From 1903 to 1933, the Hiawatha Asylum for Insane Indians housed hundreds of inmates in Canton, SD. It closed in 1933 in a cloud of scandal and controversy. Death certificate data from deceased inmates were analyzed for diagnostic cause of death and for age. These findings were compared to a sample of non-Asylum adult deaths for the same years in the same county. The inmates died younger (average age-42), and of tuberculosis (63 of 182 deaths). The historical import of this is discussed.