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Authors Accepted Manuscript

Ayurvedic medicine in Mauritius: Profile of


Ayurvedic outlet, use, sale, distribution, regulation
and importation

Naailah Elaheebocus, Fawzi Mahomoodally

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PII: S0378-8741(16)30454-8
DOI: http://dx.doi.org/10.1016/j.jep.2016.07.031
Reference: JEP10296
To appear in: Journal of Ethnopharmacology
Received date: 6 April 2016
Revised date: 29 June 2016
Accepted date: 8 July 2016
Cite this article as: Naailah Elaheebocus and Fawzi Mahomoodally, Ayurvedic
medicine in Mauritius: Profile of Ayurvedic outlet, use, sale, distribution,
regulation and importation, Journal of Ethnopharmacology,
http://dx.doi.org/10.1016/j.jep.2016.07.031
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Ayurvedic medicine in Mauritius: profile of Ayurvedic outlet, use, sale, distribution, regulation
and importation
Naailah Elaheebocus, Fawzi Mahomoodally*
Department of Health Sciences, Faculty of Science, University of Mauritius, 230 Rduit, Mauritius
*
Corresponding author: M. Fawzi Mahomoodally, PhD, Department of Health Sciences, Faculty of
Science, University of Mauritius, 230 Rduit, Mauritius. Tel.: +230 4037578; Fax: +230 4656928;
E-mail: f.mahomoodally@uom.ac.mu

Abstract
Ethnopharmacological relevance
Ayurvedic medicine (AM) is a legalized alternative traditional medical system in the multicultural
tropical island of Mauritius. A panoply of Ayurvedic specialised shops/centers involved in the
provision of Ayurvedic services hereafter termed as outlets operates in different regions of the
island and is extensively exploited by a significant number of Mauritians. Nonetheless, there is
currently no study geared towards studying the status of AM and profile of Ayurvedic outlets in
Mauritius and there is undoubtedly a dearth of standardized regulatory framework governing the
practice of AM in Mauritius. The present study attempts to study the profile of Ayurvedic outlets,
sale, distribution, regulation and importation of AM in Mauritius.
Aim of study
To evaluate the characteristics profile of Ayurvedic shops/clinics/pharmacies/centres, document
common Ayurvedic products used in the treatment and management of diseases, and to analyse
existing regulatory control of AM in Mauritius.
Material and methods
Ayurvedic outlets were identified using a random approach. Once permission granted, outlets were
visited where face-to-face interviews with Ayurvedic practitioners/directors/dispensers were
undertaken using a semi-structured questionnaire. The characteristics of the outlets with respect to
the type of business registration, procurement and dispensing of products, registration and
qualification of personnels employed amongst others were studied. The International Classification
of Diseases (ICD) 10 was used to classify common AM dispensed to patients. Additionally,
information was sought from local authorities pertaining to existing legislation governing the
importation and regulation of AM in Mauritius.
Results
A total of 16 Ayurvedic outlets (pharmacies (n=3), clinics (n=2), shops (n=5) and centres (n=6))
was surveyed. Six outlets dispensed AM strictly on prescription only after consultation with an
onsite full-time employed registered Ayurvedic practitioner. Seven outlets offered AM both on
prescription and over-the-counter where consultation was not mandatory. The remaining three
outlets, where no Ayurvedic practitioner was employed, did not offer consultation at any time and
dispensed the medicines over-the-counter most of the time. There is currently no such legal
framework that acknowledges the existence of an Ayurvedic pharmacy in Mauritius and no trained
Ayurvedic pharmacist was recruited in any of the outlets. It was also found that no specific
requirements were in place to establish an Ayurvedic outlet in Mauritius. A wide variety of
Ayurvedic formulated and single herb products were recorded to be in use against common diseases.
Ayurvedic products were imported from India (n=10), purchased from local suppliers (n=6) or
locally manufactured (n=1). The Traditional Medicine Board under the aegis of the pharmacy board
is a regulatory body which requires Ayurvedic practitioners to be registered so as to practice AM in
Mauritius. Additionally, the government has an Ayurvedic committee, under the aegis of the
1
Pharmacy board in the Ministry of Health and Quality of Life to monitor the importation of
Ayurvedic medicines. However, no legal framework has been enacted to regulate the sale of AM
under prescription or under the supervision of an Ayurvedic practitioner.
Conclusion
The current regulatory framework is such that the sale/use/distribution of AM is not strictly
controlled unlike its importation. This has led to a certain form of unregulated practice in the private
sector whereby the dispensing and sale of AM are being done over-the-counter without professional
recommendations. It is recommended that authorities need to regulate the Ayurvedic medical system
in Mauritius by amending stringent laws to ensure safety of patients.

Abbreviations
AM, Ayurvedic medicine; BRN, Business Registration Number; GMP, Good Manufacturing
Practices; ICD, International Classification of Diseases; MOH & QL, Ministry of Health and Quality
of Life; NCCAM, National Center for Complementary and Alternative Medicine; SSRNH, Sir
Seewoosagur Ramgoolam National Hospital.

Keywords: Ayurveda; Ayurvedic outlets; Ayurvedic medicines; sale; regulation; procurement;


importation; Mauritius.

1. Introduction

Ayurveda, known as the Mother of all healing is one of the oldest medical systems in the world. It
is a combination of two words; Ayur (whole lifespan) and Veda (total knowledge) literally mean
the total knowledge of the whole lifespan (Garodia et al. 2006). Originated in India more than 3000-
5000 years ago, this medical system is still widely practiced in many regions of India and remains
the countrys most popular and common traditional medicine (NCCAM, 2015; Parasuraman et al.
2014).

Ayurvedic medicine is traditionally used by Mauritians and its practice is considered legal as per
Mauritian law. A significant percentage of the Mauritian population has adopted the Ayurvedic
system as a first-line healthcare system. Interestingly, Mauritians are shifting from allopathic to
traditional medicine, such as Ayurvedic, with the hope to obtain a relatively more effective
therapeutic outcome in the management or relief of symptoms of common diseases.

In Mauritius, Ayurvedic medicine is seen as a flourishing business and practice. It is not surprising
to see how the number of establishments offering Ayurvedic services has mushroomed since recent
years. Although, the practice of Ayurvedic medicine has been legalised in the country, there seems
to be little control and regulation over it. This medical system is governed by the Ayurvedic and
other Traditional Medicines Act 1989 (42) and the Traditional Medicine Board, which was set up to

2
maintain a discipline in the practice of Ayurveda (World Health Organisation, 2011). The Ministry
of Health and Quality of Life (MOH&QL) has also set up an Ayurvedic committee that attempts to
regulate the importation of Ayurvedic products. The importation and procurement of Ayurvedic
medicines to the island are becoming more and more popular and increasing day by day. There are
both private and government-employed Ayurvedic practitioners offering consultation and
prescribing Ayurvedic medicines to patients. Despite being extensively dispensed and sold over the
island, the status of Ayurvedic medicines has never been explored. There is no documentation on the
characteristics of Ayurvedic outlets and the evaluation of sale, dispense, use and importation of
Ayurvedic medicines in Mauritius. No rigid legal framework and national policies have been put
into place to govern these aspects of the system.

This study aims to examine the characteristics of outlets selling Ayurvedic medicine in different
regions of Mauritius using an observational approach. Many types of establishments such as shops,
pharmacies, centres and clinics sell Ayurvedic medicines in Mauritius to patients opting for an
Ayurvedic treatment. Some commonly available Ayurvedic medicinal products in the Ayurvedic
establishments will be documented. This project also endeavours to evaluate the practice, sale,
dispensing, regulation and importation of Ayurvedic medicines in Mauritius.

2. Methodology

2.1 Study area

The study was carried out in Mauritius, a small multicultural island located in south of Indian Ocean.
The country inhabits people from different ethnic groups and these include Indo-Mauritians (68%),
making up the majority of the Mauritian population, Creoles (27%), Sino-Mauritians (3%), and
Franco-Mauritians (2%) (CIA, 2014; Suroowan and Mahomoodally, 2015).

An important segment of the Mauritian people is shifting from allopathic medicine to Ayurvedic
medicines. People suffering from various diseases consult Ayurvedic practitioners who prescribe
Ayurvedic medicines to them. Ayurvedic medicines are sold in many outlets around the island for
instance pharmacies, shops and clinics while they are being dispensed freely in governmental health
centres. In the the current study, an outlet/establishment was defined as a point of sale specialised in
the provision of Ayurvedic services including the sale of Ayurvedic medicines and the offer of
Ayurvedic therapies and consultation.

3
2.2 Data collection

This project was approved by the Department of Health Sciences, Faculty of Science at the
University of Mauritius. It was carried out in the best attempt so as to comply with the Code of
Ethics of International Society of Ethnobiology. Data was collected from November 2015 to Febuary
2016 from different regions as illustrated in Figure 1 within the convenient reach of the researcher.
At the beginning of the data collection process, the person in charge of respective establishments
was contacted.

Key:

Governmental Ayurvedic outlet

Parastatal Ayurvedic outlet

Private Ayurvedic outlet

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Figure 1: Sampling sites.

Relevant documents notably, an information sheet on the project and official letter from the
university were presented to the in-charge personnel so as to avoid any doubts on the researchers
identity. The former clearly outlined the entire research giving a brief summary of the research
project, its aims and objectives as well assured the confidentiality and privacy of each informant.

Once authorization was granted, face to face interviews were carried out with the person in charge
(director/Ayurvedic practitioner/dispenser) in Creole, the native language of Mauritius and English.
Visits to the outlets were usually done on several occasions to extract enough data from an
Ayurvedic establishment.

Corresponding botanical and Ayurvedic name of plants were searched in the Encyclopedia of
Medicinal Plants (www.indianmedicinalplants.info) and the Indian Medicinal Plant: An Illustrated
5
Dictionary. Catalogue of Life (www.catalogueoflife.org) and International Plant Name index
(www.ipni.org) were used as databases to find the authority name of each Ayurvedic plant found
during this study.

2.3 Survey instruments

This research took a survey based approach to facilitate the collection of data whereby a semi-
structured questionnaire was designed for the purpose of collecting data in a standardised method
and administered to Ayurvedic consultants, directors or dispensers of Ayurvedic establishments.

The questionnaire was adapted from two studies conducted in UK on traditional Chinese medicine
and in Nepal on Ayurvedic medicines (Teng et al. 2015; Adhikari and Regmi, 2008). The
questionnaire consisted of both open and close-ended questions and was divided into 3 sections
(supplementary file). Open-ended questions enable participants to give their own opinions, ideas and
comments in their own words. On the other hand, close-ended questions allow the researcher to have
standardised answers, which are simple to administer, compile and interpret

Section A consisted of data on the characteristics of Ayurvedic establishment; Section B investigated


on the services offered by the establishment such as the sale of medicines and the common
Ayurvedic products sold or dispensed. The final section was to investigate the procurement and the
approval system of Ayurvedic medicines in Mauritius. Besides, pictures of the common Ayurvedic
products available in the outlets were captured to achieve the objective of documenting the common
Ayurvedic medicines available in Mauritius. The name, compositions and uses on the medication
containers were emphasized while taking pictures. The same approach was maintained for each
outlet except where the products were strictly out of reach and not allowed to be accessed to the
researcher. In this case, one of the staff verbally communicated the names of the common Ayurvedic
medicines in the outlet. Most of the time, the employee was referring to booklets where the names,
compositions, and indications were recorded. Relevant pages of the booklets were taken in photos.

2.4 Classification of Ayurvedic medicinal products

A panoply of Ayurvedic medicinal products used for one or more diseases and other health
complications were obtained during data collection. These data were presented in the form of a table
with respective names, dosage forms, number of occurrences, claimed medicinal uses and
compositions.
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The system International Classification of diseases 10 (ICD-10) (who.int/classifications/icd10) was
adopted to classify the products into specific disease categories to facilitate documentation.

2.5 Sampling method

The sample size was estimated through a purposive sampling approach which is a non-random and
deliberate choice of an informant with respect to the qualities the latter possesses. The researcher
selectively decides what needs to be known and sets out to find the respondents who can and are
willing to participate in the study by virtue of knowledge or experience (Bernard 2002; Lewis and
Sheppard 2006).

An existing list of registered Ayurvedic establishments in Mauritius was neither available on any
local online database nor easily accessible from the government. Therefore, Ayurvedic outlets in
Mauritius were identified through the help of health care professionals, families, friends and other
acquaintances. Yellow pages, multiple online sources available to the Mauritian public and
newspapers were additionally consulted to identify locations of more Ayurvedic outlets. Their
names, contact details and exact addresses were further investigated through other resources. A total
of 22 outlets were identified but the refusal and unavailability of some of the outlets led to an
inclusion of a total of 16 Ayurvedic outlets in the study.

2.6 Data analysis

Microsoft Excel 2010 was used to input relevant data and to classify the products list obtained from
all Ayurvedic outlets.

3. Results

3.1 Identification of the Ayurvedic outlets

In total, 22 Ayurvedic outlets were identified across Mauritius. All of them dispensed and/or sold
solely Ayurvedic products which were catergorised as either Ayurvedic medicinal or cosmetic
products. Six of the outlets were excluded from the study; two of them refused to participate in the
study and four of them did not give any response to participate in the study. A total of 16 Ayurvedic
outlets were included in the study.

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3.2 General information of the outlets

Table 1 provides a general description of each Ayurvedic outlet visited in Mauritius. It was found
that different types of Ayurvedic outlets selling and dispensing Ayurvedic medicines operate under
different names, namely shops (n=5), pharmacies (n=3), centres (n=6) and clinics (n=2).

Out of the 16 Ayurvedic outlets, 11 of them were private establishments running on their own funds,
three centres were owned by the government functioning in accordance to the public hospitals and
two of the centres were parastatal bodies where part of their services were funded by local
authorities.

3.3 Characteristics of the outlets

As shown in Table 2, all of the Ayurvedic outlets consisted of a reception desk and dispensing area.
Nine had a separate consultation room and 11 of them had a waiting room. Five Ayurvedic centres
(three governmental and two parastatal establishments) were found to consist of a separate pharmacy
where all Ayurvedic medicines were stocked and 16 outlets had a dispensing area.

The establishments estimated the number of staff working at all time to undertake the sale or
dispensing of Ayurvedic medicines. It was found that seven of the Ayurvedic establishments
employed one to two staff. Six and three Ayurvedic outlets employed three to six and ten or more
staff respectively.

The respondents were requested to describe the responsibilities of their staff. Thirteen outlets
employed an Ayurvedic practitioner who was present on a regular basis for consultation in six of the
outlets. In the remaining seven outlets, an Ayurvedic practitioner was only present when a patient
requested for an appointment. Three establishments had no Ayurvedic doctor at any time. There was
at least one dispenser in the 16 Ayurvedic outlets.

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Table 1: General description of Ayurvedic outlet in Mauritius.

Ayurvedic Category Organisation Type of Ayurvedic Sale of Location/District


outlet business Ayurvedic
medicines
1 Clin Pri Consultation P Vacoas/ Plaines
offered Wilhems
2 Phr Pri Consultation P/O Vacoas/ Plaines
offered & Walk-in Wilhems
retail shop
3 Cen Govt Consultation P La Source/ Flacq
offered
4 Sh Pri Walk-in retail shop P/O Candos/Plaine
Wilhems
5 Cen Para Consultation P Calebasses/
offered Pamplemousses
6 Cen Para Consultation P Paillote/ Plaine
offered Wilhems
7 Phr Pri Consultation P/O City Center/Port-Louis
offered & Walk-in
retail shop
8 Cen Govt Consultation P Candos/Plaine
offered Wilhems
9 Phr Pri Walk-in retail shop P/O Le-Hochet/
Pamplemousses
10 Sh Pri Consultation P/O Central region/ Flacq
offered & Walk-in
retail shop
11 Sh Pri Consultation P/O Curepipe/ Plaine
offered & Walk-in Wilhems
retail shop
12 Sh Pri Walk-in retail shop O Mesnil/Plaine
Wilhems
13 Cen Govt Consultation P Pamplemousses/
offered Pamplemousses
14 Sh Pri Consultation P/O Curepipe/ Plaine
offered & Walk-in Wilhems
retail shop
15 Clin Pri Consultation P/O Goodlands/Rivire du
offered & Walk-in Rempart
retail shop
16 Cen Pri Consultation P/O Goodlands/Rivire du
offered & Walk-in Rempart
retail shop
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Clin: Clinic; Sh: Shop; Cen: Centre; Phr: Pharmacy; Pri: Private; Govt: Governmental; Para:
Parastatal; P: Prescription; O: Over-the-counter; P/O: Prescription/Over-the-counter.
Table 2: Characteristics of Ayurvedic outlets

Characteristics Description Frequency (n)


Categories Shops 5
Pharmacies 3
Centres 6
Clinics 2
Setting Reception desks 16
Consultation area 9
Waiting area 11
Dispensing area 16
Nubmer of staff 1-2 7
3-6 6
>10 3
Responsibilities of Ayurvedic practitioner 13
staff Dispenser 16
Director/Manager 13
Other assistants 9
Type of business Walk-in retail shops 3
Consultation offered 6
Walk-in retail shops and consultation 7
offered

Moreover, the dispensers (n= 12) mentioned that they were not qualified and trained formally in the
field of Ayurveda rather acquired knowledge through work experience and/or self-learning.

Only a few of the dispensers (n=4) claimed that they were formerly trained and earned certificates in
Ayurveda. Thirteen establishments had a director/manager who oversees its day-to-day activities.
Many Ayurvedic outlets (n=9) employed other staff to help in delivering an improved healthcare to
their customers. Their occupations vary from receptionists; nursing officers in the governmental
Ayurvedic centres; therapists in parastatal establishments and private clinics to attendants. However,
no Ayurvedic pharmacist qualified by training was employed in any of the Ayurvedic outlets.

3.4 Ayurvedic service provided by outlets


The approach adopted in offering an Ayurvedic service(s) differed from outlets to outlets (Table 2)
surveyed in the present study. Consultation by an Ayurvedic practitioner was offered in 13 outlets
on an appointment basis. However, only six of them including three governmental health centres,
two parastatal bodies and one private clinic dispense Ayurvedic medicines strictly on prescriptions

10
after consultation by the Ayurvedic practitioner of the establishment. The practitioners were present
on a regular basis to consult patients and prescribe medications to them at all time.

On the other hand, the remaining seven outlets were both walk-in shops and outlet offering
consultation on an appointment basis. The recruited Ayurvedic doctors are only present when they
are to consult patients as requested by the latter. Ayurvedic medicines are dispensed both on
prescription and over-the-counter independent of the presence of the prescribers.

Furthermore, walk-in Ayurvedic outlets (n=3) were visited during the study whereby no consultation
was offered at any time and the medicines were available both under prescription by any Ayurvedic
doctor and over-the-counter. It was found that Ayurvedic medicines are also dispensed freely in the
three governmental health centres while they are charged in the private and parastatal Ayurvedic
centres.

There are both classical and patented products available in the Ayurvedic outlets. Some of them
(n=11) offer a wide variety of both type of products while others were dispensing only propriety
products (n=5). Tables 3 depicts some locally manufactured products.These were produced by a
registered Ayurvedic practioner based on his knowledge in Ayurveda whereby he claims that 40% of
his raw materials were imported from India and 60% were obtained locally. Table 4 represents some
classical and propriety Ayurvedic medicines recorded during the survey which were imported from
India. Classical Ayurvedic products are based according to authentic Ayurvedic texts compiled in
the Ayurvedic pharmacopoeia of India. Propriety/patented Ayurvedic medicines are usually
manufactured according to a formulation decided by the manufacturing companies.

Out of 16 Ayurvedic outlets, 15 stated that no side effects were reported from any patient. Only one
dispenser claimed to have encountered at times mild side effects reported by the customers. No
pharmacopeia is used in the majority of the visited outlets except Ayurvedic practitioner of a clinic
claimed to refer to an Indian pharmacopeia.

The number of Ayurvedic medicines dispensed and/or sold per day ranges from 15-100; less than 15
(n=3), products, 15-30 products (n=4), 31-65 products (n=5) and more than 100 products (n=3). The
number of patients ranged from 10 to 100; 10-30 patients (n=13), 50-60 patients (n=2), and 75-100
patients (n=1).

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Table 3: Locally manufactured Ayurvedic products
Product name Dosage Claimed medicinal use Compositions Manufactured*
form
Restora Syr Boost energy, strength and Grapes Locally
endurance. Honey
Promoted testosterone level, Herbs & Spices
helps sexual desire and
ability. Increase sperm count,
supports reproduction and
nervous system.
Amlaroma Oil Hair growth, anti-stress, Embelica officinalis Gaertn. Locally
remove dandruff, prevent & Trigonella foenum L.
stop hair fall Centella asiatica (L.) Urb.
Eclipta alba L.
Sesame oil
Coconut oil
Sunflower oil
Citronella oil

Barista Syr Obesity, diabetes, cholesterol, Aloe barbadensis Mill. Locally


detoxification, constipation, Terminalia arjuna (Roxb.) Wight
hypertension, skin diseases & Arn.
Azadirachta indica A.Juss.
Commiphora wightii (Arn.)
Eclipta alba L.
Embelica officinalis Gaertn.
Boerhaavia diffusa L.
Gymnema sylvestre (Retz.)
Schult.
Achyranthex aspera L.
Bhandari

Kasamrita Syr Cough, Nasc-respiratory Myristica fragans Houtt. Locally


allergy, Bronchitis, Bronchial Piper longum L.
asthma, Bronchietasis, Syzygium aromaticum (L.) Merr.
Laryngitis, Inflammatory et Perry
catarrhal conditions of the Justicia adhatoda L.
respiratory tract. Alpinia galangal (L.) Willd.
Ocimun tenuiflorum Burm F.
Zingiber officinale Rosc.
*These products are manufactured by an Ayurvedic practitioner based on his knowledge in Ayurveda where 40% of his
raw materials were imported from India and 60% were obtained locally.

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Table 4: Common Ayurvedic medicinal products available locally
Product name Dosage Number of Claimed medicinal Compositions
form occurrences uses
1. Certain infectious
and parasitic diseases
Amritarishta Syr 5 Chronic fever, Tinospora cordifolia Jaggery
Relapsing fever, (Willd.) Miers. Piper longum L.
Malaria Dashmool* Piper nigrum L.
Woodfordia fruticosa (L.) Cyperus rotundus
Kurz. L.
Cuminum cyminum L. Mesua ferrea L.
Fumaria officinalis L. Holarrhena
Alstonia scholaris (L.) antidysenterica
R.Br. (G.Don) Wall. ex
Zingiber officinale Rosc. A.DC.(L.)
Giloy satva Tabs 5 Fever Tinospora cordifolia
(Willd.) Miers.
2. Diseases of the blood and blood-forming organs
and certain disorders involving the immune mechanism
Punarnavarishta Syr 5 Anaemia Boerhaavia verticilata Plumbago
Poir. zeylanica L.
Boerhaavia diffusa L. Solanum
Sida cordifolia L. xanthocarpum L.
Abutilon indicum L. Elletaria
Cyclea peltata Lam. cardamomum (L.)
Cissampelos pareira L. Maton.
Justicia adhatoda L. Jaggery
Tinospora cordifolia Honey
(Willd.) Miers. Mesua ferrea L.

Lohasav Syr 5 Anaemia Loha bhasma* Trachyspermum


Woodfordia fruticosa ammi L.
(L.) Kurtz. Terminalia
Piper nigrum L. chebula Retz.
Piper longum L. Terminalia
Zingiber officinale Rosc. belerica Roxb.
Embelia ribes Burm. F. Embelica
officnalis Gaertn.
Plumbago
zeylanica L.
Cyperus rotundus
L.
Dhatri Lauha Tabs 5 Anaemia, Iron Embelica officinalis Loha Bhasma*
deficiency Gaertn.
Glycyrrhiza glabra L.

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Mahamanjisthadi Syr 5 Blood purifier Rubia cordifolia L. Shorea robusta
kadha Cyperus rotundus L. Gaertner F.
Holarrhena Asparagus
antidysenterica (G.Don) racemosus Willd.
Wall. ex A.DC.(L.) Gentiana kurroo
Tinospora cordifolia Royle.
(Willd.) Miers. Sphaeranthus
Inula racemose Hook. f. indicus L.
Zingiber officinale Rosc. Justicia adhatoda
Clerpdendrum serratum L.
(L.) Moon Eclipta alba L.
Solanum surattense Cedrus deodar
Burm F. Batsch.
Acorus calamus L. Cissampelos
Azadirachta indica pareira L.
A.Juss. Acacia catechu (L.
Curcuma longa L. f.) Willd
Berberis aristata DC Pavonia odorata.
Terminalia chebula Retz. Willd.
Terminalia belerica Operculina
Roxb. turpethum L.
Embelica officinalis Crataeva nurvala
Roxb. Buch-Ham.
Trichosanthes dioica Psoralea
Roxb. corylifolia L.
Cyperus rotundus L. Cassia fistula L.
Sansevieria Sreblus asper
roxburghiana Schult. & Lour.
Schult.f. Melia azedarach
Embelia ribes Burm. F. L.
Pterocarpus marsupium Pongamia glabra
L. Vent.
Vetiveria
zizanioides (L.)
Nash
Citrullus
colocynthis (L.)
Schrader
Fagonia cretica L.
Hemidesmus
indicus (L.) R. Br.
Oldenlandia
herbacea (L.)
Roxb.
Ashokarishta Syr 7 Anaemia Saraca asoka (Roxb.) Terminalia
Willd. chebula Retz.
Woodfordia fructicosa Terminalia
(L.) Kurtz. belerica Roxb.
Carum carvi L. Embelica
Cyperus rotundus L. officinalis Gaertn.
Zingiber officinale Rosc. Mangnifera indica
Berberis aristata DC. (Gaertner) Retz.
Nelumbo nucifera Cuminum
Gaertn. cyminum L.
Justicia adhatoda
L.

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Septiline Syr 2 As an immune- Commiphora wightii Trikatu*
modulator in the (Arn.) Bhandari Inula racemose
management of upper Maharasnadi kwath* Hook. f
and lower respiratory Rubia cordifolia L. Embelica
tract infections, Tinospora cordifolia officinalis Gaertn.
allergic disorders of (Willd.) Miers. Glycyrrhiza glabra
the upper respiratory L.
tract, bone and joint
infections and urinary
tract infections,
ocular infections, skin
and soft tissue
infections, dental and
periodontal infections

3.Endocrine, nutritional and


metabolic diseases
Madhunashini vati Tabs 2 Maintains blood sugar Tinospora cardifolia Terminalia
level (Willd.) Miers. belerica Roxb.
Salacia chinensis L. Embelica
Azadirachta indica officinalis Gaertn.
A.Juss Aegle marmelos
Swertia chirata (Roxb.) (L.) Correa
Holarrhena Curcuma zedoaria
antidysenterica (G.Don) Rosc.
Wall. ex A.DC.(L.) Ficus benghalensis
Gymnema sylvestre L.
(Retz.) Schult. Tribulus terrestris
Withania somnifera L. L.
Terminala chebula
Retz.
Diabecon Tabs 2 Maintains normal Gymnema sylvestre Aloe barbadensis
blood sugar levels, (Retz.) Schult. Mill.
cholesterol levels Pterocarpus marsupium Triphala*
Roxb. Vidangadi
Glycyrrhiza glabra L. lauham*
Casearia esculenta Momordica
Roxb. charantia L.
Eugenia jambolana Lam. Piper nigrum L.
Asparagus racemosus Ocimum sanctum
Willd. L.
Boerhaavia diffusa L. Abutilon indicum
Sphaeranthus indicus L. L.
Tinospora cordifolia Curcuma longa L.
(Willd.) Miers. Abhrak bhasma*
Swertia chirata (Roxb.) Coral pishti*
Tribulus terrestris L. Rumex maritmus
Phyllanthus niruri L. L.
Gmelina arborea Roxb. Vang bhasma*
Gossypium herbaceum Akik pishti*
L. Shingraf yashad
Berberis aristata DC. bhasma*
Trikatu*

15
Shilajeet Rasayana Tabs 1 Diabetes Withania somnifera L. Embelica
Phyllanthus niruri L. officinalis Gaertn.
Terminalia chebula Retz. Purified asphalt
Terminalia belerica
Roxb.
Arogyavardhini Tabs 2 Obesity Purified mercury Terminalia
vati Purified sulphur belerica Roxb.
Iron Embelica
Mica officinalis Gaertn.
Copper Commiphora
Terminalia chebula Retz. mukul (Arn.)
Purified asphalt Bhandari
Ricinus communis
L.
Picrorhiza kurroa
Royle ex Benth.
Azadirachta indica
A.Juss.
Gymnema Tabs 2 Weight loss, Diabetes Gymnea sylvestre (Retz.)
Schult.

4. Mental and behavioural


disorders
Brahmi Pow, 8 Strengthens memory, Sesasum indicum L. Bacopa monnieri
Tabs, Prevents L.
Oil sleeplessness
Makaradhwaj vati Tabs 5 Chronic fatigue, Lack Red sulphide of mercury Syzygium
of strength, stamina, Dryobalanops camphora aromaticum (L.)
energy Colebr. Merr. et Perry.
Piper nigrum L. Myristica fragrans
Houtt.
Ashwagandharishta Syr 7 Loss of memory, Withania somnifera L. Cyperus rotundus
Insomnia, Epilepsy, Chlorophytum L.
Mania borivillanum Santapau & Operculina
R.R.Fern. turpethum L.
Rubia cordifolia L. Hemidesmus
Terminalia chebula Retz. indicus (L.) R. Br.
Curcuma longa L. Ichnocarpus
Berberis aristata DC. frutescens (L.) W.
Glycyrrhiza glabra L. T. Aiton
Acorus calamus L. Santalum album L.
Pueraria tubercosa Pavonia odorata
(Roxb.ex Willd.) DC Willd.
Terminalia arjuna Plumbago
(Roxb.) Wight & Arn. zeylanica L.
Cinnamomum Woodfordia
zeylanicum Nees fruticosa (L.)
Cinnamomum tamala Kurtz
(Buch.-Ham.) Th. G. G. Zingiber officinale
Nees Rosc.
Piper nigrum L.
Piper longum L.
Elettaria
cardamomum (L.)
Maton
Callicarpa
16
macrophylla Vahl.
Mesua ferra L.

Aswaghanda Pow 5 Weakness, Tonic, Withania somnifera L.


churna Insomnia
Mansyadi kashaya Syr Sleep, Anxiety Nardostachys jatamansi Hyoscyamus niger
(D.Don) DC. Withania L.
somnifera L .
Mentat Syr 2 Memory and learning Bacopa monnieri L. Celastrus
disorders, Centella asiatica (L.) paniculatus Willd.
Behavioural Urb. Oroxylum indicum
disorders, Attention Withania somnifera L. (L.) Kurz Mucuna
deficit hyperactivity Evolvulus alsinoides L. pruriens (L.)DC.
disorder (ADHD), Nardostachys jatamansi Elettaria
Anxiety and stress- (D.Don) DC. cardamomum (L.)
related disorders, Valeriana wallichii DC. Maton
Mental fatigue, Senile Embelia ribes Burm. F. Terminalia arjuna
dementia, As an Acorus calamus L. (Roxb.) Wight &
adjuvant in Prunus amygdalus Arn.
Alzheimer's and Batsch. Foeniculum
Parkinson's disease, Terminalia chebula Retz. vulgare Mill.
Supportive therapy in Embelica officinalis Ipomoea digitate
mild to moderate Gaertn.. L.
mental retardation, As Tinospora cordifolia Orchis mascula L.
an adjuvant in (Willd.) Miers. Zingiber officinale
epilepsy and post- Rosc.
stroke aphasia Terminalia
belirica Roxb.
Myristica fragrans
Houtt.
Syzygium
aromaticum (L.)
Merr. et Perry.
Shilajeet Rasayana Tabs 1 Fatigue Withania somnifera L. Embelica
Phyllanthus niruri L. officinalis Gaertn.
Terminalia chebula Retz. Purified asphalt
Terminalia belerica
Roxb.
Makaradhwaj vati Tabs 4 Lack of stamina and Red sulphide of mercury Syzygium
strength, Chronic Dryobalanops camphora aromaticum (L.)
fatigue, Colebr. Merr. et Perry
Piper nigrum L. Myristica fragrans
Houtt.

17
Geriforte 4 Health tonic, Stress- Chyavanaprash Caesalpinia
related anxiety, concentrate* digyna Rottler.
Chronic fatigue Capparis spinose L. Mucuna pruriens
syndrome (CFS), Cichorium intybus L. (L.) DC.
Occupational stress Berberis aristata DC Piper longum L.
and Age-related Justicia adhatoda L. Eclipta alba L.
debility Solanum nigrum L. Argyreia speciosa
Terminalia arjuna L.f
(Roxb.) Wight & Arn. Abhrak bhasma*
Achillea millefolium L. Yashada bhasma*
Cassia occidentalis L. Crocus sativus L.
Tamarix gallica L. Mandura bhasma*
Withania somnifera L. Syzygium
Asparagus racemosus aromaticum (L.)
Willd. Merr. et Perry
Glycyrrhiza glabra L. Elettaria
Centella asiatica (L.) cardamomum (L.)
Urb. Maton
Purified asphalt Trachyspermum
Terminalia chebula Retz. ammi L.
Makardhwaj* Curcuma longa L.
Celastrus
paniculatus Willd.
Loha bhasma*
Asparagus
adscendens Roxb.
Gokshura Tabs 1 Improves sexual Tribulus terrestris L.
desire and
performance.
Strengthens the penile
tissue and enhances
penile erection useful
in erectile
dysfunction.
Gotu kola Tabs 2 Promotes intelligence, Centella asiatica (L.)
Relieves nervous Urb.
irritation or agitation,
memory, psychosis,
epilepsy and anxiety.
Bacopa Tabs 2 Mental clarity, Bacopa monnieri L.
Consciousness,
Attention span

5. Diseases of the nervous system


Ekangvir ras Tabs 5 Neurological Ras sindur* Loha bhasma*
weakness Kanht loh bhasma* Sulphur
Vang bhasma* Zingiber officinale
Nag bhasma* Rosc.
Tamra bhasma* Piper longum L.
6. Diseases of the eye and
adnexa
Triphala churna Pow 6 Conjunctivitis Terminalia chebula Retz. Embelica
Terminalia belerica officinalis Gaertn.
Roxb.
Amla churna Pow 6 Eye disorders Embelica officinalis
Gaertn.

18
7. Diseases of the
circulatory system
Mukta vati Tabs 1 Hypertension Bacopa monnieri L. Tinospora
Acorus calamus L. cordifolia (Willd.)
Onosma bracteatum Miers.
Wall. Praval pishti*
Celastrus paniculatus Mukta pishti*
Willd. Withania
somnifera L.
Sarpagandha Tabs 5 Maintains blood Rauwolfia serpentina Cannabis sativa L.
pressure Benth. Piper longum L.
Hyoscyamus niger L.
Arjunarishta Syr 5 Heart diseases, Heart Terminalia arjuna Woodfordia
tonic (Roxb.) Wight & Arn. fruticosa (L.)
Vitis vinifera L. Kurtz.
Jaggery
Madhuca indica
J.F.Gmel.
Abana Tabs 3 Dyslipidaemia (high Terminalia arjuna Nagapashana
cholesterol and (Roxb.) Wight & Arn. bhasma*
triglycerides), Mild to Withania somnifera L. Shankha bhasma*
moderate Nepeta hindostana Cyperus rotundus
hypertension, (Roth.) Hain L.
Cardiovascular and Tinospora cordifolia Acorus calamus L.
cerebrovascular (Willd.) Miers. Embelia ribes
conditions, As an Embelica officinalis Burm. F.
adjuvant in the Gaertn. Syzygium
treatment of angina, Terminalia chebula Retz. aromaticum (L.)
and in patients with Eclipta alba L. Merr. et Perry
cardiac risk factors Glycyrrhiza glabra L. Celastrus
Asparagus racemosus paniculatus Willd.
Willd. Santalum album L.
Boerhaavia diffusa L. Elettaria
Commiphora wightii cardamomum (L.)
(Arn.) Bhandari Maton.
Purified asphalt Foeniculum
Centella asiatica (L.) vulgare Mill.
Urb. Convolvulus Rosa damascena
pluricaulis Wall. ex Mill.
Choisy Cinnamomum
Ocimum sanctum L. cassia (L.) Presl
Nardostachys jatamansi Abhraka bhasma*
(D.Don) DC. Mukta pishti*
Piper longum L. Agate pishti*
Trachyspermum ammi L. Yeshab pishti
Zingiber officinale Rosc. Yakut pishti*
Akik pishti* Pravala pishti*
Praval bhasma*
Crocus sativus L.
8. Diseases of the respiratory system
Arjunarishta Syr 5 Respiratory diseases Terminalia arjuna Woodfordia
(Roxb.) Wight & Arn. fruticosa (L.)
Vitis vinifera L. Kurtz.
Madhuca indica Jaggery
J.F.Gmel.

19
Sitopaladi churna Pow 6 Bronchitis, Cough Sugar candy Elettaria
Bambusa arundinacea cardamomum (L.)
(Retz.) Willd Maton
Piper longum L. Cinnamomum
zeylanicum Nees.
Koflet Syr 3 Allergic cough. Commiphora wightii Onosma
Bronchitis, Cough (Arn.) Bhandari bracteatum Wall.
with expectoration, Vitis vinifera L. Viola odorata L.
Dry irritating cough. Ocimum sanctum L. Triphala*
Hyssopus officinalis L. Trikatu*
Tinospora cordifolia Embelia ribes
(Willd.) Miers. Burm. F.
Justicia adhatoda L. Solanum
Myristica fragrans surattense Burm F.
Houtt. Cinnamomum
Glycyrrhiza glabra L. cassia (L.) Presl.
Ammonium
Chloride.
Liquorice Tabs 2 Asthma, Acute and Glycyrrhiza glabra L.
chronic bronchitis,
Chronic cough
9. Diseases of the digestive system
Triphala churna Pow 6 Constipation, Terminalia chebula Embelica
Regulates digestion Retz.. officinalis Gaertn.
Terminalia belerica
Roxb..
Sanjeevani vati Tabs 6 Indigestion Embelia ribes Burm F. Acorus calalmus
Zingiber officinale Rosc. L.
Piper longum L. Tinospora
Terminalia chebula Retz. cordifolia (Willd.)
Terminalia belirica Miers.
Roxb Semecarpus
Embelica officinalis anacardium L. fil.
Gaertn. Aconitum
Processed with cows chasmanthum
urine Stapf ex Holmes.

Abhayarishta Syr 8 Piles, Chronic Terminalia chebula Retz. Woofordia


constipation Vtis vinifera L. fructosa (L) Kurtz.
Madhuca indica Citrullus
J.F.Gmel. colocynthis (L.)
Embelia ribes Burm. F. Schrader
Jaggery Piper retrofractum
Tribulus terrestris L. Vahl.
Operculina turpethum L. Foeniculum
Coriandrum sativum L. vulgare Mill.
Zingiber officinale
Rosc.
Baliospermum
montanum (Willd.)
Mull.Arg.
Bombax Ceiba L.
Liv.52 Tabs 4 Liver disorders, Fatty Capparis spinose L. Cassia
liver, Pre-cirrhotic Cichorium intybus L. occidentalis L.
conditions and early Mandur bhasma* Achillea
cirrhosis, Alcoholic Terminalia arjuna millefolium L.
liver disease (Roxb.) Wight & Arn. Tamarix gallica L.

20
Solanum nigrum
L.

Kumariasav Syr 5 Liver tonic Aloe barbedensis Mill. Terminalia


Jaggery belerica Roxb.
Honey Embelica
Loha bhasma* officinalis Gaertn.
Zingiber officinale Rosc. Acorus calamus L.
Piper nigrum L. Cedrus deodara
Piper longum L. Batsch.
Syzygium aromaticum Berberis aristata
(L.) Merr. et Perry DC.
Cinnamomum Curcuma longa L.
zeylanicum Nees. Helicteres isora L.
Amomum subulatum Glycyrrhiza glabra
Roxb. L.
Mesua ferra L. Baliospermum
Cinnamomum tamala montanum (Willd.)
(Buch.-Ham.) Th. G. G. Mull.Arg.
Nees Inula racemose
Plumbago zeylanica L. Hook. f.
Piper longum L. Sida cordifolia L.
Embelia ribes Burm. F. Linum
Scindapsus officinalis usitatissimum L.
(Roxb.) Schott Mucuna pruriens
Piper chaba Bl. (L.) DC.
Juniperus communis L. Tribulus terrestris
Coriandrum sativum L. L.
Areca catechu L. Foeniculum
Cyperus rotundus L. vulgare Mill.
Terminalia chebula Retz. Gardenia
gummifera L.f.
Anacyclus
pyrethrum (L.)
Lag.
Blepharis adulis L.
Boerhaavia diffusa
L.
Symplocos
racemosa Roxb.
Swarm makshik*
Woodfordia
fruticosa (L.)
Kurtz.
Pilex Tabs 2 Internal and external Commiphora wightii Terminalia
haemorrhoids (Arn.) Bhandari chebula Retz.
Purified asphalt Terminalia
Azadirachta indica belerica Roxb.
A.Juss. Cassia fistula L.
Berberis aristata DC. Bauhinia variegate
Embelica officinalis L.
Gaertn Mesua ferrea L.
Amla churna Pow 6 Chronic Constipation Embelica officinalis
Gaertn.

21
Avipattikar Pow 8 Constipation, Zingiber officinale Rosc. Embelia ribes
churna indigestion, Piper nigrum L. Burm. F.
Piper longum L. Elettaria
Terminalia chebula Retz. cardamomum (L.)
Terminalia belerica Maton
Roxb. Cinnamomum
Cyperus rotundus L. tamala (Buch.-
Embelica officinalis Ham.) Th. G. G.
Gaertn. Nees
Syzygium
aromaticum
Operculina
turpethum L.
Candy sugar
Herbolax Tabs 1 Chronic constipation Operculina turpethum L. Solanum nigrum
Terminalia chebula Retz. L.
Cichorium intybus L. Glycyrrhiza glabra
Cassia occidentalis L. L.
Zingiber officinale
Rosc.
Embelia ribes
Burm. F.
Gasex Tabs 2 Dyspepsia/Indigestion Aconitum palmatum D. Embelia ribes
Flatulence, Don Burm. F.
Abdominal Cowrie bhasma* Triphala*
distension, Belching Shankha bhasma* Zingiber officinale
Piper nigrum L. Rosc.
Slim-N-Trim Tabs 1 Indigestion, Piper nigrum L. Piper longum L.
Trikatu flatulence, Weak Zingiber officinale Rosc.
digestion
Liquorice Tabs 2 Gastric, duodenal Glycyrrhiza glabra L.
Oesophageal
ulceration or
Inflammation,
Heartburn, Mouth
ulcers.
10. Diseases of the skin and
subcutaneous tissue
Haridrakhand Tabs 5 Scabies, Eczema, Curcuma longa L. Abhrak bhasma*
brihat Skin diseases Terminalia chebula Retz. Sacharum
Embelica officinalis officinarum
Gaertn. Berberis aristata
Piper longum L. DC
Operculina turpethum L. Cyperus scariosus
Cinnamomum tamala R.Br.
(Buch.-Ham.) Th. G. G. Trachyspermum
Nees ammi L.
Cinnamomum Plumbago
zeylanicum Nees zeylanica L.
Embelia ribes Burm. F. Cyperus rotundus
Terminalia belerica L.
Roxb. Cuminum
Piper retrofractum Vahl. cyminum L.
Coriandrum sativum L. Zingiber officinale
Loha bhasma* Rosc.
Elettaria
cardamomum L.
Tinospora
22
cordifolia (Willd.)
Miers.
Inula racemose
Hook. f.

Khadirarista Syr 5 Skin diseases, Cedrus deodar Batsch. Terminalia


Scabies, Boils Acacia catechu (L. f.) chebula Retz.
Willd Woodfordia
Berberis aristata DC. fruticosa (L.)
Embelica offinalis Kurtz.
Gaertn. Terminalia
Psoralea corylifolia L. belerica Roxb.
Honey
Bakuchi churan Pow 5 Skin diseases Psoralea corylifolia L.
Sarivadyasava Syr 5 Skin ailments Hemidesmus indicus (L.) Trachyspermum
R. Br. ammi L.
Cyperus rotundus L. Picrorrhiza kurroa
Symplocos racemosa Royle ex Benth.
Roxb. Cinnamomum
Ficus bengalensis L. tamala (Buch.-
Ficus religiosa L. Ham.) Th. G. G.
Hedychium spicatum Nees
Sm. Amomum
Prunus cerasoides subulatum Roxb.
D.Don. Elettaria
Coleus vettiveroides cardamomum (L.)
Jacob. Maton
Cissampelos pariera L. Saussurea lappa
Embelica officinalis (Decne.)
Gaertn. C.B.Clarke
Tinospora cordifolia Cassia
(Willd.) Miers. angustifolia
Vetiveria zizanioides (L.) Symon.
Nash. Terminalia
Santalum album L. chebula Retz.
Pterocarpus marsupium Woodfordia
Roxb. fruticosa (L.)
Kurtz.
Raisins
Kanchnar guggulu Tabs 6 Skin diseases Bauhinia variegate L. Crateava religiosa
Terminalia chebula Retz. Forst. f.
Terminalia belerica Elletaria
Roxb. cardamomum (L.)
Emeblica offficinalis Maton
Gaertn. Cinnamomum
Zingiber officinale Rosc. zeylanicum Nees
Piper nigrum L. Cinnamomum
Piper longum L. tamala (Buch.-
Ham.) Th. G. G.

23
Nees
Commiphora
mukul (Hook.)
Engl.
11. Diseases of the musculoskeletal system
and connective tissue
Maharasnadi Syr 2 Arthritis, Muscle pain Acorus calamus L. Cyperus rotundus
kwath Alhagi pseudalhagi L.
Sida cordifolia L. Boerhaavia diffusa
Ricinus communis L. L.
Cedrus deodara Batsch. Tinospora
Acorus calamus L. cordifolia (Willd.)
Justicia adhatoda L. Miers.
Zingiber officinale Rosc. Argyreia speciosa
Terminalia chebula Retz. L.f
Piper chaba Bl. Foeniculum
Coriandrum sativum L. vulgure Mill.
Solanum indicum L. Tribulus terrestris
Solanum surattense L.
Burm F. Withania
somnifera L.
Cassia fistula L.
Asparagus
racemosus Willd.
Piper longum L.
Barieria priontis
L.

Mansyadi kashaya Syr 2 Strain Nardostachys jatamansi Hyoscyamus niger


(D.Don) DC. L.
Withania
somnifera L.
Kaishor guggulu Tabs 5 Joint diseases Tinospora cordifolia Embelia ribes
(Willd.) Miers. Burm. F.
Commiphora mukul Baliospermum
(Hook.) Engl. montanum (Willd.)
Triphala* Mll.Arg.
Trikatu* Operculina
turpethum L.
Rumalaya Tabs 2 Rheumatic arthritis, Mahayograj guggul* Swarnamakshik
Rheumatoid Arthritis, Shankh bhasma* bhasma*
Osteoarthritis, Gout, Purified asphalt Rubia cordifolia L.
Cervical and lumbar Abelmoschus moschatus Moringa
spondylosis Medik. pterygosperma
Gaertn.
Tribulus terrestris
L.
12. Diseases of the genitourinary system

24
Punarnasava Syr 5 Urinary tract Piper longum L., Ricinus communis
infections Piper nigrum L. L.
Terminalia chebula Solanum
Retz. virginianum L.
Terminalia beleirica Tribulus terrestris
Roxb. L.
Scindapsus officinalis Picrorhiza kurrooa
(Roxb.) Schott. Royle ex Benth.
Justicia adhatoda L. Embelica
Sida cordifolia L. officinalis Gaertn.
Milletia pinnata L. Raphanus sativus
Grewia hirsute Vahl. L.
Tinospora
cordifolia (Willd.)
Miers.
Vitis vinifera L.
Saccharum
officinarum L.

Kam dudha ras Tabs 5 Urinary trouble, Tinospora cordifolia Swarnamakshik


Burning sensation (Willd.) Miers. Abhrak gairik*
bhasma*
Chandanasav Syr 6 Urinary tonic Andographis paniculata Bauhinia variegate
Nees. L.
Callicarpa macrophylla Bombaz Ceiba L.
Vahl. Mangnifera indica
Cissampelos pareira L. (Gaertner) Retz.
Cyperus rotundus L. Pluchea lanceolata
Ficus bengalenisis L. (DC.) C.B.Clarke
Fumaria prviflora Lam. Rubia codifolia L.
Gmelina arborea Roxb. Symplocos
Hedychium spicatum racemosa Roxb.
Sm. Trichosanthes
Madhuca indica dioica Roxb.
J.F.Gmel. Vetiveria
Nelumbo nucifera zizanioides (L.)
Gaertn. Nash.
Piper longum L. Vitis vinifera L.
Prunus cerasoides Glucose
D.Don Jaggery
Ashokarishta Syr 5 Regularisation of Saraca asoka (Roxb.) Terminalalia
menstrual cycle, Willd. chebula Retz.
urethral inflammation Woodfordia fructicosa Terminalia belerica
(L.) Kurtz. Roxb.
Carum carvi L. Embelica
Cyperus rotundus L. officinalis Gaertn.
Zingiber officinale Mangnifera indica
Rosc. (Gaertner) Retz.
Berberis aristata DC. Cuminum cyminum
Nelumbo nucifera L.
Gaertn. Justicia adhatoda
L.
Vangeshwar Ras Tabs 5 Obstinateurinary Vang bhasma* Mesua ferrea L.
disorder Kantloha bhasma* Aloe barbadensis
Abhrak bhasma* Mill.
Gokshuradi Tabs 5 Urinary disorders Tribulus terrestris L. Terminalia chebula
guguulu Commiphora mukul Retz.
(Hook.) Engl. Terminalia belerica
25
Zingiber officinale Roxb.
Rosc. Embelica
Piper nigrum L. officinalis Gaertn.
Piper longum L. Cyperus rotundus
L.
Ricinus communis
L.
13. Pregnancy, childbirth and the puerperium
Dashmularist Syr 5 Provide vitality Desmodium gangeticum Piper longum L..
during childbirth, L. DC. Areca catechu L.
improve lactation Uraria picta (Jacq.) DC. Curcuma zadoaria
Solanum surattense Curcuma longa L.
Burm F. Anethum sowa
Solanum indcum L. Kurz.
Tribulus terrestris L. Prurius cerasoides
Aegle marmelos (L.) D.Don.
Correa. Mesua ferra L.
Clerodendrum plomidis Cyperus rotundus
L. L.
Oroxylum indicum (L.) Holarrrhena
Kurz. antidysenterica
Stereospermum (G.Don) Wall. ex
suaveolens (Roxb.) DC. A.DC.(L.)
Gmelina arborea Roxb. Pistacia chinesis L.
Plumbago zeylanica L. Peuraria tuberosa
Inula racemose Hook. f. (Roxb.ex Willd.)
Symplocos racemosa Asparagus
Roxb. racemosus Willd.
Tinospora cordifolia Withania somnifera
(Willd.) Miers. L.
Embelica officinalis Dioscorea
Gaertn. bulbifera L.
Alhagi pseudalhagi Itis. Vitis vinifera L.
Acacia catechu (L. f.) Honey
Willd Jaggery
Embelia ribes Burm. F. Woodfordia
Glycyrrrhiza glabra L. fruticosa (L.)
Clerpdendrum serratum Kurtz.
(L.) Moon. Piper cubeba L.fil.
Feronia elephantum Valeriana wallichi
Correa. DC.
Terminalia belerica Pavonia odorata
Roxb. Willd.
Boerhaavia diffusa L. Myristica fragrans
Piper longum L. Houtt.
Piper chaba Bl. Syzygium
Callicarpa macrophylla aromaticum (L.)
Vahl. Merr. et Perry
Hemidesmus indicus Cinnamomum
(L.) R.Br. zeylanicum Nees.
Carum carvi L. Elettaria
Operculina turpethum cardamomum (L.)
L. Maton
Vitex negundo L. Acorus calamus L.
Cinnamomum
tamala (Buch.-
Ham.) Th. G. G.
Nees
26
14. Symptoms, signs and abnormal clinical and laboratory findings,
not elsewhere classified
Vangeshwar Ras Tabs 5 Polyuria Vang bhasma* Mesua ferrea L.
Kantloha bhasma* Aloe barbadensis
Abhrak bhasma* Mill.
Hinghwastak bati Tabs 5 Flatulence Zingiber officinale Rosc. Cuminum
Piper nigrum L. cyminum L.
Piper longum L. Ferula assa-
Trachyspermum ammi L. foetida L.
Carum carvi L.
Syr: Syrup; Tabs: Tablets; Pow: Powder
*Please refer to supplementary materials for more information on these ingredients. English, Ayurvedic/Sanskrit
and Hindi names of each Ayurvedic medicinal plant are included in supplementary materials.

3.5 Promotion of Ayurvedic services

Only a few (n=3) outlets displayed their products intended to be seen by potential customers. No
outlets displayed their products that could be reached by customers. It was found that the
governmental (n=3) and two parastatal outlets do not have any product displayed openly within the
sight of patients. In addition, the dispensing of medications is carried out in such a way where the
patients and dispensers are not in direct contact and all Ayurvedic products were stored in the
pharmacy.

Of all the Ayurvedic establishments visited, it was found that only one displayed a notice of medical
conditions for which products are available for the sight of the public. There are some outlets that
promote their products and business by using leaflets distributed to customers (n=5) and via its
website (n=2).

Besides, one of the outlets recruited representatives to promote their products to other retail outlets
and to health care professionals. Posters affixed outside and/or inside outlets (n=4) promoting their
products; the most common being against diabetes and weight loss products.

3.6 Type of patients

The participants (n=16) claimed they receive different types of patients from children to elderly; the
most common being middle-aged individuals. Foreigners were also reported to access services
delivered by these outlets (n=14) for both consultation and purchase of Ayurvedic medicines. The
most mentioned foreigners by the informants were from European countries (n=10) and Reunion
Island (n=4).

27
3.7 Procurement of Ayurvedic medicines

This study showed that Ayurvedic products are either manufactured locally (n=1) or imported from
India as finished products thus readily available for sale (n=10) or are purchased from local suppliers
(n=6) as depicted in Figure 2.

The MOH & QL import Ayurvedic medicines directly from India and distribute to the respective
governmental Ayurvedic centres around the island. There are local suppliers as well acting as
primary importers of Ayurvedic medicines who in turn distribute individually to pharmacies and
shops.

One manufacturer claimed that 40% of his raw materials were imported from India and 60%
obtained locally. One of the outlet director claimed that he received his products in bulk which are
then packaged in Mauritius.

12
10
Number of Ayurvedic outlets

10

6 5

2 1

0
Manufactured Purchased from local supplier Imported from India
locally/Purchased from local
supplier
Procurement of Ayurvedic medicines

Figure 2: Procurement of Ayurvedic medicines


3.8 Other retail outlets

Other outlets not specialised in Ayurvedic medicines include supermarkets, retail community
pharmacies and central markets. However, Ayurvedic medicines form only a minor part of their
business.

3.9 Importation regulations for Ayurvedic Medicines in Mauritius

This study found that all Ayurvedic outlets have clearance from the Pharmacy Board, MOH & QL,
together with their business registration number (BRN) and trade registration fee certificate issued
28
by the Municipal or District Council to undertake the sale of Ayurvedic medicines in Mauritius. The
10 importers of Ayurvedic medicines were found to hold an importation clearance issued by the
Ayurvedic committee working under the aegis of the MOH & QL.

The government has an Ayurvedic committee, under the aegis of the Pharmacy board in the MOH &
QL to monitor the importation and trade of Ayurvedic medicines. The committee is chaired by a
registered Ayurvedic practioner and other members of this committee include two other Ayurvedic
medical officers from Ayurvedic department of the public sector, 2 pharmacists, 1 government
analyst and 1 academic who are mandated to undertake decisions on matter pertaining to the use and
importation of Ayurvedic medicines. The committee currently controls the importation of Ayurvedic
medicines by granting an importation permit/clearance testimonial with respect to any Ayurvedic
product to enter the Mauritian authority to any applicant. There are specific requisites developed by
the committee that have to be addressed during an application. These include a list of all Ayurvedic
medicines presenting their individual ingredients (e.g. name of plants), Good Manufacturing
Practices (GMP) certification of the products to be imported, leaflet/information sheet of product
and sample of product, certificate of microbiological and heavy metal analysis and the endorsement
of a registered Mauritian Ayurvedic practitioner for customs clearance. The members of the
committee will grant a clearance only after analysing each product detail and reviewing other
relevant documents.

4. Discussion

There is an emerging interest in Ayurvedic medicines in Mauritius whereby a significant number of


patients are seen to adopt Ayurvedic treatment. Ayurvedic medicine was officially introduced to
Mauritius in 1989, as quoted by a director of Ayurvedic clinic, so as to provide an effective, safe
and affordable healthcare system to the less fortunate of the society who are not able to afford proper
medical care. The practice and use of Ayurvedic medicines were at that time not as popular as it is
now among the public. However, over the years, Ayurveda has gained increasing attention by the
public. Nonetheless, no documentation or investigation pertaining to the use of Ayurvedic medicines
in Mauritius has ever been conducted. As such, this is the first study to explore the characteristics of
Ayurvedic outlets in Mauritius, the type of Ayurvedic products available in Mauritius, and the
regulation and importation of Ayurvedic medicines in Mauritius.

29
4.1 Ayurvedic services offered by Ayurvedic outlets

It was found that that there are different outlets selling/dispensing Ayurvedic medicines in Mauritius,
notably, pharmacies, centres, clinics and shops. The approach in undertaking the sale/dispensing of
Ayurvedic medicines may differ.

There are a total of 5 centres set up by the MOH & QL offering free Ayurvedic treatment to
Mauritians. They are located at Victoria Hospital, Sir Seewoosagur Ramgoolam National Hospital
(SSRNH), Flacq Hospital, LEscalier mediclinic and Belvedere mediclinic and operate as an
affiliated but separate Ayurvedic department in a health care centre. The Ayurvedic department is
either attached to the hospital in the same building, for instance at Victoria Hospital, or is located in
the vicinity of the hospital, as in the case of SSRNH Ayurvedic department.

The study also showed that the three governmental outlets visited function similarly as health centres
where an Ayurvedic practitioner is employed by the MOH & QL. The latter consults and prescribes
Ayurvedic medicines to outpatients. Patients are allowed to consult the doctor on an appointment-
basis only. The prescribed medications are then dispensed freely in the pharmacy by a dispenser. On
the other hand, the parastatal Ayurvedic centres visited operate in a similar structure as the
governmental ones, except that the medicines provided to patients are charged.

There are many pharmacies and shops in Mauritius specialised in the sale and dispensing of
Ayurvedic medicines. Most of them offer consultation only when patients wish to be consulted, that
is, no Ayurvedic practitioner is present to prescribe these medicines on a full time basis.
Furthermore, there are no Ayurvedic pharmacists employed in these outlets but only a dispenser to
undertake the sale/dispensing of Ayurvedic medicines. As observed, clients turn up in these retail
outlets and request for medications such as those to control blood sugar level or high blood pressure
or to relieve joint pain. The dispensers recommend them a medication with the appropriate
indications and as deemed proper according to their knowledge. Some dispensers have even claimed
that they refer to the indications mentioned on the box or leaflets of the medications when advising
patients. Moreover, most of the dispensers do not have a proper training in the field of Ayurveda.

It is clear that most outlets do not find it mandatory to employ an Ayurvedic pharmacist to supervise
the dispensing of Ayurvedic medicines or even to employ a full-time practitioner. They prefer to sell
the products even in the absence of both a practitioner and pharmacist. Considering the same criteria
for setting up a conventional pharmacy as per the Pharmacy Act 1983, Ayurvedic outlets cannot be

30
recognised as pharmacy unless a pharmacist is employed. In fact, there is no such law that
acknowledges the existence of an Ayurvedic pharmacy in Mauritius. Yet, there were some
dispensers who verbally mentioned to be working in an Ayurvedic pharmacy. Above all, one of the
Ayurvedic shop was registered under retail pharmacy despite being an Ayurvedic shop.

The scarcity of Ayurvedic pharmacists further shows that Ayurveda has not yet been fully integrated
in the healthcare system, whether private, public or parastatal. The proper way to offer an Ayurvedic
therapeutic service would be to consult a diseased patient and prescribe medicines that are to be
dispensed under the supervision of an Ayurvedic pharmacist so as not to endanger the health of the
public.

However, with respect to government owned public outlets, the MOH & QL has already started
taking measures to develop the practice of Ayurveda. The government is presently offering
Ayurvedic teaching programs to allopathic dispensers already employed in the public sector. Trained
staff can in this way practice as qualified Ayurvedic dispensers in the public Ayurvedic pharmacies.
But yet on the private sector, the regulations are still not stringent enough.

It was found that many Ayurvedic medicinal products are also available in community pharmacies
alongside allopathic medicines. Pharmacists not specialised in Ayurvedic medicines and having no
knowledge on Ayurveda sell Ayurvedic medicines. Ayurvedic drug therapy requires a completely
different approach compared to conventional treatment. Ayurvedic medicine aims to eradicate the
root of a disease in a holistic and individualistic manner while allopathic medicines rather treat a
disease in a symptomatic and mass basis (Selvadurai et al, 2013). Therefore, a pharmacist trained in
allopathic field is not allowed to dispense any Ayurvedic medicine or advise on how to specifically
take Ayurvedic medications unless the customer has consulted an Ayurvedic practitioner and has
been provided with an official prescription.

It is worth noting that no national pharmacopeia or formulary has ever been created since the advent
of Ayurvedic medicines in Mauritius. However, a memorandum of understanding was signed
between India and Mauritius on Ayurvedic and Traditional medicine where one of the objectives
was mutual recognition of pharmacopoeias and formularies. This initiative is yet to be implemented
in the country (Mauriceinfo, 2015).

It is quite ambiguous that no side effects have ever been reported to most Ayurvedic outlets by any
Ayurvedic medicine user. A large number of people including practitioners believed that Ayurvedic

31
products are without side effects and are completely safe for use. When asked, many dispensers
stated that Ayurvedic medicines, being herbal and natural medicines, do not have side effects. The
concept of Ayurveda is wrongly interpreted since Ayurveda is not only about herbal products but
also involves the use of minerals and metals (NCCAM, 2009). Thus, users have to be encouraged to
report any side effect to the practitioners.

4.2 Ayurvedic medicinal products

The Ayurvedic outlets visited provide both classical and patented medicines to their clients. The
governmental and parastatal establishments are inclined towards classical Ayurvedic products while
private clinics, pharmacies and shops indulge themselves both in classical and proprietary Ayurvedic
medicines. Many outlets provide the same products but are procured from different companies from
India.

A panoply of Ayurvedic medicines has been encountered during this study in the form of many
dosage forms. The medicines are offered in the form of tablets (vati), powders (churna, bhasma,
mandooora. parpati), syrups (arista/asava), decoction (kwath), oral and topical oils (taila).

The majority of Ayurvedic medicines are used for one or more health issue(s). It has been observed
that Mauritians use Ayurvedic treatment to treat and manage chronic diseases. For instance, diabetes,
high blood pressure, hyperlipidaemia, joint pain associated with arthritis and heart diseases. Skin
diseases, weight loss, sexual dysfunction and liver disorders are other examples of disorders where
Ayurvedic treatment is being adopted. It can be argued that the Mauritian population is integrating
itself into Ayurvedic medicines to treat significant health complications. There is thus a strong belief
among a percentage of Mauritians that Ayurvedic medicines do impart an effective therapeutic
action.

Ayurvedic medicines imported to Mauritius contain heavy metals and minerals like mercury,
asphalt, sulphur, processed zinc, copper, lead, jade and iron as active ingredients. Asphalt known as
Shilajeet was observed to be included in Ayurvedic formulations (e.g. Shilajeet Rasayana,
Geriforte) used for diabetes, stress-related disorders amongst others. It is a blackish-brown exuded
from high mountain rocks. Animal studies have in fact shown the antihyperglycemic effect of the
mineral whereby it has lowered the blood glucose level by inhibiting B-cells destruction caused by
streptozotocin. It has additionally imparted significant anti-anxiety activity comparable to that of
diazepam (Bhattacharya, 1995; Chopra et al, 2010).

32
The presence of heavy metals can be a cause of poisoning and intoxication in case of improper
handling at the level of manufacturing processes. Evidences are those studies conducted in United
Kingdom and United States of America where Ayurvedic medicines from India were shown to
contain heavy metals above permissible limits being causes of poisoning (Dargan et al, 2008; Saper
et al, 2004; NCCAM, 2009). It is therefore imperative to control the use or even the entry of metals
containing Ayurvedic medicines in the country especially being country where most cases of adverse
effects are not reported by medicine users. In Mauritius no regulatory framework has yet been
developed relating to the use of heavy metals as therapeutic agents.

4.3 Registration of Ayurvedic practitioner in Mauritius

In Mauritius, the practice of Ayurvedic medicine is governed by the Ayurvedic and Other
Traditional Medicines Act of 1989 (42). According to this act, no person can practice Ayurvedic
medicine until he/she has registered under this act. Section 12 (1)(a) of the act states: Every person
who wishes to be registered as a practitioner may apply in writing to the Registrar and submit with
the application - his diploma in traditional medicine (Ministry of Health & Quality of Life, 1990).

As claimed by the act, any person must have at least a diploma in Ayurveda to be able to register to
the Traditional Medicine Board. However, when enquired, an Ayurvedic practitioner deems to have
a full-fledged university degree in Ayurveda to be able to register as Ayurvedic practitioner in
Mauritius.

The Traditional Medicine Board is a regulatory body which requires Ayurvedic practitioners to be
registered so as to practice Ayurvedic medicine in Mauritius. The board is composed of government
officials, medical practitioners, persons knowledgeable in traditional medicine, as well as
laypersons. The functions of the board are to exercise and maintain discipline in the practice of
traditional medicine; to advise the Minister on any matter relating to traditional medicine or any
matter from this act and to publish an annual list of practitioners (MOH & QL, 1990).

This list contains the name of all registered practitioners of traditional medicine including Ayurvedic
medicine. Ayurvedic practitioners have to pay a yearly fee so as to include their name on this list to
officially register as Ayurvedic practitioners and thus be legible to practice in Mauritius.

33
4.4 Sale of Ayurvedic medicines in Mauritius

This study has shown that no specific requirements and guidelines are available to establish and set
up an Ayurvedic business/outlet. Potential applicant does not need to be affiliated to an Ayurvedic
practitioner to get a clearance from the authority. Once granted an authorisation from the pharmacy
board and an issued BRN and trade fee receipt, the Ayurvedic business can operate without an
Ayurvedic practitioner or qualified dispenser.

Most importantly, in contrast to conventional pharmacies, the sheer absence of an Ayurvedic


pharmacist in all the Ayurvedic pharmacies visited as discussed earlier implies that a pharmacist is
certainly not a prerequisite to set up an Ayurvedic pharmacy.

Another important point is that the government currently do not have any approved guideline with
respect to dispensing/seling of Ayurvedic medicines in Mauritius. This study shows that Ayurvedic
medicines are sold under strict prescription only in governmental and parastatal Ayurvedic centres
and in one private clinic. On the other hand, the majority private Ayurvedic establishments have
been observed to sell their products over-the-counter without the need of any prescription. No rules
and regulations have been designed to control and monitor the sale of Ayurvedic medicines under
prescription or under the supervision of an Ayurvedic practitioner or pharmacist.

4.5 Local manufacture of Ayurvedic medicines

Only one of the outlets visited produces some of its products. However, Mauritius is not yet
integrated into the manufacture of Ayurvedic medicines. No laws have been legislated relating to
GMP standards to ensure authenticity of raw materials used in the manufacture of products, whether
adequate quality control measures are being adopted and to validate the quality, safety and efficacy
of the products manufactured locally. Therefore, neither manufactured products are GMP certified
nor their quality is assured. On top of that, practitioners do not require any license to manufacture
Ayurvedic medicines.

4.6 Importation of Ayurvedic medicines in public hospitals

The importation of Ayurvedic medicines are carried out by the government of Mauritius, private
Ayurvedic outlets and individuals. The Ministry imports the medicines through an open tender
procurement while private outlets and independent importers have to follow a strict procedure
developed by the MOH & QL before accepting any Ayurvedic medicine in the island. Before

34
importing any Ayurvedic medicine, an importation permit is granted. Besides, a regulated procedure
has to be respected.

First and foremost, a list of all intended Ayurvedic medicines to be imported should be sent to the
MOH & QL. This list contains the name of all medicines and their ingredients, their compositions,
medicinal properties and other important information on the medications. In addition, any product to
be imported to Mauritius has to be GMP certified. For this, GMP certification of the products to be
imported has to be presented to the Ayurvedic committee. This is provided by the manufacturing
companies to ensure their manufactured products are GMP certified.

Another key thing to note is that a registered Ayurvedic practitioner has to be affiliated with any
importer of Ayurvedic medicines unless the importer is himself/herself an Ayurvedic practitioner.
The latter acts as an approver and signs all the documents sent to the committee.

The list of medicines is viewed by the members of the Ayurvedic committee of the government. All
ingredients and compositions are verified by the latter ensuring no banned or dangerous ingredients
are contained in the products. Additionally, literature reviews are required for classical Ayurvedic
medicines and clinical trials reports are necessary for patented Ayurvedic medicines. After the
approval from the Ayurvedic committee, a clearance is sent to the establishment. Conversely, if any
medicine is refused by the committee, reasons and justification of the refusal are given.

Another requirement of a letter to prove how the imported Ayurvedic medicines would be
distributed and displayed has been a recent advent in the importation process. Once the products are
received in Mauritius, the customs cross-check the list of ordered products and the list of received
products. Only when both lists correspond to each other, the products are allowed to be despatched
and delivered to the respective importers. It is to be noted that the same procedure has to be followed
each time a batch of Ayurvedic products is intended to be imported.

5. Conclusion and recommendations

It is of no doubt that Ayurveda has integrated to a great extent in the Mauritian healthcare system. A
large number of patients can be seen waiting at the Ayurvedic department national hospitals for
consulting an Ayurvedic practitioner. In addition, other Ayurvedic outlets do receive a significant
number of customers for recommendation on the use of Ayurvedic medications.

35
Being a legalised medical system, Ayurveda is being widely practised across Mauritius. Many
outlets specialised in Ayurvedic medicines operate in different regions of the island. The MOH &
QL offers free Ayurvedic treatment to the public. Likewise, there are private outlets providing both
Ayurvedic consultation and Ayurvedic medicines. The importation of Ayurvedic medicines is
strictly regulated by the Ayurvedic committee. This body controls the entry of Ayurvedic medicines
in Mauritius. However, beyond the level of importation no other aspects of this medical system are
regulated. As this present study clearly elucidates, the practice of Ayurveda in Mauritius including
the sale, distribution and use of Ayurvedic medicines are not properly regulated. Basically,
according to the current situation, anyone can set up an Ayurvedic business and distribute or sell
Ayurvedic medicines in the island.

Another imperative observation is that no regulation in the practice has led to some form of
malpractice of Ayurvedic medicine. This refers to the private Ayurvedic outlets whereby most
Ayurvedic medicines are sold over the counter without the supervision of an Ayurvedic pharmacist
or consultation with an Ayurvedic practitioner. In fact, no Ayurvedic pharmacist was employed in
any of the outlet visited. The present work shows that only dispensers are employed for the sale of
these medicines. Above all, most dispensers do not have a formal training in Ayurveda. One cannot
depend exclusively on the recommendations of an unqualified sale person or dispenser. The
presence of a pharmacist is fundamental and compulsory in a conventional pharmacy. Similarly, this
requirement cannot be overlooked when it comes to the dispensing of Ayurvedic medicines. A
consultation with an Ayurvedic practitioner is also of utmost importance especially for those patients
willing a long term Ayurvedic treatment.

Presently, the use of Ayurvedic medicines at the governmental centres is well controlled. In contrast,
a lot has to be done from the part of the government so to discipline the sale, distribution and use of
Ayurvedic medicines in private outlets. Taking into considerations the findings of this research, the
way Ayurvedic medicines are being dispensed on the private sector is detrimental to the health and
safety of the public. Now that Ayurveda has been legalised and considered as a healthcare system,
stringent regulatory policies have to be designed in every aspect of this field to avoid malpractice.
Laws governing the setting up of an Ayurvedic outlet and the sale, dispensing and distribution of
Ayurvedic medicines have to be amended. One example is that Ayurvedic medicines shall be
dispensed strictly under prescriptions with the consultation of an Ayurvedic practitioner.
Furthermore, it is important to affiliate with an Ayurvedic practitioner or an Ayurvedic pharmacist
when applying for the establishment of Ayurvedic outlet or Ayurvedic pharmacy respectively.
36
Another possible requisite can be the recruitment of an Ayurvedic pharmacist or practitioner when
operating an Ayurvedic outlet or pharmacy respectively. Besides, strict guidelines on the type of
establishment have to be set up.

It should also be pointed out that every aspect of the practice of Ayurvedic medicines in Mauritius
has not been covered in this study like the use of Ayurvedic medicines among lay people, its safety,
efficacy and compliance. This study has nonetheless provided a general view on the practice of
Ayurvedic medicines in Mauritius and is a possible subject to further investigations in this field of
work emphasizing on the practice and malpractice of Ayurvedic medicines in Mauritius.

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