At this point in the play, Lady Macbeth is not in her
            right mind.  The doctor has already told Macbeth that he can't cure what is wrong with
            her.
The Thane of Fife was Lady Macduff.  Macbeth had her
            and her children murdered.  Lady Macbeth imagines that she sees the blood of Duncan (and
            Macbeth's other victims) on her hands.  If you remember, she returned the bloody daggers
            after Macbeth killed Duncan and by mistake did not leave them with the drugged grooms. 
            It was necessary for her to literally get the blood on her hands.  Her guilt drives her
            insane and she sees the evidence of her guilt, the blood, on her hands.  It is not
            literal blood at this point.  The blood becomes metaphorical, a symbol of her guilt. 
            Since she planned Duncan's murder and pushed him to do it, she is just as guilty as
            Macbeth of the bloodbath that followed.
Her guilt
            eventually drove her to commit suicide.
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