each specific malady, while another focused primarily on German spas and hydropathic establishments, but including other areas. While many bathing establishments were open all year round, doctors advised patients not to go before May, "nor to remain after October. English visitors rather prefer cold weather, and they often arrive for the baths in May, and return again in September. Americans come during the whole season, but prefer summer. The most fashionable and crowded time is during July and August". In Europe, interest in various forms of hydrotherapy and spa tourism continued unabated through the 19th century and into the 20th century, where "in France, Italy and Germany, several million people spend time each year at a spa." In 1891, when Mark Twain toured Europe and discovered that a bath of spring water at Aix-les-Bains soothed his rheumatism, he described the experience as "so enjoyable that if I hadn't had a disease I would have borrowed one just to have a pretext for going on". This was not the first time such forms of spa tourism had been popular in Europe and the U.K. Indeed, in Europe, the application of water in the treatment of fevers and other maladies had, since the seventeenth century, been consistently promoted by a number of medical writers. In the eighteenth century, taking to the waters became a fashionable pastime for the wealthy classes who decamped to resorts around Britain and Europe to cure the ills of over-consumption. In the main, treatment in the heyday of the British spa consisted of sense and sociability: promenading, bathing, and the repetitive quaffing of foul-tasting mineral waters. A hydropathic establishment is a place where people receive hydropathic treatment. They are commonly built in spa towns, where mineral-rich or hot water occurs naturally. Several hydropathic institutions wholly transferred their operations away from therapeutic purposes to become tourist hotels in the late 20th century whilst retaining the name 'Hydro'. There are several prominent examples in Scotland at Crieff, Peebles and Seamill amongst others. Other animals Canine hydrotherapy is a form of hydrotherapy directed at the treatment of chronic conditions, post-operative recovery, and pre-operative or general fitness in dogs. See also Balneotherapy or "bath therapy" Colon cleansing Destination spa Enema Finnish sauna Halliwick Hot tub Mineral spring Sebastian Kneipp Kneipp facility Spa Spa bath Spa town Spotted Lake (Kliluk) Steam shower Thalassotherapy Water aerobics Notes a. While the second sense, of water