Tuesday, February 3, 2009

Sanitas Per Aquas

This is an article I wrote previously for the popular NCNM journal, "The Student Naturopath". I wanted to share it again because it is something I am very passionate about. Thanks for indulging me, I hope you enjoy.

The ancient practice of the use of water as medicine has fluctuated throughout the centuries, barely resembling its popular use in spas today. The term 'spa' is thought to be derived from the phrase sanitas per aquas, which means health through water. Other names have been given to this practice such as balneotherapy, thalassotherapy, and hydropathy (hydrotherapy). The origins of the spa are found in Roman times where bathing was done for cleansing purposes. It was Hippocrates who first included bathing as part of a health program to restore the balance of bodily fluids. Bathing in public baths became commonplace.

After the fall of the Roman Empire, Christianity prohibited the use of medicinal bathing and allowed it only for prayer. During this period people went without bathing for years at a time. The first publication, a literature review, on the medicinal value of water occurred in 1553. A small number of spas existed during this time but by the 1700’s there was a French revival of spas. These spas consisted of natural hot springs for bathing, cold springs for drinking, healthy eating, purging, mud baths, and activities all under medical supervision.

The turn of the following century brought many developments in spa therapy by two people in particular: Priessnitz and Kneipp. The work of these practitioners led to the discovery that different temperatures and compositions of the water acted in different ways and they were able to individualize treatments for each patient. Kneipp also had a large impact on the people by bringing the water cure to everyone, not just the wealthy elite. He adhered to a holistic philosophy and incorporated other treatments into his program such as massage.

The popularization of the spa became apparent when hotels and guesthouses were developed around them which brought “health tourism” throughout Europe and North America. Because of this, the focus on health in spas lessened in favor of a more pleasurable social and leisure event.

With the exception of continental Europe, the last century witnessed the decline of medical spas and, more recently, the birth of the modern spa with its focus on beautification and anti-aging. An internet search of “medical spas” results in thousands of spas whose specialty is cosmetic surgery.

In North America the traditional practice of hydrotherapy is relegated to Naturopathic Physicians alone, many of whom do not have the facilities to perform these treatments on their patients. The use of water as a healing resource is being largely ignored today in medicine. Consequently, the vital force of our patients has weakened. I believe this is reflected in the fact that the average internal temperature of the human population is decreasing.

Naturopathic Physicians have an opportunity to resurrect this powerful healing modality that acts directly on the vital force. There are relatively few methods that have direct stimulatory effects on an individual’s vitality. With such a rich history and unlimited uses the simple and profound agent of water should not be allowed to slip through our fingers.


  1. Your posts are very erudite and chock full of info. I wish there was a financially sound way of making hydrotherapy part of a practice. Until then, I guess education will have to do. I think bathhouses also went out of fashion around 3 A.D. because they were found to spread disease through the aqueduct system (which was also tainted with lead). Then they swung the other way and found that being dirty made you sick too (imagine that! ha). Supposedly Hot Lake Hotel in La Grande is up and running again with their hot sulphur springs. Will have to check it out!

  2. Hi Sheryl,
    I agree, sometimes hydrotherapy can be time consuming. However it can also be a great addition to accelerate healing in your patients if you can find an efficient way to do it. It is not for every practice but you can do constitutional hydro 2 hours per week rotating 4 patients per hour. And you can do this without a sine-wave machine, however you need the tables, space (divided by a curtain or screen), and hot water. If this hydro session fills up you can even get a preceptor or ND student to assist you which frees up your time to see other patients. Now a hot soaking tub, sauna, or other expensive equipment is a challenge for sure which is why more traditional euro spas are needed in this country and this is what I am working on! Wish me luck!
    Thanks for your comment!