Science and Cure

The baths of Budapest have always been sold partly as medicine. This chapter asks what is actually in the water, what it has traditionally been used for, how the prescription tradition works in Hungary, and where the evidence stands. It is a historical and general account, not medical advice: anyone with a health condition should ask a doctor before relying on any claim here. Figures, names and findings are from general knowledge and flagged for checking.

What Is in the Water

Thermal water is rainwater that has been heated deep underground and has dissolved minerals from the rock it passed through. Each spring differs, but the Budapest waters are generally described as follows (check the analysis of each spring):

The water's temperature varies from lukewarm to very hot. A bath will often be a mixture of springs, cooled or heated to the required pool temperature (check).

Conditions Traditionally Treated

The baths have traditionally been used for conditions affecting joints, muscles and movement, and for general relaxation and recovery (check the list):

• Joint and muscle complaints. Arthritis, back pain and stiffness, with warm water used to ease movement (check).
• Rehabilitation. Gentle exercise in warm water after injury or surgery, which is a well-established use of any warm pool (check).
• Circulation and skin. Claims are made for these, with a weaker base of evidence (check).
• Drinking cures. Some waters were taken by mouth for digestive complaints (see Chapter 3, and check what is still done).

The Prescription Tradition

In Hungary, spa treatments have long been part of the health system, and doctors may prescribe a course of bath-based treatment, sometimes with partial public funding (check how the system works now, who qualifies and what is covered). Hospitals and clinics attached to the baths provide treatments such as medicinal baths, massage and physiotherapy by appointment. Treatments are given by trained staff, and are distinct from simply visiting the baths for pleasure (check). This is one reason the baths are seen as institutions of public health as well as leisure.

What Research Says

Reviews of the evidence on balneotherapy (treatment by bathing in mineral waters) generally report some short-term benefit for pain and function in conditions such as osteoarthritis and chronic low back pain, but the studies are often small and hard to blind, and it is difficult to separate the effect of the minerals from the effect of heat, buoyancy, rest and relaxation (check the current reviews and treat this summary with caution).

• Reasonably plausible. Warm water eases pain and stiffness and makes exercise easier, a general effect of heat and buoyancy.
• Less clear. That the specific minerals in the water have effects beyond this, whether through the skin or by drinking.
• Weak or unsupported. Broad claims that the waters cure a wide list of diseases, or detoxify the body, as sometimes found in promotional material.

Exercises