In Act 1, Scene 5, Lady Macbeth is confident, decisive, and ruthless. In this scene, she receives the letter from Macbeth that acquaints her with the Weird Sisters' statements that he would become Thane of Cawdor and king, as well as the fact that he was shortly thereafter named Thane of Cawdor. After she reads his letter, she immediately resolves that he shall be king: "Glamis, thou art, and Cawdor, and shalt be / What thou art promised" (1.5.15-18). She initially worries that Macbeth's nature "is too full o' th' milk of human kindness / To catch the nearest way" (1.5.17-18). In other words, she never doubts for a moment that Macbeth will be king; she only worries that he may be too gentle to be willing to kill Duncan in order to hurry the process along.
When she learns from a messenger that Duncan's retinue approaches, she calls his arrival at her home his "fatal entrance," letting us know that she has already, even at this early stage, conceived of a plan to have him killed so that Macbeth can take his place (1.5.46). She then requests the assistance of those supernatural spirits that "That on mortal thoughts," saying
[...] unsex me here,
And fill me from the crown to the toe top-full
Of direst cruelty. Make thick my blood.
Stop up th' access and passage to remorse,
That no compunctious visitings of nature
Shake my fell purpose, nor keep peace between
Th' effect and it. (1.5.48-54)
Lady Macbeth wants any nurturing, compassionate impulse of hers to be removed so that only her cruel and ruthless tendencies will remain. She wants to make sure that she will feel no regret so that nothing in her womanly nature might dissuade her from the course of action on which she has resolved. She requests that she be "unsex[ed]" so that she can be more like a man (or the way in which she and her society conceive of men to be): hard-hearted, implacable, and remorseless.
By Act 5, Scene 1, however, we see a very different Lady Macbeth. It is clear that her earlier to become immune to "remorse" has not been granted. As she sleepwalks, she is transported back in time to the night of Duncan's murder. She imagines that his blood is still on her hands, crying, "Out, damn spot, out, I say!" (5.1.37). Though she said right after the actual murder that "A little water clears us of this deed," it is clear that she no longer believes it to be so easy to escape one's guilt (2.2.86). Even the doctor that her servant brings to watch her recognizes that her "heart is sorely charged" (5.1.56-57). Lady Macbeth clearly feels the heavy weight of self-reproach, and even the doctor knows he cannot help her because her ailment is not a physical one, but an emotional/spiritual one.
In this scene, she recalls trying to force Macbeth to quickly move on from the guilt he felt immediately after the murder, saying, "What's done cannot be undone. To bed, to bed, to bed" (5.1.70-71). There was no point in regretting what they did then because there was nothing they could have done to change it. By this time in the play, though, it is clear that Lady Macbeth has not successfully managed to keep regret away, that her weaker (and, to her, more feminine) impulses have overcome her desire to be ruthless, and her former decisiveness -- and unwillingness to consider any other course of action -- can now be blamed for her current, sad state.
It is notable, too, that in Act 1, Scene 5, Lady Macbeth speaks in blank verse (unrhymed iambic pentameter). In Act 5, Scene 1, she speaks in prose. Often, in Shakespeare's plays, when a noble character's speech changes from verse to prose, it is an indication that they have "gone mad." Such an interpretation certainly seems to fit here given Lady Macbeth's slipping grasp on reality and her later suicide. Thus, we can also read this change in the way she speaks as further evidence of her character's transformation.
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