Sarah Shelton Henry died at Scotchtown in Hanover County, Virginia, in the spring of 1775, after several years of serious mental illness. Accounts place the onset after the birth of her last child, Edward, and describe Patrick Henry's decision to have her cared for at home rather than sent to the new hospital in Williamsburg. Later descriptions include confinement in a cellar room, attendance by a servant, and the use of restraint. These reports reflect the limited and often harsh responses available to families confronting mental illness in the eighteenth century; they do not establish a modern psychiatric diagnosis. Nor does a history of mental illness alone identify the immediate physical cause of her death. The supplied account does not provide a dependable medical chart or a precise day of death. Her burial is traditionally placed near the house, but its exact location remains uncertain. The final years can be described as a period of grave illness and restricted life at home, while specific final symptoms, treatment, attendants at the moment of death, and last words cannot be responsibly reconstructed from the material available.