TSL 5

"This idea was countenanced by the strong interest which the physician ever manifested in the young clergyman; he attached himself to him as a parishioner, and sought to win a friendly regard and confidence from his naturally reserved sensibility"(110).

Uh-oh. Roger has already found Dimmesdale out. However, as it was mentioned in class, Roger reads the heart, the scarlet letter is printed on Hester's heart, and Dimmesdale, "put[s] his hand over his heart" (109-110). Dimmesdale does that action as if his heart was in pain. Possibly the pain of being read? Roger "now dug into the clergyman's heart" (117), which may be what is causing him the pain.Roger knows because it was terribly obvious in Dimmesdale's little slips of guilt that pass by unnoticed to his loving worshipers. However, I doubt that Roger would be making him sick, unless he's trying to hint that he was wronged. Hawthorne even says it right out: "A man burdened with a secret should especially avoid the intimacy of his physician" (113).

"'They grew out of his heart, and typify, it may be, some hideous secret that was buried with him, and which he had done better to confess during his lifetime.'
'Perchance... he reanestly desired it, but could not.'
'And wherefore? ... Wherefore not; since all the powers of nature call so earnestly for the confession of a sin, that these black weeds have sprung up out of a buried heart, to make manifest an unspoken crime?'
... 'There can be, if I forbade aright, no power, short of the Divine mercy, to disclose, whether by uttered words, or by type or emblem, the secrets that may be buried with a human heart.'
... 'Then why not reveal them here?'
...'They mostly do,' said the clergyman, gripping hard at his breast as if afflicted with an importune throb of pain" (119).

Roger knows what the two are talking about, and Dimmesdale knows what he himself is speaking of. Dimmesdale does not know that Roger is aware of his sin. It is as if the two are conversing on a topic that can not speak of, because it is both a secret that they know of the incident. Speaking of it caused Dimmesdale's heart pain, as if Roger's eyes were searing into his heart, reading every last detail of his secret through his own words. Dimmesdale will be his own demise.