Licence: Public Domain Mark
Credit: Handbook of general therapeutics. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
417/442 (page 391)
![action of the lactic acid. It is, then, not to be wondered at if under favourable conditions of climate, and aided by the physical and mental rest enjoyed by the patients, koumiss should give the best results. In my report sixty-two cases are referred to, of 'which twenty-seven made a peri'ect recovery and twenty-four were materially improved by means of the koumiss cure, nine left the establishment no better, one case of acute tuberculosis got rapidly worse, and another died in the institution. Thus in tifty-one of the sixty-two, or 82 ])er cent., there was either recovery or material improvement, and in the remaining eleven the cause of the want of success lay in the specially severe form of the disease (phthisis florida, acute tuberculosis, &c.) or in the duration of treatment being too short. Among the twelve cases of consumption, there were five of chronic catarrhal pneumonia, with well-marked symptoms of consolidation and ulceration of the lung, elevated temperature, and hmraoptysis. Koumiss could not be given in large doses on account of the h£emoptysis, and conse- quently the gain of weight was small, viz. 1 to 3 kilos.; the cough became less, and the temperature sank, but the objective sj^mptoms were unchanged. On the other hand, in those cases of consumption in which the process was more of an interstitial character, in which cicatrisation and contraction with the formation of bronchiectasic cavities played the principal part, the im- provement was considerable. The symptoms of the bronchial catarrh which accompanies the changes in the lung substance disappeared rapidly, but even in these the objective signs remained unaltered, and in no single instance could I assure myself of the complete healing up of the cavities. In five of the twelve, cases haemoptysis recurred, so that the patients were compelled to use the koumiss sparingly. Of ten cases of chronic bronchitis seven recovered completely; the rales disappeared, together wdth the cough, pains, and difiiculty of breathing. In the remaining three the bronchitis was associated with emphysema, which obviously^ could not but persist, and in one other hasmoptysis occurred during the koumiss treatment. The patient was a man, with a narrow paralytic {sic) thorax and extreme emaciation, wdio had previously’ had several attacks of haemoptysis. lie could bear only small doses of koumiss, and this naturally^ detracted from the full success of the treatment; yet he gained 2-5 kilos. And lastly the remaining case of bronchitis in which there w’as only an improvement was a y’oung woman of twenty-two, of a consumpth’e family, w’ho had frequently suffered from bronchitis, with fever, dry pleurisy, and haemoptysis. After an unhappy marriage she developed hystero-epileptis attacks, and paresis of the lower extremities, and had, too, a constantly elevated temperature of 104'’ to 108° F, After a course of koumiss she could scarcely Ije recognised ; she had gained 5 kilos., was quite free from cough, and able to take part in the dancing, but the temperature remained above the normal. Iluring the following winter she took a fresh chill, lost flesh rapidly, high fever and bloody' expectoration set in, and she was at length unable to walk. In this condition she came to me, and I found, on examination, only a few dry rhonchi over both lungs, and also the signs of an old pleurisy at](https://iiif.wellcomecollection.org/image/b24908058_0001_0417.jp2/full/800%2C/0/default.jpg)
