There are various stories about the origin of the name. A Belgian spring of iron bearing water was called Espa from the Walloon language term for "fountain", and was used in 1326 as a cure by an iron master with such success that he founded a health resort which developed into the town. It is also suggested that the term Espa may be derived from the name of the resort, and that its source could be the Latin word "spagere" meaning to scatter, sprinkle or moisten.
It has been suggested, with no evidence, that the word is an acronym of various Latin phrases such as "Salus Per Aquam” or "Sanitas Per Aquam" meaning "health through water". These are "backronyms" — back-formed acronyms. Acronyms arose in the twentieth century, and were not used in classical times.
Many people around the world believed that bathing in a particular spring, well, or river resulted in physical and spiritual purification. Forms of ritual purification existed among the native Americans, Persians, Babylonians, Egyptians, Greeks, and Romans. Today, ritual purification through water can be found in the religious ceremonies of Jews, Muslims, Christians, Buddhists, and Hindus. These ceremonies reflect the ancient belief in the healing and purifying properties of water. Complex bathing rituals were also practiced in ancient Egypt, in prehistoric cities of the Indus Valley, and in Aegean civilizations. Most often these ancient people did little building construction around the water, and wht they did construct was very temporary in nature.
The Romans emulated many of the Greek bathing practices. Romans surpassed the Greeks in the size and complexity of their baths. As in Greece, the Roman bath became a focal center for social and recreational activity. As the Roman Empire expanded, the idea of the public bath spread to all parts of the Mediterranean and into regions of Europe and North Africa. With the construction of the aqueducts, the Romans had enough water not only for domestic, agricultural, and industrial uses, but also for their leisurely pursuits. The aqueducts provided water that was later heated for use in the baths. Today, the extent of the Roman bath is revealed at ruins and in archaeological excavations in Europe, Africa, and the Middle East.
The Romans also developed baths in their colonies, taking advantage of the natural hot springs occurring in Europe to construct baths at Aix and Vichy in France, Bath and Buxton in England, Aachen and Wiesbaden in Germany, Baden, Austria, and Aquincum in Hungary, among other locations. These baths became centers for recreational and social activities in Roman communities. Libraries, lecture halls, gymnasiums, and formal gardens became part of some bath complexes. In addition, the Romans used the hot thermal waters to relieve their suffering from rheumatism, arthritis, and overindulgence in food and drink. The decline of the Roman Empire in the west, beginning in A.D. 337 after the death of Emperor Constantine, resulted in Roman legions abandoning their outlying provinces and leaving the baths to be taken over by the local population or destroyed.
Thus, the Romans elevated bathing to a fine art, and their bathhouses physically reflected these advancements. The Roman bath, for instance, included a far more complex ritual than a simple immersion or sweating procedure. The various parts of the bathing ritual — undressing, bathing, sweating, receiving a massage, and resting — required separated rooms which the Romans built to accommodate those functions. The segregation of the sexes and the additions of diversions not directly related to bathing also had direct impacts on the shape and form of bathhouses. The elaborate Roman bathing ritual and its resultant architecture served as precedents for later European and American bathing facilities. Formal garden spaces and opulent architectural arrangement equal to those of the Romans reappeared in Europe by the end of the eighteenth century. Major American spas followed suit a century later.
People continued to seek out a few select hot and cold springs, believed to be holy wells, to cure various ailments. In an age of religious fervor, the benefits of the water were attributed to God or one of the saints. In 1326 Collin le Loup, an ironmaster from Liefe, Belgium, discovered the chalybeate springs of Spa, Belgium. Around these springs, a famous health resort eventually grew and the term "spa" came to refer to any health resort located near natural springs. During this period, individual springs became associated with the specific ailment that they could allegedly benefit.
Bathing procedures during this period varied greatly. By the 16th century, physicians at Karlsbad, Bohemia, prescribed that the mineral water be taken internally as well as externally. Patients periodically bathed in warm water for up to 10 or 11 hours while drinking glasses of mineral water. The first bath session occurred in the morning, and the second commenced in the afternoon. This treatment lasted several days until skin pustules formed and broke resulting in the draining of "poisons" considered to be the source of the disease. Then followed another series of shorter, hotter baths to wash the infection away and close the eruptions.
In the English coastal town of Scarborough in 1626, a Mrs Elizabeth Farrow discovered a stream of acidic water running from one of the cliffs to the south of the town. This was deemed to have health-giving properties and gave birth to Scarborough Spa. Dr Wittie's book about the spa waters published in 1660 attracted a flood of visitors to the town. Sea bathing was added to the cure, and Scarborough became Britain's first seaside resort. The first rolling bathing machines for bathers are recorded on the sands in 1735.
A typical day at Bath might be an early morning communal bath followed by a private breakfast party. Afterwards, one either drank water at the Pump Room (a building constructed over the thermal water source) or attended a fashion show. Physicians encouraged health resort patrons to bathe in and drink the waters with equal vigor. The next several hours of the day could be spent in shopping, visiting the lending library, attending concerts, or stopping at one of the coffeehouses. At 4:00 P.M., the rich and famous dressed up in their finery and promenaded down the streets. Next came dinner, more promenading, and an evening of dancing or gambling.
Similar activities occurred in health resorts throughout Europe. The spas became stages on which Europeans paraded with great pageantry. These resorts became infamous as places of gossip and scandals. The various social and economic classes selected specific seasons during the year's course, staying from one to several months, to vacation at each resort. One season aristocrats occupied the resorts; at other times, prosperous farmers or retired military men took the baths. The wealthy and the criminals that preyed on them moved from one spa to the next as the fashionable season for that resort changed.
During the 18th century a revival in the medical uses of spring water took place among some Italian, German, and English physicians. This revival changed the way of taking a spa treatment. For example, in Karlsbad the accepted method of drinking the mineral water required sending large barrels to individual boardinghouses where the patients drank physician-prescribed dosages in the solitude of their rooms. Dr. David Beecher in 1777 recommended that the patients come to the fountainhead for the water and that each patient should first do some prescribed exercises. This innovation increased the medicinal benefits obtained and gradually physical activity became part of the European bathing regimen. In 1797 in England Dr. James Currier published The Effects of Water, Cold and Warm, as a Remedy in Fever and other Diseases. This book stimulated additional interest in water cures and advocated the external and internal use of water as part of the curing process.
In most instances the formal architectural development of European spas took place in the 18th and 19th centuries. The architecture of Bath, England, developed along Georgian and Neoclassical lines, generally following Palladian structures. The most important architectural form that emerged was the "crescent" — a semi-elliptical street plan used in many areas of England. The architecture of Karlsbad, Marienbad, Franzenbad, and Baden-Baden was primarily Neoclassical, but the literature seems to indicate that large bathhouses were not constructed until well into the 19th century. The emphasis on drinking the waters rather than bathing in them led to the development of separate structures known as Trinkhallen (drinking halls) where those taking the cure spent hours drinking water from the springs.
By the mid-19th century the situation had changed dramatically. Visitors to the European spas began to stress bathing in addition to drinking the waters. Besides fountains, pavilions, and Trinkhallen, bathhouses on the scale of the Roman baths were revived. Photographs of a 19th-century spa complex taken in the 1930s, detailing the earlier architecture, show a heavy use of mosaic floors, marble walls, classical statuary, arched openings, domed ceilings, segmental arches, triangular pediments, Corinthian columns, and all the other trappings of a Neoclassical revival. The buildings were usually separated by function — with the Trinkhalle, the bathhouse, the inhalatorium (for inhaling the vapors), and the Kurhaus or Conversationhaus that was the center of social activity. Baden-Baden featured golf courses and tennis courts, "superb roads to motor over, and drives along quaint lanes where wild deer are as common as cows to us, and almost as unafraid."
The European spa, then, started with structures to house the drinking function — from simple fountains to pavilions to elaborate Trinkhallen. The enormous bathhouses came later in the 19th century as a renewed preference for an elaborate bathing ritual to cure ills and improve health came into vogue. European architects looked back to Roman civilizations and carefully studied its fine architectural precedents. The Europeans copied the same formality, symmetry, division of rooms by function, and opulent interior design in their bathhouses. They emulated the fountains and formal garden spaces in their resorts, and they also added new diversions. The tour books always mentioned the roomy, woodsy offerings in the vicinity and the faster-paced evening diversions.
By the beginning of the 19th century the European bathing regimen consisted of numerous accumulated traditions. The bathing routine included soaking in hot water, drinking the water, steaming in a vapor room, and relaxing in a cooling room. In addition doctors ordered that patients be douched with hot or cold water and given a select diet to promote a cure. Authors began writing guidebooks to the health resorts of Europe explaining the medical benefits and social amenities of each. Rich Europeans and Americans traveled to these resorts to take in cultural activities and the baths.
Each European spa began offering similar cures while maintaining a certain amount of individuality. The 19th century bathing regimen at Karlsbad can serve as a general portrayal of European bathing practices during this century. Visitors arose at 6:00 AM to drink the water and be serenaded by a band. Next came a light breakfast, bath, and lunch. The doctors at Karlsbad usually limited patients to certain foods for each meal. In the afternoon visitors went sight-seeing or attended concerts. Nightly theatrical performances followed the evening meal. This ended around 9:00 PM with the patients returning to their boardinghouses to sleep until six the next morning. This regimen continued for as long as a month and then the patients returned home until the next year. Other 19th century European spa regimens followed similar schedules.
At the beginning of the 20th century, European spas combined a strict diet and exercise regimen with a complex bathing procedure to achieve benefits for the patients. One example will suffice to illustrate the change in bathing procedures. Patients at Baden-Baden, which specialized in treating rheumatoid arthritis, were directed to see a doctor before taking the baths. Once this occurred the bathers proceeded to the main bathhouse where they paid for their baths and stored their valuables before being assigned a booth for undressing. The bathhouse supplied bathers with towels, sheets, and slippers.
The Baden-Baden bathing procedure began with a warm shower. The bathers next entered a room of circulating, 140-degree hot air for 20 minutes, spent another 10 minutes in a room with 150-degree temperature, partook of a 154-degree vapor bath, then showered and received a soap massage. After the massage, the bathers swam in a pool heated approximately to body temperature. After the swim, the bathers rested for 15 to 20 minutes in the warm \"Sprudel\" room pool. This shallow pool's bottom contained an 8-inch layer of sand through with naturally carbonated water bubbled up. This was followed by a series of gradually cooler showers and pools. After that, the attendants rubbed down the bathers with warm towels and then wrapped them in sheets and covered them with blankets to rest for 20 minutes. This ended the bathing portion of the treatment. The rest of the cure consisted of a prescribed diet, exercise, and water-drinking program.
The European spas provided various other diversions for guests after the bath, including gambling, horse racing, fishing, hunting, tennis, skating, dancing, golf, and horseback riding. Sight-seeing and theatrical performances served as further incentives for people to go to the spa. Some European governments even recognized the medical benefits of spa therapy and paid a portion of the patient's expenses. A number of these spas catered to those suffering from obesity and overindulgence in addition to various other medical complaints. In recent years, elegance and style of earlier centuries may have diminished, but people still come to the natural hot springs for relaxation and health.
Colonial doctors gradually began to recommend hot springs for ailments. Dr. Benjamin Rush, American patriot and physician, praised the springs of Bristol, Pennsylvania, in 1773. Dr. Samuel Tenney in 1783 and Dr. Valentine Seaman in 1792 examined the water of Saratoga Springs in New York and wrote of possible medicinal uses of the springs. Hotels were constructed to accommodate visitors to the various springs. Entrepreneurs opened taverns where the travelers could lodge, eat, and drink. Thus began the health resort industry in the United States.
These resorts offered swimming, fishing, hunting, and horseback riding as well as facilities for bathing. The Virginia resorts, particularly White Sulphur Springs, proved popular before and after the Civil War. After the Civil War, spa vacations became very popular as returning soldiers bathed to heal wounds and the American economy allowed more leisure time. Saratoga Springs in New York became one of the main centers for this type of activity. Bathing in and drinking the warm, carbonated spring water only served as a prelude to the more interesting social activities of gambling, promenading, horse racing, and dancing.
Saratoga Springs in New York had extensive architectural development by the 1830s — a time when the buildings of Hot Springs, Arkansas, were small log and frame structures without particularly distinctive detailing — just basic envelopes to keep occupants from the weather. By 1815 Saratoga had large, four-story, Greek revival hotels. The availability of train and steamship service to that destination by 1832 meant larger numbers of more sophisticated clients. With the exception of specialized baths provided in boardinghouses or small bathhouses connected with the hotels, Saratoga's development during the 19th century was based on leisure pursuits other than baths. Although Saratoga and other spas in New York centered their developments around the healthful mineral waters, their real drawing card was the complex social life — that included pursuits from gambling on racehorses to seeing the latest Paris fashions. Going to the mountains for the summer was a major exodus undertaken by urban dwellers who could afford it, and Saratoga became a hub of summer activity. Private development there featured enormous hotels with great ballrooms, opera houses, stores, and clubhouses. In 1865 the Union Hotel had its own esplanade, with fountain and formal landscaping, and two small bathhouses. Yet, during the 19th century the bathhouses were auxiliary structures and not the central features of the resort.
During the last half of the 19th century western entrepreneurs developed natural hot and cold springs into resorts — from the Mississippi River to the West Coast. Many of these spas offered individual tub baths, vapor baths, douche sprays, needle showers, and pool bathing to their guests. The various railroads that spanned the country promoted these resorts to encourage train travel. Hot Springs, Arkansas, became a major resort for people from the large metropolitan areas of St. Louis and Chicago.
The popularity of the spas continued into the 20th century. Some medical critics, however, charged that the thermal waters in such renowed resorts as Hot Springs, Virginia, and Saratoga Springs, New York, were no more beneficial to health than ordinary heated water. The various spa owners countered these arguments by developing better hydrotherapy for their patients. At the Saratoga spa, treatments for heart and circulatory disorders, rheumatic conditions, nervous disorders, metabolic diseases, and skin diseases were developed. In 1910 the New York state government began purchasing the principal springs to protect them from exploitation. When Franklin Delano Roosevelt was governor of New York, he pushed for a European type of spa development at Saratoga. The architects for the new complex spent two years studying the technical aspects of bathing in Europe. Completed in 1933, the development had three bathhouses — Lincoln, Washington, and Roosevelt — a drinking hall, the Hall of Springs, and a building housing the Simon Baruch Research Institute. Four additional buildings composed the recreation area and housed arcades and a swimming pool decorated with blue faience terra-cotta tile. Saratoga spa's Neoclassical buildings were laid out in a grand manner, with formal perpendicular axes, solid brick construction, and stone and concrete Roman-revival detailing. The spa was surrounded by a 1,200 acre natural park that had 18 miles of bridle paths, \"with measured walks at scientifically calculated gradients through its groves and vales, with spouting springs adding unexpected touches to its vistas, with the tumbling waters of Geyser Brook flowing beneath bridges of the fine roads. Full advantage has been taken of the natural beauty of the park, but no formal landscaping.\" Promotional literature again advertised the attractions directly outside the spa: shopping, horse races, and historic sites associated with revolutionary war history. New York Governor Herbert Lehman opened the new facilities to the public in July 1935.
Other leading spas in the country during this period were French Lick, Indiana; Hot Springs and White Sulphur Springs, West Virginia; Hot Springs, Arkansas; and Warm Springs, Georgia. French Lick specialized in treating obesity and constipation through a combination of bathing and drinking the water and exercising. Hot Springs, Virginia, specialized in digestive ailments and heart diseases, and White Sulphur Springs, Virginia, treated these ailments and skin diseases. Both resorts offered baths where the water would wash continuously over the patients as they lay in a shallow pool. Warm Springs, Georgia, gained a reputation for treating infantile paralysis by a procedure of baths and exercise. President Franklin D. Roosevelt, who earlier supported Saratoga, became a frequent visitor and promoter of this spa.
By the late 1930s more than 2,000 hot- or cold-springs health resorts were operating in the United States. This number had diminished greatly by the 1950s and continued to decline in the following two decades. Today's spas emphasize dietary, exercise, or recreational programs more than traditional bathing activities. The public bathing industry remains stagnant, but companies selling the individual home spas attract a large and growing market.
Cruise ship spa – A spa aboard a cruise ship providing professionally administered spa services, fitness and wellness components and spa cuisine menu choices.
Day spa – A spa offering a variety of professionally administered spa services to clients on a day-use basis.
Destination spa - A destination spa is a facility with the primary purpose of guiding individual spa-goers to develop healthy habits. Historically a seven-day stay, this lifestyle transformation can be accomplished by providing a comprehensive program that includes spa services, physical fitness activities, wellness education, healthful cuisine and special interest programming.
Medical spa - A facility that operates under the full-time, on-site supervision of a licensed health care professional whose primary purpose is to provide comprehensive medical and wellness care in an environment that integrates spa services, as well as traditional, complimentary and/or alternative therapies and treatments. The facility operates within the scope of practice of its staff, which can include both aesthetic/cosmetic and prevention/wellness procedures and services. Mineral springs spa - A spa offering an on-site source of natural mineral, thermal or seawater used in hydrotherapy treatments.
Resort/hotel spa - A spa owned by and located within a resort or hotel providing professionally administered spa services, fitness and wellness components and spa cuisine menu choices.