May 6,1871.] 
THE PHARMACEUTICAL JOURNAL AND TRANSACTIONS. 
885 
anti digested in a small flask at a gentle lieat, leave 
not more than 5 grains undissolved, which should be 
entirely soluble in hydrochloric acid.] This residue 
unacted upon by the iodine is, of course, the oxide 
which is present, the metallic iron being removed in 
solution in the form of iodide. 
Ferrum Tartaratum (see Ferri et Ammon. Cit. 
and Ferri et Quixje Cit.). —The tartarated iron is 
generally recognizable by its deep colour and sweet¬ 
ish taste. The tests indicated in the Pharmacopoeia 
are intended to show that it is free from ammonia, 
that it is made from cream of tartar, and that it 
contains a due proportion of iron, viz. 30 per cent, 
of the peroxide.. 
KOUMISS. 
BY VICTOR JAGIELSKI, M.D. 
{Concluded from page 865.) 
The fermentation which milk undergoes by the pro¬ 
cess which converts it into koumiss, presents many 
differences from those changes induced in milk by 
the ordinary methods of souring and curdling it, such as 
exposure to air and heat, addition of acids or rennet, 
.etc. In all these cases lactic acid is formed; but in the 
fermentation process for koumiss, that product is accom¬ 
panied with other derivatives of the milk which impart 
a peculiar character, physical as well as chemical. This 
character not only distinguishes the fresh koumiss, but 
pushes it on, under the influence of time, into further 
changes, which are not common to milk under ordinary 
circumstances. According to With, Stahlberg, Hartier, 
and, more recently, Weinberg, koumiss is composed of 
alcohol ', lactic acid , sugar, finely divided caseine , fat, salts, 
carbonic acid and water . This composition represents the 
mare’s milk (koumiss) in its fresh or No. 1 state. After 
having been in bottle for from five to ten days, accord¬ 
ing to the temperature of the atmosphere, it has changed 
by progressive fermentation into koumiss No. 2. This 
latter differs chemically from the former in containing 
more alcohol and carbonic acid, but less of solid matters. 
At the same time, its external or physical character has 
perceptibly changed, for it is homogeneous when well 
shaken and sparkles like champagne. It is also more 
acidulous than sweet, owing to the development of traces 
of acetic acid. By further age it becomes spontaneously 
No. 3; and this modification not only contains all the 
elements of the koumiss Nos. 1 and 2, but more or less 
butyric acid, succinic acid, acetic acid, and glycerine in 
addition. The proportion of alcohol and carbonic acid, 
moreover, has largely risen at the expense of the solid 
constituents. This koumiss is also more acidulous and 
sparkling than even No. 2, and rushes through the top of 
the bottle as a rich foaming liquor. It will be observed, 
then, that the fermentation progresses with age, and also 
that the older a koumiss becomes, the higher rises its 
proportion of alcohol and carbonic acid, and the lower 
falls its amount of solid matters. 
Cow’s milk koumiss should be made to correspond in 
composition with that from mare’s milk ; nevertheless it 
is sometimes necessary to make different modifications to 
suit the varying exigencies of disease and personal idio¬ 
syncrasy. This, of course, requires a certain chemical 
knowledge and skill which will give thick koumiss, 
skimmed koumiss, whey koumiss, diabetic koumiss, me¬ 
dicated koumiss, or any other modification that may be 
desired. 
According to Morfit, the koumiss No. 2, from cow’s 
milk, contains traces in variable degree of certain fra¬ 
grant compounds, to which it may owe its character of a 
delicious beverage. These, he supposes, are generated 
from the volatile elements of the fat under the influence 
of the fermenting action and of the strong gaseous pres- 
s urc in the bottle. There arc other original and sug¬ 
gestive views by this able chemist upon the relations of 
koumiss, and as they tend to confirm my own observa¬ 
tions, I propose to make them the subject in part of a 
more scientific paper at some future leisure. 
Mare's milk koumiss runs through the transition state 
of No. 2 much more quickly than the koumiss from 
cow’s milk. It is also more acid in the No. 3 state, and 
preliminary to its decay assumes a bitter taste. This 
bitter taste differs from the slight bitter of No. 3, cow’s 
milk koumiss, which is a pleasant peculiarity and not a 
sign of approaching decay. All the different numbers 
have the colour and appearance of milk, and it should be 
noted here, that the cow’s milk koumiss is a most agree¬ 
able beverage throughout. 
Koumiss, unlike milk, agrees well with the feeblest 
stomach; and the molecular condition of its butter and 
caseine, together with the presence of lactic acid and 
other aids to digestion, render it the type of assimilable 
nutriments. 
The foregoing description applies equally to the mare’s 
milk koumiss of the steppes and the cow’s milk koumiss 
of this country, with the differences noted. This latter, 
or cow’s milk koumiss, as made on the Continent, does 
not retain its soundness so long, and, moreover, is not so 
agreeable to the taste. 
The next point in sequence is the physiological rela¬ 
tions of koumiss: but to elucidate these would require 
more space than the limits of this paper allow. I will, 
however, embrace the general physiology of the subject 
in the remarks which I am about to make upon its 
therapeutics. Moreover, I have already discussed the 
special physiology of the several constituents of koumiss 
in my treatise of the last year. 
The high reputation of koumiss on the Continent has 
been fully confirmed in my own private practice and 
that of my professional brethren who have used it. With 
its aid, I have been able to treat certain diseases with 
gratifying results to both patient and physician. Most 
remarkable benefit is obtained by its use in all those 
complaints arising from feeble digestion, whether caused 
by impoverishment of the gastric juice or catarrhal com¬ 
plications, in nervous irritation and in the different 
phases of dyspepsia. Although the general properties 
correspond throughout the three numbers, the chemical 
and physical modifications which make the differences 
between them, give to each, in addition, a special cha¬ 
racter, and by this character it is adapted for special 
cases. In like manner these special koumisses, which 
are designated severally as thick, skimmed, whey, and 
diabetes koumiss, are modifications prepared to suit par¬ 
ticular diseases. 
In commencing the koumiss treatment, the physician 
must judiciously consider the condition of his patient, 
and regulate the use of this remedy accordingly. If 
debility be so great that the patient must keep in bed, 
then the koumiss is to be given only in very small quan¬ 
tities at short intervals, that is, about an ounce every 
hour. In such case it is necessary, and indeed in all 
cases it will be better, to restrict the diet solely, to this 
beverage for a period. The power of assimilation will 
improve gradually, and sometimes even rapidly, and as 
this improvement advances, so will the taste for koumiss 
increase, and enable the patient to drink all that is re¬ 
quired for a wholesome nutrition. 
In this connection it must be remembered that the 
koumiss not only contains all the plastic, respiratory and 
heat-giving elements of the body, but presents them in 
such a form that they are rapidly absorbed to renew the 
wasted tissues of the body. In this respect koumiss is 
notably distinguished from milk, which, in any other 
modification, is intolerable to many stomachs, even in 
small quantities. When the patient is drinking the 
second quart of koumiss per clay, his increase ot flesh 
and strength will be very perceptible. I have had cases 
in which the gain amounted to as much as ten pounds in 
a month, where the only food taken with the koumiss 
