488 MEALS MEDICINAL. 
albumen in the urine. If the patient grows tired of new milk, 
then butter-milk will make a welcome change ; or the “ skimmed 
milk” from which the cream has been first separated, and in 
which, if left to itself and not too cold, is developed through bac- 
terial action lactic acid, with a formation of the casein into curds, 
leaving a liquid whey, suitable as a change from the butter-milk. 
This whey will contain sugar of milk, and some of the mineral 
salts, though with a tendency to constipate; in which case, 
nevertheless, the swarms of putrefactive microbes, which 
commonly occupy the large intestine, producing poisonous 
alkaloids, toxins, and fatty acids, will be prevented from doing 
mischief by the lactic acid of the whey. A similar curative 
effect will follow the external use of butter-milk, or whey, in cases 
of chronic skin disease, such as persistent eczema, by destroying 
the noxious microbes which infest the affected skin. Amongst 
the normal symptoms exhibited by a patient on a purely milk 
diet, are a certain amount of drowsiness, and the passage of 
- a large quantity of urine of a pale greenish colour; the tongue 
becomes coated with a white fur, and there is often a sweetish 
taste in the mouth. A moderate degree of constipation is 
favourable, orange-coloured stools being passed at intervals 
of two or three days. But if this symptom becomes too pro- 
nounced, then a little coffee or caramel may be added to the 
morning’s milk, or a small plateful of stewed fruit, apples, figs, 
or French plums, may be eaten once a day. 
Koumiss, which consists, in its integrity, of mares’ milk, 
fermented, is of particular value as a food for weakly, or consump- 
tive patients, because of certain products generated from the 
milk sugar, which materially help a defective power of digestion. 
An imitation of the Russian Tartar Koumiss is now made with ~ 
considerable success at our principal dairies, with cows’ milk, 
sugar, and yeast. The original Koumiss was used by the Bashkirs 
of the steppes of Orenburg, and Ssamura, having been prepared 
by them from time immemorial as a restorative food, and a mild 
alcoholic drink, after the hardships and deprivations endured 
throughout a rigorous winter. It attracted the attention of 
the Russian physicians in 1830, and thirty years later, of the 
Germans; but mares’ milk would be too laxative for ordinary 
use. Kephir is the modern substitute for Koumiss. It is @ 
white, foaming, slightly sweet, acidulous, and alcoholic refreshing 
drink, the alcohol increasing until the whole of the sugar is used 
