Histories of spas generally focus on a particular place or region. David Clay Large's lively study ignores the myriad of smaller, lesser-known establishments of Central European spa culture, concentrating instead on the truly grand Kurorte and situating them within an unusual narrative that embraces not only their individual histories, but also their role in European social, political, and cultural history. Scholarly studies of the spas usually prioritize either their therapeutic, medical function or their role as pleasure resorts. Large's ambitious survey not only covers both of these functions but also does so over a vast timespan.

Beginning with an outline of classical spa culture and its decline, Large takes the reader through to the Renaissance and the rise of court and urban spas, and then to their transformation into the highly profitable and architecturally imposing grand Kurorte of the nineteenth century, which experienced a “golden age” in the decades before World War I. The story of spa culture in the twentieth century is generally one of decline, though the epilogue considers the modest present-day revival, thanks to new capital investment in luxury wellness, gambling, and conference centers.

The first half of the book covers relatively familiar ground, including an array of glittering royal patrons, as well as many of the prominent personalities, entrepreneurs, adventuresses, writers, musicians, and composers who hoped to find business opportunities, health, fortune, patrons, and romantic encounters in these cosmopolitan and high-class health resorts. Large uses racy tales of the personal woes and ambitions of famous figures—such as Johann Wolfgang von Goethe, Feodor Dostoyevsky, Ivan Turgenev, Ludwig van Beethoven, Friedrich Liszt, Richard Wagner, and Lola Montes—to explore wider aspects of the European social, cultural, and political scene, as well as to demonstrate the growing attraction of the grand Kurorte for the European haute bourgeoisie as these sites developed into international leisure resorts, centers of influential cultural activity and transfer, and disseminators of fashion. Later chapters dealing with figures such as Karl Marx, Mark Twain, and Hermann Göring, follow a similar pattern.

The spas were, above all, important economic endeavors. Distinguished by their cosmopolitan clientele, they attracted a workforce that was often as international as the wealthy elites they served. Large does not really discuss the competitive relationship among spas that served as an important stimulus for the development of new initiatives and improvements to infrastructure, such as the use of green spaces to camouflage signs of urbanization. A strength of the narrative is nevertheless the way it maps out the impact of external technological, social, and political developments on spa culture—at the same time demonstrating the importance of this culture to broader European cultural life.

Wars brought in the wounded and the military, exiles, and refugees. The rise of the Napoleon family was good for business generally and contributed to the resurrection of Baden-Baden. Louis Philippe's prohibition of gambling in France also benefited that city and Wiesbaden, where entrepreneurial Frenchmen set up the casinos that would play such a large role in these cities’ transformation into luxury leisure resorts. When political events in Germany and the imposition of Prussian prohibitions on official forms of gambling threatened their wellbeing, both spas transformed themselves by instituting fashionable new medical regimes and building increasingly grand treatment centers and leisure amenities.

Leading diplomats, politicians, and crowned heads combined curing, sociability, and business in well-appointed and relatively secluded locations: “pleasant nests in which to do occasional bad business” (270). Large gives a brisk account of the role that these visits played in some of the major diplomatic and political events of modern European history. Diplomatic congresses typically brought in customers, though the outcomes of political intrigues, such as the Karlsbad Decrees of 1819 and the Ems Dispatch of 1870, could have an unfavorable, if temporary, impact on customer traffic. In the later decades of the nineteenth century, growing ethnic rivalries encouraged a trend toward thermal nationalism that reflected growing international tensions, notably after the Franco-Prussian war of 1870–1871. Greater accessibility, as well as economic and social change, heightened demand, changing the visitor profile and the nature of spa life, which became more socially fragmented as individual groups of visitors grew more exclusive.

Shifts in medical theory and practice created competition from the new Luftorte (air resorts), while Jews—excluded from many areas of conventional medicine—found their way into spa medicine once fashionable diagnoses began to focus on psychological disorders that were often treated in the new private clinics. At the same time, spa resorts, particularly the Bohemian Kurorte, became increasingly popular with Jewish communities, whose relationship with the spas is one of the main themes running throughout the book. Large shows how antisemitism impinged on spa life and was given a powerful new impetus in the post-World War I era.

The book's later chapters are the most interesting because in them, Large uses the fate of the grand Kurorte to track the spas’ journey through the vicissitudes of the two world wars. Tracing their effect on central European life, he follows them through the collapse of the Habsburg Monarchy; the difficult years of the Weimar Republic and the Nazi era, when the spas became “judenfrei” and a “branch of the German war machine” (319); and the postwar division between East and West. He concludes with his personal experience of spa towns after the collapse of the Eastern Bloc.

Though Large draws on a wide range of primary sources, including local newspapers, archival sources, and memoirs, as well as secondary material, he has chosen to eschew the usual academic apparatus for a more popular approach, merely listing principal sources and suggestions for further reading. Moreover, as the author acknowledges, the book is the outcome of a longstanding personal interest, especially for Baden-Baden; as a result, it adopts a personal tone at some points. It is nonetheless a valuable, highly informative, and readable contribution to the cultural and political history of the grand spas.