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When asked if she knows the reason her mother wears the red letter, Pearl exclaims that she does and explains (pg. 171 of my copy), "It is for the same reason that the minister keeps his hand over his heart!"
Though Pearl goes on to say that she doesn't know the reason for Dimmesdale's placing of his hand on his heart, she is aware of the connection, which is indicative of Pearl's powers of observation as well as the possibility that others have noticed.
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