"The Invalid's Story" is among Mark Twain's "scatological" pieces, "immensely true," De Voto writes, "to one kind of humor of the frontier and of Mark Twain." Gibson links it to "1601," though he claims that more notorious piece is "formless and even mild" when read juxtaposed to "The Invalid's Story." Additional parallels might be drawn to "Cannibalism in the Cars" (1868) and "The Great Prize Fight" (1863), sketches that depend for their effect on what Bellamy calls "the primitive humor of cruelty." Horowitz sees in the story a preview of the cynicism characteristic of Mark Twain's later writings on institutionalized religion. The indelicate—some would say offensive—subject and tone of the story, written in 1877, should give pause to those who emphasize Mark Twain's overzealous desire to placate his wife's genteel tastes or his surrender to her heavy editorial hand in the decade following their marriage.

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