In this scene, Lady Macbeth is presented as overwrought and restless, so much so that she cannot sleep and has taken to somnambulism. She consistently walks in her sleep so much that it has alarmed one of her gentlewomen to such an extent that she has reported her lady's strange conduct to the doctor. At the beginning of the scene she informs him:
... I have seen
her rise from her bed, throw her night-gown upon
her, unlock her closet, take forth paper, fold it,
write upon't, read it, afterwards seal it, and again
return to bed; yet all this while in a most fast sleep
When the doctor asks her what Lady Macbeth had to say whilst she was in this state, the gentlewoman refuses to repeat what she had heard, stating that she cannot say it to anyone since she has no witness to confirm her report.
At this point, Lady Macbeth enters with a candle. The gentlewoman reports that Lady Macbeth had commanded that that there continuously be light next to her bed. It appears that she has grown afraid of the dark. The two witness her walking with the candle, open-eyed but with no sense of sight, since she is fast asleep. The Lady then starts rubbing her hands and the gentlewoman says about this:
It is an accustomed action with her, to seem thus
washing her hands: I have known her continue in
this a quarter of an hour.
Lady Macbeth then begins to speak, saying firstly, "Out damned spot." She perceives a mark on her hand and wishes to erase it. Witnessed by the doctor and gentlewoman, she furthermore utters:
Out, damned spot! out, I say!--One: two: why,
then, 'tis time to do't.--Hell is murky!--Fie, my
lord, fie! a soldier, and afeard? What need we
fear who knows it, when none can call our power to
account?--Yet who would have thought the old man
to have had so much blood in him.
She seems to be hallucinating and her speech is garbled. In her confusion she refers to her husband, asking him to flee, and then is suddenly critical of him. She then gives the assurance that they should not fear since none can call them to account. She then suddenly refers to Duncan's murder, stating that no one could have expected him to have so much blood.
Lady Macbeth then makes reference to Lady Macduff, who Macbeth has murdered. She then promptly refers to the supposed blight on her hands and refers to Macbeth again, stating that he spoils everything with his sudden shows of fear. The doctor is shocked by this and instructs the gentlewoman to leave since she has heard what she should not. Lady Macbeth continues in her somnambulistic state and remarks:
Here's the smell of the blood still: all the
perfumes of Arabia will not sweeten this little
hand. Oh, oh, oh!
She is clearly obsessed by the stain on her hand and its bloody smell. Her cry is a piteous wail, for she believes that the smell and the stain are impossible to remove. In her delirium, Lady Macbeth imagines that her husband is with her and instructs him to dress for bed and not look so afraid since Banquo's buried and obviously cannot return from the grave - a reference to Macbeth's fear when he saw Banquo's ghost. She then asks that Macbeth come to bed since there's "knocking at the gate," an obvious reference to the period just after they murdered the king. She beseeches the imagined Macbeth to come to bed since they cannot undo what they have done. The gentlewoman tells the doctor that she will now go directly to bed.
It is clear that Lady Macbeth is overwhelmed by remorse. She is so stricken by guilt that it sits on her conscience constantly so that she cannot sleep. She and her husband's evil has enveloped her completely and she realizes that she cannot undo the harm that they have done. She is haunted by images of their malevolence and is a tortured, pitiful soul.
The Lady Macbeth we witness here is in direct contrast to the forthright and ruthless conspirator we have come to know earlier in the play. She then had no qualms in encouraging her husband to commit the most pernicious evil. At one point, when Macbeth expressed doubt about assassinating the king, she said the following:
... I have given suck, and know
How tender 'tis to love the babe that milks me:
I would, while it was smiling in my face,
Have pluck'd my nipple from his boneless gums,
And dash'd the brains out, had I so sworn as you
Have done to this.
This illustrates the degree of remorseless evil she was prepared to commit to. She had no reservations about doing whatever was necessary to achieve their ambition. When Macbeth fears that they could fail, she says:
... What cannot you and I perform upon
The unguarded Duncan? what not put upon
His spongy officers, who shall bear the guilt
Of our great quell?
In this instance, she had already planned to intoxicate Duncan's guards by plying them with alcohol and adding a potion to their drink so that they would sleep like swine and not remember anything, whilst they committed their dastardly deed. She displayed such depth of savagery and ruthlessness that her husband commented:
Bring forth men-children only;
For thy undaunted mettle should compose
Nothing but males.
Lady Macbeth has now lost this undaunted fervor and has become a miserable, overwrought, and paranoid version of her former self. She has been overwhelmed by the cruelty and overly sanguine nature of their malice and has lost her sanity--just punishment for their greed. Eventually, she is so overcome by guilt that she takes her own life.
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