The dominant symbol in this scene is blood, or the imagined blood that Lady Macbeth sees on her hands which represents the guilt that she feels over the murders, the blood that she refers to is Duncan's, "the old man". But she is also stricken by the deaths of Banquo and especially that of Lady Macduff and her children, the most senseless and illogical of the murders that Macbeth commits.
She is constantly washing her hands, trying to rid herself of the blood, but she cannot. She also experiences the smell of blood, which she says all the perfume in Arabia cannot mask. The blood, like the guilt, is permanent.
She has descended into madness, dragged down by her conscience and her sense of overwhelming guilt. She actually confesses to the murders when she sleepwalks and talks in front of her servant and the doctor.
Her guilty conscience frees itself when the sub-conscious takes over during sleep. Then, as the servant has said, she says all kinds of things that she should not say.
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