Poetry and Medicine XX: Shakespeare’s Macbeth

Insomnia associated with guilt.

Although we think of Shakespeare’s tragedies as plays rather than poetry, they are also mostly written in verse with ten syllables to each line. With liberal use of original metaphors, these lines from a famous tragedy are most certainly poetic.

Macbeth:

Methought I heard a voice cry 'Sleep no more!

Macbeth does murder sleep', the innocent sleep,

Sleep that knits up the ravell'd sleeve of care,

The death of each day's life, sore labour's bath,

Balm of hurt minds, great nature's second course,

Chief nourisher in life's feast,—

and later,

Lady Macbeth (rubbing her hands while sleep-walking):

          Out damned spot! Out I say!

A lot of progress has been made in the field of sleep science in recent years, but most of the restorative aspects of sleep are captured in the metaphors Shakespeare used here in the 17^th century.

After killing Duncan, King of Scotland, Macbeth and his wife who assisted him, struggle to manage their guilt.

Lady Macbeth starts to lose her mind as she becomes obsessed with seeing spots of blood on her hands that she cannot wash off. Macbeth anticipates a future in which his conscience prevents him from ever sleeping well. He thinks he hears a voice declaring that he has murdered sleep, personifying sleep as an innocent individual.

After this personification of sleep, several striking metaphors for sleep are used in rapid succession. Note that a metaphor is a figure of speech in which a term or phrase is used to suggest a resemblance to something else, not literally related. This often produces a colourful illustration. If the words ‘like’ or ‘as’ are used in making the comparison, the figure of speech is called a simile rather than a metaphor. A metaphor is often more striking, more dramatic. Sleep is the death of each day’s life. Wow!

Shakespeare displays impressive insights into psychology and sleep physiology. In these wonderful metaphors, the role of sleep is acknowledged in restoring the effects of care or anxiety, relaxation after sore labour, and the soothing of hurt minds.

I find the last illustration, of sleep providing nourishment in life’s feast, particularly satisfying in the light of our recent understanding that our brains are flushed with cerebrospinal fluid during sleep. This has nutritional and waste-removal benefits in addition to that provided through cerebral blood circulation. It now also seems that chronic sleep deprivation is a contributing factor in the development of dementia.

In Shakespeare’s time, few people would have access to poetry in written form. They were very astute at listening and at retaining much of what they heard. Shakespeare gave them plenty of choice phrases and lines to enjoy, their recall aided by the vivid metaphoric illustrations that he was a master in painting with words.