The 4-Step Werthmann Protocol: How a Full SANUM Programme Is Built

Part 9 of our series, "Understanding SANUM Therapy."

This article is educational in nature and does not replace personalised medical advice. If you are managing a health condition, please consult a qualified practitioner.

Across this series we have looked at the individual pieces of the SANUM range in turn — pleomorphism and cyclogeny in Parts 1 and 2, the foundation preparations Mucokehl and Nigersan in Part 3, the isopathic and haptenic principles in Parts 4, 5 and 8, acid-base terrain in Part 6, and bacterial-phase immune stimulation in Part 7. This article puts those pieces together into the structure practitioners actually use: the 4-Steps-Basic Scheme of SANUM Therapy according to Dr Werthmann, typically run over six to eight weeks depending on the individual's clinical picture and how the course of treatment progresses.

Step 1: Milieu Regulation, Running Throughout

Unlike the steps that follow, milieu regulation is not a phase to complete and move past — it runs across the entire duration of treatment, from day one to the last. It has two components. The first is a change of nutrition intended to repair the atrophy of the intestinal mucosa, achieved by omitting the primary antigens most closely linked to that atrophy: cow's milk and hen's eggs. The second is active deacidification and detoxification, drawing on the acid-base preparations covered in Part 6 — Alkala® N, Sanuvis®, Citrokehl® and Formasan®, alongside Cerivikehl®, Okoubasan® and Luffasan® — with Selenokehl®, Zinkokehl®, Mapurit® L and general vitamin support available as substitutions where needed.

Step 2: Specific Regulation With Fungal Preparations

Started at the same time as Step 1, this is where treatment becomes personal to the individual's presentation, choosing a single fungal preparation matched to the pattern involved: Notakehl® for bacterial affections, a Sanukehl or related preparation for viral affections, Fortakehl® for intestinal affections, Exmykehl® or Pefrakehl® for fungal affections, Albicansan® for candida affections, and Larifikehl® for respiratory tract and intestinal disease, or primary chronic polyarthritis. The choice among these is where a practitioner's read of the individual case matters most — the whole point of Step 2 is specificity, not a one-size-fits-all default.

Step 3: Basic Regulation, After 10 to 20 Days

After ten to twenty days on the Step 2 preparation, the programme shifts to the broad, foundational remedies explored in detail in Part 3: Mucokehl® in the morning and Nigersan® in the evening, alternatively with the Step 2 preparation continued for two days at a time, following a five-days-on, two-days-off rhythm sustained across roughly two weeks. This is the point in the programme where basic regulation of the cyclogenetic cycle itself, rather than a single specific organism, becomes the focus.

"Duration of the treatment: 6 to 8 weeks (depending on the clinical picture and the course of treatment)."

Step 4: Immunomodulation With Bacterial Preparations

Begun alongside Step 3, this final step brings in the immunobiological and haptenic preparations covered in Parts 7 and 8: Latensin®, Recarcin®, Utilin® or Utilin® "S", Bovisan®, and the relevant Sanukehl preparation for the case at hand. Where Step 2 addresses a specific fungal presentation and Step 3 restores basic cyclogenetic balance, Step 4 works directly on the immune system's own capacity to recognise and respond — bringing the programme full circle from terrain, to specific organism, to basic regulation, to immune competence.

Why the Sequence Matters

It would be a mistake to read these four steps as interchangeable or optional extras to a "main" remedy. The sequence is deliberate. Milieu regulation runs first and continuously because, as we saw in Part 6, no remedy targeted at a specific organism works well in a terrain that keeps recreating the conditions for that organism to thrive. Specific regulation comes next because it addresses the presentation the person actually walked in with. Basic regulation follows because, once the acute picture has been addressed, the cyclogenetic cycle itself — the process explored in Part 2, by which any symbiont can rise toward pathogenic forms — needs its own ongoing support. And immunomodulation comes last because an immune system asked to recognise and respond to pathogens works best once the terrain and specific presentation are already being managed.

Throughout all four steps, the same practical disciplines apply that we have touched on across this series: dosage adapted to individual responsiveness, attention to the organs of elimination, awareness that focal disturbance fields — in teeth, tonsils, paranasal sinuses, the intestine, or even old amalgam fillings — can limit the effectiveness of any biological therapy if left unaddressed, and a nutritional foundation rich in vitamins and vital substances throughout.

Having seen how the full protocol fits together, the final article in this series looks beyond the core fungal, bacterial and acid-base preparations to the supporting cast: organ preparations, trace elements and plant extracts that round out the SANUM practitioner's toolkit.

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Related reading

• Sanukehl and Haptenic Therapy: Helping the Body Recognise Hidden Pathogens
• Beyond the Gut: Organ Support, Trace Elements and Plant Extracts in SANUM Practice
• Restoring the Terrain: Acid-Base Balance with Alkala, Citrokehl and Sanuvis

Source: SANUM-Kehlbeck Practitioner Reference Guide, "4-Steps-Basic Scheme of SANUM Therapy according to Dr Werthmann."

Tags: Sanum Articles, Understanding SANUM Therapy, Werthmann Protocol, Treatment Programme