The sweat lodge is also called a medicine lodge, medicine house, or simply a sweat. Vapour Baths were the Native American equivalent of a modern day sauna and these are also described in this article.

The Native American Sweat Lodge
Only a Medicine Man has the right to build a Sweat Lodge. The building of a sweat lodge is his responsibility but he has helpers who work to build the sweat lodge under his direction. The sweat lodge in usually a temporary structure and built  as a domed structure. Stones were either heated in an exterior fire. The hot stones were placed in a pit in the center of the Sweat Lodge and cold water was poured on them to create the steam that would purify and cleanse the participants in the ritual.

Building a Sweat Lodge
The procedure for building the dome style sweat lodge is as follows:

• Location: The ideal location for a Sweat Lodge was near water
• Orientation: The door is a small, crawl-in entryway and usually faces The entrance always faces west, and the Evening Star
• Building materials: Flexible wood or saplings such as willow
• Gather enough poles to create the sweat lodge. The sizes of a sweat lodge varied according to requirement and were built for a minimum of 2 people but many lodes were able to seat more than ten people. The Kiowa built their sweat lodge with a framework of 12 reeds, or saplings, but other tribes used more
• The diameter and shape of the sweat lodge was traced on the ground
• The thick end of the poles were placed into the earth and their tops bent over to form a dome structure
• The joints of the poles were wrapped with twine to secure them into place
• A small, shallow pit is dug in the center of the Sweat Lodge in which the hot stones would be placed
• Cover: Animal skins and blankets were use to completely cover the frame to make sure that none of the heat or steam escaped
• A movable door flap is added to cover the entry
• The floor would be covered with aromatic herbs such as wild sage
• The Medicine man would place the symbol of his spirit guide, or Power Animal, which was often an animal skull, at the entrance of the Sweat Lodge

Sweat Lodge Rituals
Sweat lodges were built for the purpose of a sweat ceremony or cleansing ritual and used in purification ceremonies for healing purpose, to mark special events or for rites of passage rituals. A Sweat Lodge ritual would be performed under the leadership of the Medicine Man, or Shaman, and would follow a ritual in four parts, with the pipe bowl being filled four times, in the following manner:

• The participants crawl through the doorway and enter the Sweat Lodge clockwise and sit in darkness in a circle
• The sweat begins when the Medicine Man conducts an opening prayer with the pipe raised to Grandfather Sky, Grandmother Earth and the Four Directions. The pipe is passed around the circle and smoked by each participant and the men shake their rattles and chant songs and incantations as the Medicine Man summons the power of his Power Animal. The end of the first part of the ritual is signalled by the Medicine Man and the rattles are shaken four times. A second set of heated rocks are placed in the Sweat Lodge
• Prayers are then offered for the universe, the animals, the birds, the plants, the water spirits and all of mankind and the ritual involving the pipe, chants and the rattles are repeated
• Prayers are then made for all the participants and their families and the ritual repeated
• The fourth stage includes prayers for strength and to the spirit deities and the ritual repeated
• Each participant then silently prays to the Great Spirit and their Medicine Animal
• Everyone then leaves the Sweat Lodge, the ritual complete

Permanent Sweat Lodges - Vapour Baths
For permanent Sweat Lodges, or Vapour Baths, support poles were added to the construction as shown in the following picture. These were the Native American equivalent of a modern day sauna and designed for the same purpose. In 1832 George Catlin wrote a description of a type sweat lodge he called a vapour bath or sudatory, used by the Mandan tribe in his book entitled 'Letter and Notes on the Manners, Customs and conditions of North American Indians'. A sudatory, or sudatorium, was a bathhouse for hot air baths or steam baths. There were several of these bathing facilities available to the men, women and children of the tribe, sick or well, young or old. George Catlin described to these bathing facilities as:

"...an everyday luxury by those who have the time and energy to indulge in it; and also used by the sick as a remedy for nearly all the diseases which are known amongst them."

In his description Catlin explains that the Vapour Baths (or public sweat lodge), were set away from the village. They were housed in a tepee which contained a bathing crib. Red hot stones were heated outside the lodge and carried in and placed under the bathing crib. The bather threw cold water over the red hot stones releasing a profusion of exhilarating vapour which was drawn into the lungs and pores. During the bathing the lodge is tightly shut. When finished the bather would then plunge into the cold, nearby stream.