BADEN-BADEN, Germany -- Her blood pressure a little low, her back aching and her office job boring, Paula arrives here in an ebullient mood: Two years of constant nagging convinced her doctor to send her away for four weeks of enforced relaxation at this costly health resort.
"I knew that if I lobbied hard enough, I'd get his permission," Paula says, beaming with satisfaction.
While anyone with enough money can spend a vacation in Baden- Baden, Paula is one of 1.7 million Germans this year whose insurance companies will cover a four-week visit to a "Kur," or cure, a doctor-supervised stay in one of Germany's 226 certified health resorts specializing in treatments of thermal springs, mud baths, deep breathing and -- on the side, of course -- healthy romance.
Cures used to be popular in many countries. Here the names of the sites nearly always contain a "bad," for "bath." In America, they tend to be attached to a "spring," as in Warm Springs, Hot Springs or Sulphur Springs. Same principle.
But over the past 75 years, the natural cures in many places have been overtaken by syringes, X-rays and Jacuzzis.
zTC Only Germans have remained true believers, outcuring their closest competitor, France, by a rate of 3-to-1. After the family doctor and the hospital, the cure is the official "third pillar" of German medicine. More than $35 billion is spent on them every year.
Almost all the Continent's 1,100 known natural health resorts are found in Central Europe. Cities like Baden-Baden, Aachen and Cologne owe their history to the warm-water longings of Roman and medieval emperors, not to mention the new rich. Other towns have acquired the coveted "Bad," title later, allowing them to open lucrative, government-approved cure resorts.
For many Germans like Paula, a visit to a health resort in a picturesque town has become something to campaign for as often as possible, which for most people is every four years. Eventually they convince the doctor of their need, and their health insurance pays. Those with state health insurance usually get less chic resorts, but they still cost up to $2,000 a month for a regimen that includes supervised treatment, a special diet and a variety of aerobic, sport and relaxation programs.
All this would be well and good, but many have their doubts that the experience is more than an extra month of vacation every few years, while others think cures are too short to do any long-term good.
"Cures are misunderstood by the modern consumer as something to snap up and enjoy," says Johannes August Laberke, a medical professor at the University of Tuebingen.
Chancellor Helmut Kohl took the cure this month at a place in Bavaria, hoping that he could sweat off a few pounds from the famous girth and come out of it with a fresh outlook on life. At the end, however, he was greeted by the worst nationwide public sector strikes in five decades.
Even if the cures do work, the reasons are sometimes uncertain. Patients with lower abdominal infections usually get sent to health resorts near moorland; although they report fewer infections the following year, doctors do not know why.
Other cures seem easier to explain. Children with respiratory problems, many of whom come from polluted industrial regions, go to fresh-air cures, where they spend 30 minutes a day in baths filled with thermal salt water. Later they take walks around 10-foot high piles of pine needles, which are sprinkled with hot mineral water and emit invigorating vapors. The rest of the day the youngsters eat big meals and play. Many people say such cures changed them from pale scarecrows into robust toddlers.
Adults on a cure also play -- or play around -- activity that put the cures into some disrepute during the Middle Ages because of the spread of venereal diseases. It took the 19th-century's Romantic back-to-nature movement to restore a measure of dignity to the cure sojourn.
Still, cures retain a slightly decadent reputation. Paula, and most singles who arrive for their four-week stay, look forward to finding a "cure shadow," something that even Germany's greatest poet, Johann Wolfgang von Goethe, seemed to find a most important part of the whole experience.
After visiting Carlsbad in 1795, he observed: "A small liaison is the only thing that can make a stay in a bath bearable, otherwise one would die of boredom."