SWARNA KALPA IN PEDIATRIC PRACTICE

INTRODUCTION

A formulation that contains gold as its prime content is known as a Swarna (gold) kalpa¹. Gold, popularly known as the noble metal has been used as therapeutic agent in the Indian Systems of Medicine and by age and time over²; the medicinal potential of gold is being proven by contemporary science as well³. In its bhasma form, in the biologically prepared nanoparticle state, gold can be used to combat chronic diseases⁴. This paper focuses on the administration of Swarna in children and the various methods available for it.

In Ayurvedic practice, the use of Swarna has been advised by all pioneers as a part of maintenance of health and for rooting out existent diseases of chronic nature. Acharya Charaka praises the property of gold against poison as being a drop on a lotus leaf which does not interact with each other⁵. The usage of gold in Pumsavana yogas endorses its potential in promotion of fertility index i.e., the proper implantation of embryo and for begetting a “shreyasipraja” (a healthy progeny)⁶. Being an indispensible part of Jatakarma - a ritual done soon after the birth, gold invigorates immunity in the newborn thus preventing forthcoming diseases⁷. Later it was studied that usage of gold is beneficial for the body right from prenatal life to senescence.

METHODS OF ADMINISTRATION

There are innumerable methods that are used in folklore medicine and as a part of culture in India for administering gold in children due to its popularity of therapeutic and auspicious properties. Some of the methods that are practiced widely which finds its references in the ancient Ayurvedic textbooks are reviewed here.

Swarnaprashana

Swarna is administered to the newborn soon after birth as an age old practice of the samskara(ritual) called Jatakarma Samskara⁸. The classical descriptions of Swarna Prashana uses metallic gold- rubbed on a clean rubbing stone with little amount of water, till fine gold particles are released⁹. The mixture is then mixed with honey and ghee in equal proportions and made to be licked by the baby. As the practice evolved, various drugs came into use along with Swarna such as Swetavacha(Acoruscalamus L.), Kushta (Saussurealappa C.B Clarke), Arkapushpi (Holostemmaadakodien), Matsyaksha (Alternantherasessilis (L.) R. Br. ex DC.)etc. which complements the potential efficacy of gold. Acharya Susruta advocates the use of this combination up to the age of one year¹⁰. Acharya Vagbhata has mentioned the use of licking of a spoon made of gold metal as a part of Jatakarma Samskara¹¹.

The practice of prashana (licking of medicine) has been explained as a method of supplementation of the nutrition the baby in view of maintaining good general health and prevention of diseases¹². Acharya Kasyapa advocates the use of gold as it increases intelligence, digestive fire, vigor, complexion, strength and longevity¹³. Swarnaprashana when administered for a month bestows the baby with high intelligence quotient and makes him more immune to diseases¹⁴. On administration for six months the baby's concentration will be remarkably improved and he becomes a scholar with great retainibility skills of what he hears (shrutadhara)¹³. Ashtanga Hrudaya states some combinations of drugs that can be used for swarna parashana which when taken in lickable form with honey and ghee for a period of one year blesses the child with good growth, intelligence, strength, complexion and virtueousness¹⁵. They are:

Gold with white variety of Vacha and Kushta

Gold with flowers of Arka(Calotropisgigantean L.)

Gold with Matsyaksha and Shankha(Turbinellapyrum L.)

Gold with Kaidarya (Murrayakoenigii (L.) Spreng.) and Vacha 

Swarnamrita prashana¹⁶

With the advent of extensive research on the benefits of gold in the body, particularly when given during childhood, the concept of Ayurvedic Immunization Programme has been developed by the scientists of Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital, Hassan and Udupi where gold is administered in the form of Swarnabindu prashana. A monthly once dose is given on the day of Pushya Nakshatra for children from the age of 0-16 years. It is also advised to be given as a daily dose for a minimum of one month to maximum of six months. The ingredients of Swarnamrita prashana are:

• Swarna Bhasma (Calcined gold)

• Guduchi(Tinosporacordifolia(Thunb.) Miers)

• Jatamamsi(Nardostachysjatamansi(D.Don) DC.)

• Ashwagandha (Withaniasomnifera(L.) Dunal)

• Shankhapuspi(Convolvulouspluricaulis Choisy)

• Yasthimadhu (Glycyrrhizaglabra L.)

• Brahmi(Bacopamonnieri(L.) Pennell)

• Vacha

• Pippali(Piper longum L.)

• Maricha (Piper nigrum L.)

• Ghrita (ghee)

• Madhu (honey)

In 200ml of Guduchi kashaya, 50 ml of Ghee is added along with Brahmi, Vacha, Jatamamsi, Ashwagandha, Shankhapuspi, Yasthimadhu, Pippali and Maricha – 2 gm powder each and heated on low temperature till attaining Ghrita paka. At the time of administration, 1.2 gm of Swarna Bhasma and 50 ml of honey is added to this prepared ghee and triturated thoroughly. Swarnamrita Prashana is used in a dose of 2 drops for 0-1 year and 4 drops for children between 1-16 years. Each dose consists of 2 mg of Swarna Bhasma(24 drops=1 ml).

SwarnaVacha

Swarna Vacha is a form of administering swarna where a purified gold wire is inserted into a processed dry or fresh underground stem of Vacha⁹. The stem along with the inserted gold wire 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 Vacha. This is then mixed with equal amounts of Ghee and honey and made to be licked by the baby. Swarna Vacha uses metallic gold as opposed to calcinated gold which is used in Swarnabindu. Due to the medicinal quality of vacha, Swarna Vachais seen to be beneficial for improvement of speech. Practitioners advise administration of Swarna Vacha in infants after 3 months of age till 5-6 years or 12 years. Amruta Gaikwad (2011) conducted a clinical study which reports the immuno modulatory effects of 17 Swarna Vachain neonates without any toxicity; further research on standardization of the technique, therapy, along with toxicity studies on appropriate animal models are required to establish the safety as well as efficacy of Swarna Vacha. 

Swarna Jala⁹ :

In the context of Pumsavana vidhi, Acharya advocates the use of gold metal for obtaining a healthy progeny¹⁸. Here the gold is to be moulded in the form of the desired akruthi (form) and made red hot on fire. It is then dipped suddenly into cooled water and this water is advised to be used for the daily requirements of the pregnant woman. By this, the tobe-born acquires the quality of that moulded form. By the adaptation of this concept, Ayurvedic Vaidyas of Indian systems uses this as another method of administration of gold in children.

Swarnayogas

Some formulations containing swarna as a main ingredient are used in daily practice for combating common disorders in children.

Kumara Kalyana Rasa³ :- finds its reference in the pharmacopeia textbook of Bhaishajya Ratnavali in the Balaroga Adhikara¹⁹ with specific doses for each age group. It contains;

Shuddha Parada (purified Mercury)

Mukta Bhasma – Bhasma (Calx) of Pearl

Swarna Bhasma – Bhasma of Gold

Abhraka Bhasma – Purified and processed Mica

Loha Bhasma – Bhasma prepared from Iron

Makshika Bhasma – Bhasma of Copper-Iron Pyrite

Kumari Rasa (juice extract) – Aloe vera

With the property of gold along with other minerals Kumara Kalyana Rasa potentially elevates Vata and assists in dhatuposhana (nourishment of body-tissues). It is indicated in improving chronic childhood conditions like developmental delay especially in combination with mukta bhasma and abhraka bhasma helping to improve intellectual power and immunity.

Kumarabharana Rasa:- ^20-21 It is acompound drug formulated by Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital, Hassan which is widely practiced with gold as the prime ingredient used extensively in chronic conditions like developmental disorders, respiratory infections such as chronic tonsillitis²² and auto-immune disorders. Fine powders of Vacha, Pippali, Shunthi, Ashwagandha, Amalaki, Haritaki and Yastimadhu along with bhasmas of Swarna, Rajata and Pravala are taken in definite quantities and one bhavana (impregnation) with each of Guduchi swarasa, Brahmi swarasa and Tulsi swarasa are given²³. Tablets of 500 mg are prepared and preserved in air tight, properly labelled bottle with seven tablets in each.

A variant of the same combination by the name Kumarabharana Prasha is used routinely in new born babies from 0-1yr of age with intent of facilitating proper growth, development and for immune-protection in them. A pinch of the combination is made to be licked by the baby in the morning on an empty stomach with an initial dose of 62mcg(1/8th of 500mg) which is gradually increased upto 500mg by 12months of age. 24

Chaturmukha Rasa²⁴ is connoted in Bhaishajya Ratnavali as an ideal drug for Dhatukshaya janya Vata roga(diseases of Vata caused due to diminution of body-tissues) as well as Srotorodha (Obstruction of body-channels). Diseases due to Dhatukshaya such as Shwasa, Rajayakshma, Pandu, Prameha, Grahani, Agnimandya, Vata prakopa janya moorchha, Unmad, Akshepak, Vatarakta, Visarpa, Hikka, Amlapitta, Arsha Chaturmukha Rasa is clubbed with Dashamoolarishta, Saraswatarishta or Triphala Choorna for exceptional clinical results. 

Chaturbhuja Rasa²⁵ is yet another combination used in treatment of chronic fever, epilepsy and psychiatric disorders which contains purified gold and mercury as the prime contents along with purified ores of Haratala and Shilajitu, Kasturi, Kanya and Eranda.

DISCUSSION ON PHARMACOLOGICAL CONNECTION OF SWARNA KALPAS

Bhasmas are biologically prepared nano particles of gold which comprises gold-containing particles that are globular and have an average size of 56-57 nm²⁶. Gold uptake in the intestine is studied to be dependent on the particle size of gold, which means smaller particles cross the gastro intestinal tract more easily²⁷. Bajaj et al., demonstrated the pharmacological potential of swarna bhasma by studying the specific and nonspecific immune responses in chronic Swarna Bhasma-treated mice²⁸. Swarna bhasma was found to have an immuno-stimulant action as it significantly stimulated the phagocytic index of macrophages²⁸. Immuno-enhancement effect of gold was also studied in mice by injecting separate concurrent organic gold compounds and antigen²⁹. On the whole, pharmacological studies of Swarna Bhasma reveals its action in immuno-modulation, immuno-enhancement, free radical scavenging activity and analgesic activity which justifies the use of swarna kalpas and its importance in maintaining health in the pediatric age.

CONCLUSION

Swarna Kalpa are can be effectively made use of in enhancing immunity and in combating developmental diseases along with various chronic disorders. A critical analysis of all available facts suggest very prominently that Swarna Bhasma is a wonder drug of Ayurveda which may be calibrated on parameters of contemporary science as researchers are adding new substantiated vision in case of Gold compounds all across globe in service of humanity.