The immediate cause of her attacks would generally seem to have been excitement or over-fatigue causing, in the first instance, loss of sleep, a feverish restlessness and ending in the complete overthrow of reason. "Her relapses," says Proctor, "were not dependent on the seasons; they came in hot summer and with the freezing winters. The only remedy seems to have been extreme quiet when any slight symptom of uneasiness was apparent. If any exciting talk occurred Charles had to dismiss his friend with a whisper. If any stupor or extraordinary silence was observed then he had to rouse her instantly. He has been seen to take the kettle from the fire and place it for a moment on her headdress, in order to startle her into recollection." Once the sudden announcement of the marriage of a young friend--whose welfare she had at heart--restored her, in a moment, after a protracted illness, "as if by an electrical stroke, to the entire possession of her senses." But if no precautions availed to remove the premonitory symptom, then would Mary "as gently as possible prepare her brother for the duty he must perform; and thus, unless he could stave off the terrible separation till Sunday, oblige him to ask leave of absence from the office, as if for a day's pleasure--a bitter mockery! On one occasion Mr. Charles Lloyd met them slowly pacing together a little foot-path in Hoxton fields, both weeping bitterly and found, on joining them, that they were taking their solemn way to the accustomed asylum." Holiday trips were almost always followed by a seizure; and never did Mary set out on one but with her own hands she packed a strait-waistcoat.
The attacks were commonly followed by a period of extreme depression, a sense of being shattered, and by a painful loss of self-reliance. These were but temporary states, however. Mary's habitual frame of mind was, as Talfourd says, serene and capable of placid enjoyment. In her letters to Sarah Stoddart there are some affecting and probably unique disclosures of how one who is suffering from madness feels; and what, taught by her own experience, Mary regarded as the most important points in the management of the insane. In reference to her friend's mother who was thus afflicted, she writes:--