Concentration	87%
3	Appetite	82.44%
4	Memory	96.95%
5	Mental stability	90.84%
6	Body strength and Immunity	92.37%
7	Alertness	89.31%

Almost all the studies have reported significant improvement in weight of the child and decrease in illnesses after administering SP even at a monthly single dose. This reiterates the pharmacological action of gold and ghee as anabolic and immunoprotective.

Safety profile

The gold use din Suvanraprashan is in purified and calcinated form known as Bhasma. Such processed form of gold has proven its safety since long time in may studies. Apart from that, in none of the clinical studies conducted on Suvarnaprashana, any adverse effects on the children have been reported. Therefore it can be stated that, Suvarnaprashana medicine prepared by an authentic, registered Vaidya (वैद्यः) or a pharmaceutical brand is safe for use. However it is best to take suvarnaprashana under a Vaidya's guidance.

Plausible Mechanisms of Swarna Prashana

Ancient literature of Ayurveda suggests that the colloidal preparation of swarna (gold particles) with honey and ghee would significantly induce robust immunity similar to the vaccines. Various studies have already shown that, Gold particles are the most promising ones which do not affect living cells and do not produce adverse effects. Suvarnaprashana comprises of administration of colloidal formulation of gold wherein the gold particles are of various different size, shape, charge and bio-molecular compositions. Owing to the molecular ingredients found in ghee and honey, these particles retain high stability, low toxicity and and immunogenicity. The molecular ingredients also contain sugars, amino acids, proteins, lipids, vitamins and other components. All these components help in capping the gold particles in Suvarnaprashana medicine which therefore exhibits multivalent interactions between the particle and membrane receptor of antigen-presenting cells (APCs) such as dendritic cells. Dendritic cells are antigen-presenting cells (also known as accessory cells) of the human immune system. These cells are responsible for initiating all antigen-specific immune responses. These cells are especially sensitive to signals derived from microbes, allergens, and the airway tissue microenvironment. Moreover these cells also effectively link the innate and adaptive arms of the immune system. Therefore targeting these dendritic cells is considered to be one of the efficient strategies in promoting immunotherapies and vaccine development. Thus, Suvanraprashana modulates the immunity by acting on cells like dendritic cells.

The plausible mechanism by which Suvarna prashana affects dendritic cells function is as follows,

• Immature dendritic cells uptake and internalize particles of Suvarnaprashana in their cytosol by various methods.
• Then the immature cells differentiate into mature dendritic cells evident by morphological changes in dendritic cells as well as expression of immune markers like CD 83 & CD 86 which are the immune markers.
• since the gold particles in this SP formulation comprise of mosaic features in terms of size, shape, charge, and composition, after internalization they cause intercellular trafficking in dendritic cells Therefore, dendritic cells present multiple antigens effectively to the T cells. This can lead to development of Non-specific immunity in a child which can protect the child from multiple infectious diseases and improve tolerance as well.

The potential application of swarna prashana in immunomodulation is the development of both prophylactic and therapeutic vaccine.

Scope for future research

Effect of Suvarnaprashana on growth hormone secretion and protein metabolism can be assessed to understand the mechanism by which it helps increase height, weight etc. in Children of growing age.