The "koumiss cure " consists in taking a large quantity of koumiss - in some cases 15 to 20 tumblerfuls a day - in combination with nourishing albuminous food. If perfectly fresh it may be drunk warm, but if it is to be kept for some time it is better to drink it cold. Koumiss which is either too fresh or which has not been kept clean may cause flatulency, colic, and diarrhoea, but old koumiss has the opposite effect upon the bowels, and, like milk, gives rise to constipation. Koumiss resembles whey in being strongly diuretic and diaphoretic, and thus relieves the mucous membranes of congestion. It also alleviates thirst, strengthens the action of the heart, and improves the vascular tone, general nutrition, and complexion. The solids of the urine are increased during its use. The use of koumiss is said to be contraindicated in renal and vascular diseases, gout, plethora, and chronic constipation.

At first but two or three tumblerfuls of koumiss are allowed daily until the stomach becomes accustomed to it; then patients are made to drink a glass at frequent intervals during the day and sometimes as often as once every half hour. Some patients can digest very large quantities of koumiss, and as much as 10 litres have been taken in twenty-four hours, but less is used now than formerly; patients do not often exceed 6 or 8 litres a day, and for the average from 2 to 4 is quite enough. Tender beef and abundant butter, cream, and a moderate supply of bread compose the basis of the other foods allowed. Sweets, salads, and other beverages than koumiss are forbidden.

The treatment should be commenced slowly in order to accustom the digestive system to the fermented drink, which otherwise may excite diarrhoea. The latter accident may be counteracted by lime water or some simple remedy, such as bismuth.

The koumiss prepared from milk in the United States does not seem to possess the peculiar properties and extraordinary nutritive value which is attributed to it when made from mare's milk in Russia, on which patients are said to gain rapidly in weight. In various Russian cities there are special institutions designed for carrying out the koumiss cure, and which are supplied with the genuine article from the steppes.

Special koumiss cures are not in vogue in this country, but in southeastern Russia there are several establishments, notably in the districts of Orenberg and Samara, where patients go for treatment during several months in summer, and derive great improvement. Like other popular " cure " resorts in Europe, these establishments furnish the patient with suitable light and varied amusement during the progress of his treatment, which is highly beneficial, by diverting the mind and relieving an otherwise monotonous regime. While undergoing the koumiss cure, patients are made to live outdoors as much as possible, and tent life with free exercise is no doubt a very important adjunct to the treatment when it can be obtained. The climate is both hot and dry, and the elevation is high.

The koumiss cure is particularly available for chronic catarrh of the respiratory and alimentary canal, and in the first stage of pulmonary tuberculosis. It is also especially recommended for general debility resulting from pronounced anaemia, and for various diatheses, such as scrofula, rhachitis, etc. The large percentage of carbonic acid which is produced by koumiss fermentation, together with the alcohol present, acts as a stimulant to the gastric mucous membrane, favourably affects digestion, and lessens irritability of the stomach. Among other effects produced by the use of koumiss may be mentioned occasional drowsiness and lassitude. This food is also said to possess some aphrodisiac influence.