Am.  Jour.  Pharm.  ) 
Dec.  1, 1874.  / 
The  Koumis  Cure. 
575 
twenty-four  hours.    The  contents  of  this  bottle  are  then  poured  into 
double  the  quantity  of  frese  mare's  milk,  and  allowed  to  ferment  for 
twenty-four  hours  more.  Then  twice  the  amount  of  fresh  mare's  milk 
is  again  added,  the  whole  fermenting  for  twenty-four  hours  more. 
Thus  a  sufficient  amount  of  the  fermenting  element  is  obtained  to 
begin  operations,  the  proportion  1 :  3  being  always  maintained  between 
the  fermenting  element  and  the  fresh  milk.    Some  patients  drink  as 
much  as  six  or  eight  bottles  of  koumis  a  day.    Some  subsist  entirely 
on  it ;  but,  generally  speaking,  people  eat  their  ordinary  meals,  and 
drink  koumis  between.  It  has  a  sharp  and  bitter  taste,  caused  by  the 
lactic  acid,  which  it  contains  in  large  quantities  ;  and  the  strongest 
sorts  of  all  leave  a  kind  of  soft,  buttery  after-taste,  which,  however, 
the  carbonic  acid  gas  helps  to  dissipate.    Some  people  never  can  get 
over  their  dislike  to  the  taste  of  koumis,  and  those  it  is  never  likely 
to  benefit.    The  complaints  for  which  koumis  is  considered  beneficial 
are  consumption,  and,  it  may  be  said  generally,  all  affections  of  the 
mucous  membrane.    It  is,  of  course,  a  mistake  to  suppose  koumis  a 
specific  for  consumption.    It  is  nothing  of  the  kind.    People  some- 
times go  to  Samara  in  the  last  stages  of  that  disease,  when  neither 
koumis  nor  anything  else  can  be  of  avail.    But  in  the  early  stages  of 
consumption  it  often  effects,  by  its  strengthening  properties,  a  bene- 
ficial change  in  the  organism  of  the  patient,  and  helps  to  arrest  the 
ravages  of  the  complaint.    Where,  however,  it  is  of  sovereign  efficacy 
is  in  cases  of  recovery  from  a  long  and  wasting  illness  where  no  or- 
ganic detriment  exists.   Often,  in  such  cases,  after  a  couple  of  months 
of  koumis-drinking  the  system  is  braced  up,  the  blood  streams  more 
quickly  through  the  veins,  the  pulsation  increases,  and  a  general 
feeling  of  bien-etre  pervades  the  whole  man.    Not  that  I  feel  inclined 
to  attribute  the  whole  benefit  which  is  derived  from  a  cure  at  Samara 
to  the  properties  of  koumis.  The  fine,  dry,  rarefied  air  of  the  steppes 
has  undoubtedly  something  to  do  with  it.    The  lungs  are  called  into 
active  play,  and  lend  their  assistance  to  the  general  recuperative 
process. 
"  You  feel  the  dryness  of  the  air  at  Samara.  In  the  higher  parts 
of  the  steppes  there  is  no  dew.  The  most  delicate  and  consumptive 
patient  can  admire,  with  impunity,  the  beauties  of  the  setting  sun — 
and  the  sunsets  are  very  beautiful  at  Samara.  He  is  not  obliged,  as 
in  Italy,  to  flee  that  treacherous  hour  :  he  can  sit  out  of  doors  with- 
out risk,  and  watch  that  setting  sun  reflected  on  the  Jigoulee  hills 
