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Ruminating on Remedies

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Julia Coyte, CHom

My thoughts on a few of the many thousands
of homeopathic remedies available.
​Where, when, how they may be applied in everyday life.

#wellnessawaits

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4/28/2022

Jet Lag

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Our first houseguests in over 2 years have arrived. A lovely thing, I can assure you!

After enduring this enforced time of not traveling, I (happily) forgot how horrible jet lag is, but I am reminded of its nastiness as I watch our over-seas visitors make the adjustment to the new time zone.

Why do we feel so exhausted after getting off a plane? All we do is sit (and eat), watch movies and maybe snooze a little bit for all those hours. We should be refreshed, like we had a day of relaxation! Yet, when finally stepping off that smelly tube with wings, it’s not at all uncommon to feel like you’ve run a marathon and got hit by a truck when you crossed the finish line!

The experts say it’s precisely because we’re sitting for long periods of time in dry air and become dehydrated, etc., etc., etc. Whatever the true pathophysiologic reasons are, jet lag is a miserable feeling.

Mainstream medicine has nothing to offer, really. Melatonin (Cipolla-Neto and Gaspar do Amaral 2018) apparently can help, and you can see how it would work (Herxheimer and Petrie 2002). Though short-term melatonin use is generally regarded as safe, I must admit, I wouldn’t mess with my hormones in this way (because melatonin is indeed a hormone), especially when homeopathy has some simple answers. For more information on possible side effects of melatonin: (Bauer 2017; American Sleep Association 2022; Drugs.com 2021).

So, what did I do for our tired guests?
In anticipation of their arrival, I left two remedies on the dresser in their room:
JetZone: Jet Lag Prevention & Helios’ Jet Candy

JETZONE, remedy information as listed on the packet:
Arnica: Sleepless and restless when overtired
Cocculus: Constant drowsiness after loss of sleep
Kali phos: Weak and tired from overexertion. Headache from fatigue.
Gelsemium: Insomnia from exhaustion
Nux vomica: Heartburn, anxiety and restlessness
Argentum nitricum: Mental anxiety

Jet Candy, by Helios:
JetCandy doesn’t list their reasonings for including the remedies, but I will fill in the blanks.
Arnica
Bellis perennis: Another trauma remedy. Some call it a “deeper” Arnica.
Cocculus
Gelsemium
Petroleum: I wrote about Petroleum’s role in seasickness here. In short, Petroleum is particularly helpful for nausea.

There are other homeopathic combination remedies for jet lag, these are just the two I happened to have lying around. 

No-Jet-Lag, by Miers Labs:
No-Jet-Lag doesn’t list their reasonings for including the remedies, but I will fill in the blanks.
Arnica
Bellis perennis
Chamomilla: Oversensitivity, anger and for when falling asleep is difficult.
Ipecac: Nausea, headache
Lycopodium: Gas and bloating; frequent waking and unrefreshing sleep

Jet Lag Relief, by Boiron 
Arnica: Relieves muscle pain and stiffness
Cocculus: Relieves nausea associated with jet lag
Nux vomica: Relieves drowsiness and digestive problems associated with travel

What do all of these jet lag combination remedies have in common? Arnica montana. Arnica is a well known homeopathic remedy for injury and trauma. Let’s face it — changing time zones is absolutely an assault on your person. It affects your body, your mind and your emotions. If you are unable to get your hands on one of these combo remedies prior to your trip, bring along a tube of Arnica and half your battle will be won.

Jetlagreview.com (who knew such a thing existed?!), claims to be “the #1 source for helping people find effective ways to effectively combat jet lag.” I have no idea who is behind this site, but I was very intrigued to see 1/2 of the products they review are homeopathic (the others are vitamins and/or herbs).

No-Jet-Lag is jetlagreview’s #2 Silver Award Winner, for whatever that’s worth.

If you find yourself headed overseas, pick up one of these combination remedies and slip it in your carry-on. They’re all slightly different, but basically the same and any one of them will certainly be better than nothing. Or, take along just a tube of Arnica and see if one of these can’t put a little spring in your exhausted tourist step!


Julia Coyte, CHom
Classically Practical homeopath


#wellnessawaits


* I have no affiliation with any of these products. I have used Jetzone and No-Jet-Lag, to good effect. Follow the directions listed on the packet.

Reference list
American Sleep Association, 2022. Melatonin Side Effects [online]. American Sleep Association. 

Bauer, B., 2017. Pros and cons of melatonin [online]. Mayo Clinic. 

Cipolla-Neto, J. and Gaspar do Amaral, F., 2018. Melatonin as a Hormone: New Physiological and Clinical Insights[online]. academic.oup.com. 

Cleveland Clinic, n.d. Jet Lag: What is it, Symptoms, How Long Does it Last & Treatment [online]. Cleveland Clinic.

Drugs.com, 2021. Melatonin Side Effects, Uses, Dosage (Kids/Adults) [online]. Drugs.com. 

Herxheimer, A. and Petrie, K. J., 2002. Melatonin for the prevention and treatment of jet lag. Cochrane Database of Systematic Reviews.

Jet Lag Review, 2022. Top Products [online]. jetlagreport.com. 

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4/20/2022

Recovery from Surgery

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Funny how the world works. I have been thinking of writing a post about recovering from surgery and lo and behold, not long ago, I awakened to a text saying my oldest son was in the ER experiencing terrible stomach pain. 

Yes. You guessed it. Within 12 hours, he had his appendix removed*.

Always remember… the procedure may be simple, but recovering from removing a piece of your anatomy is never simple!

He was prescribed and he filled all of the meds the doctors recommended. Has he used them? Nope. (I take that back. He took one single Tylenol the first morning.)

How did we address this post-surgical pain? With 2 little tubes of homeopathic remedies: homeopathic Nux vomica and Helios’** homeopathic combination remedy, "Surg".

Why Nux vomica following an appendectomy and anesthesia? 

Dr. Ratera (2016, p. 310) lists Nux vomica among a selection of only 11 remedies for use following general anesthesia, including narcosis (“a state of stupor, drowsiness or unconsciousness produced by drugs”). 

Schroyens (2012) lists Nux in the following rubrics in his homeopathic repertory:

• Stomach, nausea, operation on abdomen, after; Including cramping pain.
• Vomiting following an operation.
• General ailments following an operation.

In addition to those “official” symptoms, Nux vomica is the remedy to turn to when you have things in your system that shouldn’t be there — (see:  Garbage in, Garbage out and Too Much!). 

Once upon a time, our Great Pyrenees, Rufus, had a minor procedure and he was not waking up following the anesthesia (see definition of Narcosis above). When I set out to his vet appointment, I didn’t know he was going to be put under, so, I didn’t bring any remedies with me. But, I always have Nux vomica 200c in my purse, (see: My Little Bag of Wellness). I slipped 2 pellets in between his gum and his cheek and he literally popped out of Neverland and was able to stand up and walk to the car. Did I mention he’s a big dog? There was no way I was going to be able to carry him to the car. We got home and he curled up on his bed and was back into a very deep sleep. Another dose of Nux placed between his gum and his cheek and he got up and drank some water. I think we did 1 final dose of Nux later that evening and he was back to his normal self.

My son didn’t want to take the Nux immediately. They told him that having the anesthesia in his system would help him to sleep that night and since it had been a long time since he had any sleep, that’s the route he chose.

The other tube of homeopathy he used was a beautiful mixture of homeopathic remedies from Helios pharmacy they call “Surg.” Surg is a combination of Arnica, Bellis perennis, Calendula, Hypericum and Staphysagria.

Homeopathic Arnica is probably the most researched homeopathic remedy. Below is a good handful of summaries and links to the actual papers.

ARNICA & SURGERY RESEARCH:

Anesthesia recovery and Analgesia in dogs -- Arnica & Papaver
“The Arnica group required rescue analgesia later than the others.” (I’m willing to bet the rescue analgesia could be have been avoided all-together if further doses of Arnica were provided.)

Postoperative Sore Throat (This is a case report.)

Knee Surgery
“In all three trials, patients receiving homeopathic arnica showed a trend towards less postoperative swelling compared to patients receiving placebo.”

Post-tonsillectomy analgesia
“The results of this trial suggest that Arnica montana given after tonsillectomy provides a small, but statistically significant, decrease in pain scores compared to placebo.”

​Healing of Wounds following surgery, compared to diclofenac
“After foot operations, Arnica… can be used instead of diclofenac to reduce wound irritation.”

Effectiveness and Safety of Arnica montana in Post-Surgical Setting, Pain and Inflammation. This is a review showing “arnica Montana is more effective than placebo when used for the treatment of several conditions including post-traumatic and postoperative pain, edema, and ecchymosis.”

Varicose vein surgery Varicose vein surgery
“The results of this pilot study showed a trend towards a beneficial effect of Arnica… with regard to reduction of hematoma and pain during the postoperative course.”


Is Homeopathic Arnica Effective for Postoperative Recovery? A Meta-analysis of Placebo-Controlled and Active Comparator Trials
“Homeopathic Arnica has a small effect size over and against placebo in preventing excessive hematoma and other sequelae of surgeries. The effect is comparable to that of anti-inflammatory substances.”

Is there a role for homeopathy in breast cancer surgery?
“A. montana… could reduce post-operative blood and seroma collection in women undergoing unilateral total mastectomy.”

Use of Arnica to relieve pain after carpal-tunnel release surgery
“…there was a significant reduction in pain experienced after 2 weeks in the Arnica-treated group.”

RESEARCH on ARNICA combined with other homeopathic remedies listed in “Surg.”

Healing of Surgical Wounds -- Arnica & Staphysagria
The table provided in this study shows the number of days needed to complete healing of the surgical wound for the control group and the groups assigned either Arnica or Staphysagria.

Homeopathic Mixture Accelerates Wound Closure -- Arnica, Calendula, and Hypericum
“A homeopathic remedy… accelerates in vitro wound scratch closure of NIH 3T3 fibroblasts.”

The effect of the homeopathic remedies Arnica montana and Bellis perennis on mild postpartum bleeding
“Treatment with homeopathic Arnica montana and Bellis perennis may reduce postpartum blood loss, as compared with placebo.

RESEARCH on Arnica and homeopathic remedies not listed in “Surg.”
Perioperative Homeopathic Arnica and Bromelain
"A systematic review of the literature demonstrates the potential for arnica and bromelain to improve perioperative outcomes including edema, ecchymosis, and pain control."

RESEARCH on Hypericum:
Hypericum perforatum to Improve Postoperative Pain Outcome After Monosegmental Spinal Sequestrectomy (HYPOS)
“Although no significant differences between the groups could be shown, we found that patients who took potentiated Hypericum in addition to usual pain management showed lower consumption of analgesics.”

Homeopathic treatment for peripheral nerve regeneration
“Hypericum improves functional recovery of peripheral nerve regeneration in rats.”

Note: Most of the research on Calendula, Hypericum and Bellis perennis  centers on herbal or mother tinctures. 

Historically speaking, in homeopathic terms, these last three remedies have a terrific reputation for post-surgical and wound healing with claims that it can promote healing and reduce risk of infection. Dr. Robin Murphy spoke often in his seminars of the healing qualities of Calendula and names it the number one remedy to use following surgery, noting the homeopathic remedy can be taken internally as well as topically. (Note: to use topically, a pellet of homeopathic Calendula can be added to clean water and used as a compress. Or, “Calendula, mother tincture, 15 drops to a wineglass of boiled water. This will cleanse the abraded surface and prevent sepsis. Calendula 6 given three to four times daily by the mouth will assist the healing process” (Shepherd and Robinson 1995).

Calendula and Hypericum tinctures are often used together following surgery or for wound healing in general. 

Dr. Dorothy Shepherd*** says, “I have never seen a cleaner wound surface or more rapid healing in a torn perineum than those which were treated with Calendula sprays, and it was much more efficacious, and more rapid than the strongest antiseptic, nor was there any rise in temperature after!” (Shephard 1989).

Bellis perennis is the common daisy. When I first learned about this remedy, the story was told about the soldiers in the war marching over fields of daisies. They were tired and they were sore and they were bruised and they didn’t realize the little flowers they were tromping over actually held the key to their ails. “Bellis perennis is long-flowering and surprisingly tough. It is resilient to the damage of mowing and human footfall, bouncing back” (Evans 2020).

The National Center for Homeopathy says it is most often used to speed surgical healing.

In addition to being helpful after surgery, Bellis can be used to assist in the healing from “long-unresolved or repeated trauma from accidents and injuries; physical, emotional or sexual abuse” (Evans 2020). Bellis is “especially useful in soft tissue injuries …. Similar to Arnica, it acts on muscle fibers and blood vessels with intense pain … deep trauma … especially in pelvis and abdomen” (Ratera 2016).


If you or a loved one has a surgery scheduled in the near future, contact Helios for a tube of “Surg” or, grab a tube of each of the remedies included in that combination (Arnica, Bellis perennis Calendula, Hypericum, and Staphysagria) and make your own combo remedy to help speed your recovery along. (Note: A good way to make your own combo remedy is to drop a pellet or two into a bottle of water and take sips as needed. Remember, every sip is a dose, so it's wise to have a water for drinking and a bottle for healing.)


For further research on the potential benefits of homeopathy, see: https://classicallypractical.com/research.html.



Julia Coyte, CHom
Classically Practical homeopath


#wellnessawaits


* Are there homeopathic remedies that can help with an inflamed appendix? Yes, there are, and perhaps I will write about those one day. In the mean time, if you are suffering from appendicitis, or, other severe stomach/abdominal pain, please go to the ER or talk to your physician.

** I have no affiliation with Helios; I just like their products.

*** Dr. Dorothy Shepherd was an orthodox physician who turned to homeopathy, saying, “I must admit that homeopathy has never let me down.” She had a homeopathic clinic in London during the war (Anon. 2009).

Reference list
Anon., 2009. Dorothy Shepherd (1885 - 1952) [online]. www.sueyounghistories.com. 

Anon., 2022. Bellis perennis [online]. National Center for Homeopathy. 

Evans, J., 2020. Asteraceae: remedies of the sunflower family. Harlem, NL: Emryss.

Ratera, Dr. M. M., 2016. First Aid with Homeopathy. Kander, Germany: Narayana Verlag.

Schroyens, F., 2012. Synthesis : repertorium homeopathicum syntheticum. Accessed through Radar Opus software. London: Homeopathic Book Publishers.

Shephard, Dr. D., 1989. The magic of the minimum dose : experiences and cases. Saffron Walden: Health Science Press.
​
Shepherd, D. and Robinson, G. E., 1995. More magic of the minimum dose : experiences and cases. Saffron Walden, Essex: C.W. Daniel Co.

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11/21/2021

Relief

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T-Relief, that is. I was annoyed when the company changed the name of Traumeel to T-Relief. No reason, I guess I just liked the name Traumeel. But today, I think the name T-Relief is far superior. 

I am riddled with osteoarthritis. It seems every time I have an x-ray done, I get confirmation as to why this or that place was stiff, sore or uncomfortable. My hands, wrists, knees, hips, ankles, feet — I’m sure there are more, but I haven’t had those black and white internal pictures yet. For the most part, my osteoarthritis is a non-issue. I credit bone broth and homeopathy (of course!) and exercise. If I don’t move regularly, my knees (right knee in particular) and hips get ornery. So, I make sure to walk frequently and for fairly long distances. Conversely, my hands and wrists can get sore if I use them too much. Go figure. (Actually, as I am thinking about it, perhaps that has to do with broken bones, as I broke a bunch of fingers and my wrist. Hmmm. I’ll have to noodle this further. I’ve never really given it any thought before.) 

I take absolutely no medicines or painkillers of any kind, aside from homeopathy. It is important to note that I have arthritis in many places, but I need to acknowledge that my arthritis is considered mild to moderate. (If you are suffering with severe osteoarthritis, homeopathy can probably still help, but I would recommend a more targeted homeopathic approach in addition to T-Relief.)

Occasionally, I wake up with sore hands. Today was one of those days. I grabbed T-Relief and put a small amount of the cream on my hands. Within less than 2 minutes, I had relief. True relief. No remnants of stiffness or soreness. None. That’s the moment I decided I prefer the new name of this homeopathic combination. (A few years ago I watched an older woman with pretty advanced arthritis use Traumeel and she said, “it’s like I put on gloves and I have new hands.” Yes! I can now relate to that! 

What’s in T-Relief and why does it help? Let’s take a look. Interestingly, this combination uses extremely low potencies: 1X, 2X, 3X, 4X, 6X and 10X. (For a refresher on homeopathic potencies, click here and ​here.) With these low potencies, the instructions of using it “2 to 3 times daily, or more often if necessary” make good sense*. 

Aconitum napellus or Aconite for short. Numbness and tingling can result when the inflamed joints press on nerves. Raynaud’s disease occurs more frequently in arthritis patients and it, too, can be helped by Aconite. “Red, shining swelling, very sensitive joints” (Murphy 2020) are helped by Aconite as are weak and lax ligaments of joints and sharp joint pains. Hip joints and thighs that feel lame. Trembling can also be associated with osteoarthritis and Aconite can help with this, too. 

Arnica montana. T-Relief takes, in my opinion, a scattershot approach (in a good way!) with their Arnica by including it in 1X, 3X and 10X potencies. One of these potencies is most likely going to provide some relief. Arnica is the go-to remedy for over-doing it, as well as experiencing a lame feeling. Limbs which ache as if they had been beaten. Aching as a result of exposure to cold and damp or muscular strain. Cramps, like writer’s cramp. Weakness in the hands, especially when grasping. Arnica is shown here and here and here to have anti-inflammatory effects.

Baptisia tinctoria is also excellent for aching, sore and bruised pains with great weakness. Wandering pains as well as stiffness and pain. 

Belladonna is well known for any ailment which is red and hot. Swollen joints, cramping pains. Spasms and shifting pains and the cold limbs which can sometimes result from arthritis. 

Bellis perennis, the common daisy, is amazing for aching pains, new or old. (If you are suffering from old injury pains, Bellis perennis may be your new best friend.) Sore joints as well as muscular soreness. A bruised, aching, sore pain. Tight wrists. Hip pains that are worse for exertion. 

Calendula officinalis. Calendula has been shown to be anti-inflammatory (and here, too) as well as being useful in repairing damaged tissues and when we get right down to it, what is osteoarthritis? “Osteoarthritis is a joint disease in which the tissues in the joint break down over time” (NIAMS 2019) so it makes sense that Calendula would be helpful in repairing not just superficial wounds, but also the deeper tissues. Like Belladonna, Calendula can also help with cold hands and feet. 

Chamomilla The Materia Medica does have some guidance regarding Chamomilla assisting when ankles give way, when there are pains in the hips and loins and numbness and stiffness of hands, particularly when grasping objects. However, I think Chamomilla’s biggest contribution to this combination remedy is its ability to soothe irritability and anger. Not being able to easily do, or do at all, what you want to do, inevitably leads to irritability. If Chamomilla can help soothe a teething toddler, it can help a grumpy old arthritic person! 

Echinacea also addresses cold hands and feet as well as aching, weakness and pain in general. 

Hamamelis virginiana is another good pain remedy. It is indicated in very sore muscles and joints and it is one of the most highly indicated remedies for varicose veins which have been found to be associated with osteoarthritis (Sisto et al. 1995). 

Hypericum perforatum is another excellent nerve remedy as well as a good remedy for when the joints feel bruised. It is also a highly indicated remedy for pain in general, especially radiating or shooting pains.

Millefolium is a pain remedy, not terribly specific to arthritis with the exception of sprains and strains of joints. (Remember, T-Relief is not specifically formulated for arthritis, it is for pain, in general.)

Ruta graveleons is a big remedy for bruised pain, particularly in the bones and shows an affinity for joints, ankles and wrists. Cracking in joints. Knees which give way. Pains in the bones of feet and ankles. Pain and stiffness in wrists and hands. 

Symphytum officinale is for bone pain and more importantly, complaints and pains of cartilage. Aching hip pain as well as joint pain, generally. See here and here for research on Comfrey, AKA Symphytum.)

As you can see, T-Relief is a beautiful combination of low potency homeopathic remedies to assist in the relieving of mild to moderate arthritis pain.

P.S. Don’t be surprised if you rub some T-Relief into your hands and find relief in your knee. Once the remedies are in your system (in this case via the skin), you will likely find relief all over, not just where it was applied.


Julia Coyte, CHom
Classically Practical homeopath


#wellnessawaits


* It’s always important to read the directions and use according to manufacturer’s recommendations.

REFERENCE LIST

Arthritis National Research Foundation, 2021. Does arthritis cause numbness or tingling? [online]. Arthritis Research | Arthritis National Research Foundation. 

Carmona-Terés, V., Moix-Queraltó, J., Pujol-Ribera, E., Lumillo-Gutiérrez, I., Mas, X., Batlle-Gualda, E., Gobbo-Montoya, M., Jodar-Fernández, L., and Berenguera, A., 2017. Understanding knee osteoarthritis from the patients’ perspective: a qualitative study. BMC musculoskeletal disorders [online], 18 (1), 225. 

Grube, B., Grünwald, J., Krug, L., and Staiger, C., 2007. Efficacy of a comfrey root (Symphyti offic. radix) extract ointment in the treatment of patients with painful osteoarthritis of the knee: Results of a double-blind, randomised, bicenter, placebo-controlled trial. Phytomedicine [online], 14 (1), 2–10. 

Jurca, T., Józsa, L., Suciu, R., Pallag, A., Marian, E., Bácskay, I., Mureșan, M., Stan, R. L., Cevei, M., Cioară, F., Vicaș, L., and Fehér, P., 2020. Formulation of Topical Dosage Forms Containing Synthetic and Natural Anti-Inflammatory Agents for the Treatment of Rheumatoid Arthritis. Molecules [online], 26 (1). 

Marzotto, M., Arruda-Silva, F., and Bellavite, P., 2020. Fibronectin Gene Up-regulation by Arnica montana in Human Macrophages: Validation by Real-Time Polymerase Chain Reaction Assay. Homeopathy [online], 109 (03), 140–145. 

Murphy, R., 2006. Nature’s materia medica : 1,400 homeopathic and herbal remedies. 3rd ed. Blackburg, Va.: Lotus Health Institute, November.

Murphy, R., 2020. Nature’s materia medica : 1,400 homeopathic and herbal remedies. 4th edition. Blackburg, Va.: Lotus Health Institute, November.

NIAMS, 2019. NIAMS Health Information on Osteoarthritis [online]. National Institute of Arthritis and Musculoskeletal and Skin Diseases. 

Sisto, T., Reunanen, A., Laurikka, J., Impivaara, O., Heliövaara, M., Knekt, P., and Aromaa, A., 1995. Prevalence and risk factors of varicose veins in lower extremities: mini-Finland health survey. The European Journal of Surgery = Acta Chirurgica [online], 161 (6), 405–414. 

Staiger, C., 2012. Comfrey: A Clinical Overview. Phytotherapy Research [online], 26 (10), n/a-n/a. 
‌​

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8/6/2021

What Hurts?

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Rufus is a big dog and he most likely suffers from the hip joint problems these big fellows are known to endure. He’s been slowing down for a while now and we dare not take him on a long off-road walk because there would be no carrying him back home if he decided to sit down and be done with the walk.

The other day, poor old Rufus couldn’t (or wouldn’t) get up to get his breakfast. He had to have his back end lifted for him to get him on his way. He seemed fine the day before. Fine is relative here. It always seems an effort for him to stand up. There is almost always a groan and a sudden drop when he tries to make himself comfy.

Having no idea what happened to Ruf — did he injure his leg or back or is it just the old age aches of a big dog — I wasn’t sure where to start and he wasn’t helping me figure it out.

After being helped up, he had his breakfast and took himself outside for a bit and plopped back down in his cool room. 

I brought him a homeopathic T-Relief spiked treat*.

T-Relief used to be known as Traumeel and was one of the first homeopathic remedies that I began using on my own. It’s a homeopathic mix which covers a lot of ground:

Arnica — Joint, back, muscle pain
Calendula — pain reliever 
Hamamelis — a good remedy to think of when Arnica didn’t act.
Bellis Perennis — joint and muscle soreness
Belladonna —  pain reliever
Hypericum — nerve pain (see “Poked by a Branch” blog)
Ruta — tendons and ligaments
And a few more remedies thrown in for good measure. 

A lot of homeopaths don’t like the combination remedies. Could an injury or pain be more specifically addressed through a targeted remedy? You bet. But, in a pinch and when you don’t have the working knowledge to guide you to the “correct” remedy, combination remedies can often quickly get you the relief you need.

And, for Rufus, it did just that.

He lounged most of the day, as usual, and he was able to get up for his dinner, albeit slower than usual. A few more doses of T-Relief put him back on track.

If you or your loved one or beloved pet is suffering from aches and pains, contact classicallypractical.com to see if homeopathy can help.

[In writing this article, I see Medinatura also offers a line of Pet products. I have not tried them. The ingredients and price appear to be identical to the people version.]

* I crush the tablet with the back of a spoon or the flat part of a knife and pick up the powder on a piece of meat or cheese and give it to him that way. They can also be put directly in the mouth, between the gum and cheek.
​
** Follow the manufacturer’s recommendation.



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