Karenin sees Betsy out to the hall, and when he goes back to his wife he sees that she's been crying.
Karenin appreciates Anna's decision not to receive Vronsky.
Anna learns about the doctor coming to examine the wet nurse, and gets angry that she wasn't allowed to nurse the baby herself.
Anna wonders why she didn't die, then tells Karenin to go away because she is upset and being unfair. She's behaving fretfully, weeping and lashing out.
Karenin feels utterly helpless. He feels that society is forcing him in a direction contrary to his own inner desires, a direction that he doesn't fully understand.