Of any symptoms of gout, for instance, of gouty swellings, we hear nothing from Luther[566] though he was wont to expatiate on his complaints, and though, according to Ebstein, he possessed a “rare knowledge of medical matters.”[567] Nor did Luther permanently suffer from sluggishness and constipation of the bowels; we hear of it only at Worms and at the Wartburg in 1521, and then again in 1525. To put down “his moodiness, melancholia and depression” as Ebstein terms the remorse of conscience experienced in 1528 at the time of his greatest “temptations” to an attack of piles, described by Luther in a letter to his friend Jonas on Jan. 6, 1528, is to misapprehend the facts of the case; for, actually, it was three years before this that Luther had for a while been troubled with hæmorrhoids, as is evident both from the text of the inquiry made by Jonas (“_ante triennium_”), and from Luther’s answer: “My illness _was_ as follows,” etc.[568] Moreover, Luther was not suffering from stone in 1521, and it is only in 1526 that we hear him speaking of it for the first time; after this the malady was for a long time in abeyance,[569] until, between 1537 and 1539, it once more attacked him severely; it is again referred to in 1543. Hence we must still await a more accurate medical diagnosis to determine—if indeed this be possible—how far the history of Luther’s outward and inward troubles was dependent on uric acid.[570] Maybe, eventually, greater stress than hitherto will be laid on Luther’s heart troubles; if so, then it will become necessary to find out what the so-called “cardiogmus” was, from which, according to Melanchthon, Luther suffered severely early in 1545; for, in his friend’s opinion, it was to this that Luther’s death later on was due.[571] Ebstein himself says of the oppression in the region of the heart and the resultant anxiety[572] from which Luther suffered, until his death was ultimately brought about by “heart failure,” that it “leads us to diagnose some heart affection”; this, according to his theory, was due, in part directly to gout, in part also to the obstinate constipation which accompanied it. According to him the periodic attacks of heart-oppression suggest heart asthma or angina pectoris, which, notoriously, often co-exists with gout.