In the United Slates, natural springs, especially geothermal ones, have gone through three stages of development: (i) use by Indians as a sacred place, (2) development by the early European settlers to emulate the spas of Europe, and (3) finally, as a place of relaxation and fitness. The main reasons that people in the U.S.A. visit geothermal spas today are to improve their health and appearance, to escape stress, and to refresh and revitalize their bodies and minds. Unlike European spas, where medical cures of specific ailments are more important, U.S. spas place more emphasis on exercise,on reducing stress, on lifting depression, and on losing weight. Soaking in hot tubs and pools, as well as in natural primitive hot springs, is a favorite pastime. There are over 115 major geothermal spas in the U.S.A., and many more smaller ones, along with thousands of hot springs. The majority of these are located in the volcanic regions of the western states, but several famous ones still exist in the east. The major spas are estimated to have an annual energy use of 1.53 x 10(12) kJ (46 x 10(3) TOE). Most of the geothermal heat is used in bathing, and very little for space heating.