Why did I not die?

Karenin returns to his wife, who has been crying, and repeats his gratitude for her confidence, calling her 'thou' in Russian, which always irritates her. He agrees there is no need for Vronsky to call; she hears the phrase and thinks of a man who wanted to die for her and has ruined himself, and presses her lips together. She finishes his sentences to spare herself his slowness, and looks at his swollen-veined hands with a physical repulsion she blames herself for and cannot overcome. Told the wet-nurse may have no milk, she flares: she had begged to nurse the child and was refused, and now the blame is hers — 'Oh God, why did I not die?' — then apologises and asks him to go. Leaving, Karenin concludes it cannot go on. He would accept almost anything, even the renewal of the affair, so long as no slur touched the children and his position stood; but he knows the world will not let him do the thing that seems natural and good, and will require of him what is wrong.

Grace cannot survive a marriage in which one party cannot bear the other's hands. Tolstoy gives Anna's repulsion as an involuntary physical fact she condemns in herself, which removes any question of blame and any hope of repair. Karenin's closing position — willing to tolerate almost anything, prevented by everyone — is the fairest and bleakest statement of his case in the novel.