The phrase comes from the end of Act II scene 1, where Macbeth ponders killing Duncan. He clutches a dagger, and proceeds to consider and examine his thoughts about murder, the dagger itself becoming the physical embodiment of the act. He then questions himself, "Is this just a dagger, or is this murder?" Or in other words, "am I really going through with this act?" and these heavy thoughts cause and continue to cause more heavy thoughts, originating from a "heat oppressed" (headache?) brain.
Later in the soliloquy, he mentions the phrase "heat of deeds," heat in the passage suggesting passion; he's therefore not thinking logically, but reacting emotionally to the murder he's about to commit.
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