External Applications in Anthroposophic Nursing

Sauerkraut Pelvic Floor Bladder Compress

Kind of substance

Raw sauerkraut, lactic acid, fermented

Guiding principle for the application

The urinary bladder, as the lowest organ underneath the peritoneal cavity, may be noticed in times of mental stress (examination anxiety, separation, trauma) due to its special sensitivity, e.g., as an irritable bladder or as bladder weakness (especially in connection with general exhaustion). 
In healthy people, the soul body connects with the region of the digestive, metabolic and sexual organs (the “lower human being”) through the kidneys and bladder. In the event of prolonged stress, severe exhaustion or serious illness, the soul body can withdraw too much from this area. Symptomatically, the bladder’s tonus and irritability may change, resulting in a permanent, unproductive urge to urinate. The first signs of the developing tonus disorder are often listlessness and a lack of drive.

Sauerkraut and warmth can help to restore balance. The sulfur contained in sauerkraut (which can be smelled) has a local invigorating effect. Strengthening the person’s etheric forces in the bladder area promotes a healthy ability to fall asleep and reduces symptoms of irritation.  The acidity directly addresses the soul body and contributes to a regulation of the tonus disorder. The deep warming caused by a wrapped sauerkraut compress can help to overcome chronic disorders of the bladder and urinary tract. Through the interaction of warmth, sulfur and acidity, the person becomes comfortably present in his lower body again, which can help him to fully experience himself.

The use of sauerkraut as a wrapped bladder compress was originally an idea of the doctors Astrid Sterner and Klaus Wilde. The use of a wrapped pelvic floor compress comes from Dr. Maria Kusserow’s research in Heidenheim. The use of sauerkraut in the wrapped pelvic floor bladder compress is a further development from the encounter of these two impulses.

Sauerkraut compresses act much more intensively as wrapped pelvic floor bladder compresses than they do as simple bladder compresses. The impulses given by sauerkraut bladder compresses are experienced as being even more clear, intensive and comprehensive when administered as wrapped pelvic floor bladder compresses. The generation of warmth is more in-depth. The pelvic area often becomes wide and comfortable again.  The compress can act very strongly on trauma-related disorders, which may trigger unexpected reactions, especially if the problem was unconscious.
Red., GS

Guiding Principle for the substance


  • Bladder voiding problems (see example case 1)
  • Depression, reactive
  • Exhaustion (see example case 1)
  • Urinary incontinence
  • Menstrual problems (Do not use during bleeding!)
  • Postmenopausal complaints in the genital area
  • Post-traumatic stress disorder (see example case 2)
  • Residual urine (see example case 1)
  • Irritable bladder (see example case 1)
  • Traumatization in the genital area (see example case 1)
  • Postpartum depression
  • Acute and chronic cystitis (see example cases)



  • In case of lichen sclerosus or wounds in the genital area, the application may only be administered as a bladder compress!
  • In older women, one should check whether a bladder compress would be preferable to a pelvic floor application.
  • Applications for men: the external genitalia must be left out, therefore the application differs from the one given to women – see instructions.

  • The following is decisive for the effectiveness of the application: the sauerkraut must be heated long enough to stay warm for the duration of the compress. Heat up for 15 minutes without boiling (lactic acid bacteria are destroyed at temperatures above 70°C or 158°F).
  • Apply the compress preferably in the first half of the day, although to help with difficulty in falling asleep it may also be administered in the evening, so that the post-treatment rest can transition into sleep.

  • 4 heaped tablespoons raw lactic-acid-fermented sauerkraut 
  • One large bath towel
  • One normal terrycloth hand towel, folded lengthwise into 3 layers
  • Inner cloth, ca. 75 x 30 cm, or a cotton diaper
  • A small pot with a little water for heating the sauerkraut
  • Knee roll or pillow
  • Hot-water bottle filled hot

  • Warm up the sauerkraut in the pot for approx. 15 min.
  • Prepare the patient (ensure warm feet, send to the toilet)
  • Place the bath towel folded once horizontally on the bed and wrap it around the hot-water bottle together with the hand towel to warm everything up
  • Spread the substance cloth on a work surface
  • Squeeze the liquid out of the sauerkraut with a spoon in a sieve
  • Apply the sauerkraut to an area of about 30 cm x 10 cm in the middle of the substance cloth and then fold in the cloth from all sides and go to the patient
  • Remove the hot-water bottle
  • Have the patient lie down on the bath towel so that her hip joints are centrally on it
  • Place the hand towel vertically on the bath towel
  • The patient lies down on it
  • Place the sauerkraut pack from the anus over the symphysis to the bladder area

Alternative application for men: Prepare 2 substance packs, one to be placed on the perineum, the other on the bladder so that the external genitals are omitted.

The rest of the procedure is the same for both sexes:
  • Cover the patient with the vertical terrycloth hand towel, bring the legs together and place a support under the knees.
  • Wrap the bath towel around the abdomen
  • Cover the patient
  • Duration: 30 minutes, or as long as the pack is warm and comfortable. Then remove all of the cloths
  • 30 minutes of post-treatment rest

  • Wash out all the cloths and hang them up to dry, discard the sauerkraut

Well-proven in many patients
Daily, once a day to start with, then see “Duration of the therapy”
Onset of effect
Immediately and/or after several days
Length of therapy
Once the symptoms have improved, continue to apply at longer intervals (3x/week, then 2x/week, later as needed)
Risk of burns, the temperature of the sauerkraut must be checked before it is applied!

Instructions to download

Case example

Fallbeispiel 1
A 67-year-old woman in good general and nutritional condition, but with early childhood sexual traumatization. Bladder voiding disorders with permanent residual urine began with her first pregnancy. Painful irritated bladder, feeling of cold in the abdomen, cold feet in the first half of the day, therapy-resistant recurrent cystitis with and without bacteria from childhood onwards. Severe permanent difficulty in falling asleep since childhood.
After the first application, the patient literally said: “I experienced a never-before-seen feeling of well-being in my bladder, I felt a strong widening of my entire abdomen. This compress has opened up areas in my abdomen that have never been accessible to my sensation before. Small groups of muscles relaxed and I can clearly tell that it was exactly these muscle groups that held back the residual urine.”
This application was administered on 4 consecutive days, but once there was no effect because the compress was not hot enough.
The patient's relaxation lasted for about 2 weeks. Then there was a renewed, diminished flare-up of symptoms. After a further application all complaints disappeared for several months. Slight symptoms occurred again in connection with a Lyme disease relapse, which could be improved by further sporadic applications.

Fallbeispiel 2
A 71-year-old woman, war generation, suffers from irritable bladder, residual urine, difficulty falling asleep, recurrent cystitis, exhaustion, circulatory dysregulation, recurrent herpes zoster, disc prolapse with lumbar spine syndrome and post-traumatic stress disorder after sexual abuse.
The patient contacted the practice almost daily over a long period of time.
After a single application of the wrapped sauerkraut pelvic floor bladder compress, she was not heard from for a week, because she experienced the following improvement: “better urination, improved deeper sleep, pleasant warming of the body from the bottom up, more stability, more clarity, finally someone is taking care of my womanhood” and “I feel self-love – which I never got from mother.”
The patient expressed the wish to “be allowed to do the compress again”.
The patient generally feels better after 6 weeks and now only rarely comes for a consultation.


Red., SK


Roggatz M, Maaser A, Zerm C, “Blase und Seelenleben”, Der Merkurstab, Heft 2 2016.