Fossils found in the town of Hot Springs, South Dakota, show that mammoths of over 20,000 years ago were attracted to the area's pools of warm water. Humans share this attraction. Native Americans considered natural hot springs to be sacred healing grounds. Throughout Europe, the ancient Romans built colossal spas, including the Baths of Caracalla. Only its ruins remain, but these baths once featured hot and cold baths, a swimming pool, a gymnasium, shops, art galleries, and acres of gardens.
Spas fell out of favor during the Middle Ages but by the 17th and 18th centuries became popular again in Europe. An interest in making use of natural resources for healing and relaxation spread. By the late 1800s there was hardly a well of natural spring water in the United States that a businessman had not capitalized upon. At the turn of the century in the United States, people visited resorts and spas (with or without natural hot springs) for exercise and relaxation. By the 1920s spas were popular retreats for the wealthy. Since that time, spas have diversified their services and attracted a wide range of visitors. Today's spas have clients ranging from busy professionals looking for several hours of stress reduction, to families looking for healthy vacations, to pregnant women seeking relaxation, to men looking to keep fit. According to the International SPA Association, there were 190 million spa visits in the United States in 2019.
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