Before the Medicine Lodge is erected, four large sweat lodges are built, all in a line, fronting to the east or toward the rising sun.  Two stand in front of the Medicine Lodge, and two behind it.  The two nearest the Medicine Lodge are built one day, and the others on the day following.  The sticks for the framework of these lodges are cut only by renowned warriors, each warrior cutting one, and, as he brings it in and lays it down, he counts a coup, which must be of some especially brave deed.  The old men then take the sticks and erect the lodges, placing on top of each a buffalo skull, one half of which is painted red, the other black, to represent day and night, or rather the sun and the moon.  When the lodges are finished and the stones heated, the warriors go in to sweat, and with them the medicine pipe men, who offer up prayers.

While this is going on, the young men cut the centre post for the Medicine Lodge, and all the other material for its construction.  The women then pack out the post and the poles on horses, followed by the men shouting, singing, and shooting.

In the morning of this day the medicine woman begins a fast, which must last four days and four nights, with only one intermission, as will shortly appear.  During that time she may not go out of doors, except between sunset and sunrise.  During the whole ceremony her face, hands, and clothing are covered with the sacred red paint.

When all the material has been brought to the spot where the lodge is to be erected, that warrior who, during the previous year, has done the most cutting and stabbing in battle is selected to cut the rawhide to bind it, and while he cuts the strings he counts three coups.

The centre post is now placed on the ground, surrounded by the poles and other smaller posts; and two bands of the I-kun-uh’-kah-tsi, the Braves, and the All Crazy Dogs approach.  Each band sings four songs, and then they raise the lodge amid the shouting of the people.  It is said that, in old times, all the bands of the I-kun-uh’-kah-tsi took part in this ceremony.  For raising the centre post, which is very heavy, lodge poles are tied in pairs, with rawhide, so as to form “shears,” each pair being handled by two men.  If one of the ropes binding the shears breaks, the men who hold the pair are said to be unlucky; it is thought that they are soon to die.  As soon as the centre post is up, the wall posts are erected, and the roof of poles put on, the whole structure being covered with brush.  The door-way faces east or southeast, and the lodge is circular in shape, about forty feet in diameter, with walls about seven feet high.