In The Scarlet Letter how did Dimmesdale's rebellion cause him to make sacrifices in his life?

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"... the young minister at once came forward, pale, and holding his hand over his heart, as was his custom whenever his peculiarly nervous temperament was thrown into agitation. He looked now more careworn and emaciated than as we described him at the scene of Hester's public ignominy; and whether it were his failing health, or whatever the cause might be, his large dark eyes had a world of pain in their troubled and melancholy depth."

In chapter 8 of The Scarlet Letter, the audience sees Reverend Dimmesdale for the first time since the opening of the book.  He has changed since then.  He looks more tired, more pale, and more worn.  As the reader continues reading, it becomes clear that this change is self imposed as he has been punishing himself for his actions with Hester. The townspeople believe that his change is because of his dedication to his profession:

About this period, however, the health of Mr. Dimmesdale had evidently begun to fail. By those best acquainted with his habits, the paleness of the young minister's cheek was accounted for by his too earnest devotion to study, his scrupulous fulfilment of parochial duty, and, more than all, to the fasts and vigils of which he made a frequent practice, in order to keep the grossness of this earthly state from clogging and obscuring his spiritual lamp.

However, these changes in his appearance are based on self inflected fasting and torture as he punishes himself and holds all night vigils so that he can unburden himself of the guilt they feel.

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The Scarlet Letter

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