The doctor and the gentlewoman witness Lady Macbeth sleepwalking and unconsciously revealing the guilt she has tried to suppress. They see her enter with a candle, rubbing her hands over and over as if washing them, even though no blood is actually there. As she does this, she cries, “Out, damned spot!,” imagining a stain that will not come clean, a sign that the murder of Duncan still clings to her mind.
While sleepwalking, she begins to speak fragments of past events, reliving the crimes she and Macbeth committed. She refers to Duncan’s murder with horror—“who would have thought the old man to have had so much blood in him?”—and echoes earlier conversations with her husband. She also reacts to imagined sounds, like knocking at the door, showing how vividly the night of the murder continues to haunt her. What she once dismissed—believing “a little water clears us of this deed”—has returned in a psychological form she cannot control.
The doctor and gentlewoman are deeply disturbed, not only by Lady Macbeth’s strange behavior but by what it reveals. The gentlewoman refuses to repeat everything Lady Macbeth has said, knowing it would be dangerous to speak such confessions aloud. The doctor concludes that her condition is beyond medical help, recognizing that “unnatural deeds / Do breed unnatural troubles.” They have essentially witnessed a mind that is too overwhelmed by guilt to be fixed.
This scene exposes the cost of the ambition that once drove Lady Macbeth. She had called on darkness to strip away her conscience, yet that conscience returns in the most uncontrollable way, turning secrecy into self-betrayal and power into psychological ruin.