In Macbeth's opening scene, the witches say, "fair is foul, and foul is fair." How does this paradox manifest itself in Act V?

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At the beginning of the play, the witches chant "Fair is foul, and foul is fair" in unison, which is a reoccurring motif throughout the play and means that appearances can be deceiving. After Macbeth commits regicide and becomes the king of Scotland, he visits the witches again, in act 4, scene 1, to learn more about his future in hopes of protecting his title and legacy. The Three Witches offer Macbeth several enigmatic prophecies, which appear to be favorable and boost his confidence. The witches conjure several apparitions that warn Macbeth to beware of Macduff, have confidence because no man born of woman can harm him, and that he will never be defeated until Birnam Wood marches to fight him at Dunsinane Hill. Despite the favorable impressions of these prophecies, they actually foreshadow Macbeth's downfall.

In act 5, Malcolm's troops disguise themselves using branches from Birnam Wood as they march towards Macbeth's castle. The witches' prophecy is proven accurate as it appears that Birnam Woods is moving towards Dunsinane Hill. The last prophecy is also revealed to be true as Macduff informs Macbeth that he was not born naturally, and was instead "untimely ripped" from his mother's womb. Macduff then defeats Macbeth in battle and Malcolm is given the title king of Scotland. The "fair is foul, and foul is fair" motif is once again proven true in act 5 after Macbeth discovers that his presumably favorable prophecies actually lead to his demise.

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The witches' words, "Fair is foul, and foul is fair" is a recurring motif throughout Shakespeare's Macbeth as reality and fantasy merge for Macbeth and Lady Macbeth.  For, this line points to the discrepancy between reality and illusion.  Macbeth's world is a world where nothing is what it seems.  He wonders at a dagger, the ghost of Banquo, and finally the Birnam Forest. 

Ironically, what Macbeth imagines cannot happen, does.  In Act V, Scene 3, he tells the doctor to bring him his armor after him, declaring, 

I will not be afraid of death and bane
Till Birnam Forest come to Dunsinane. (5.3.68-69)

Then, in Act V, Scene 5, a messenger arrives to report that Birnam Wood appears to be moving toward Dunsinane--"nothing is what is not"; "fair is foul, and foul is fair" and the witches' prophesy that Macbeth need fear nothing until "the Wood of Birnam rise" is apparently and fatally true.

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