Here's a short story:

CHAPTER SEVEN. 

A LEARNED SQUABBLE. 

Bartolommeo Scala, secretary of the Florentine Republic, on whom Tito Melema had been thus led to anchor his hopes, lived in a handsome palace close to the Porta Pinti, now known as the Casa Gherardesca. His arms-- an azure ladder transverse on a golden field, with the motto _Gradatim_ placed over the entrance--told all comers that the miller's son held his ascent to honours by his own efforts a fact to be proclaimed without wincing. The secretary was a vain and pompous man, but he was also an honest one: he was sincerely convinced of his own merit, and could see no reason for feigning. The topmost round of his azure ladder had been reached by this time: he had held his secretaryship these twenty years-- had long since made his orations on the _ringhiera_, or platform of the Old Palace, as the custom was, in the presence of princely visitors, while Marzocco, the republican lion, wore his gold crown on the occasion, and all the people cried, "Viva Messer Bartolommeo!"--had been on an embassy to Rome, and had there been made titular Senator, Apostolical Secretary, Knight of the Golden Spur; and had, eight years ago, been Gonfaloniere--last goal of the Florentine citizen's ambition. Meantime he had got richer and richer, and more and more gouty, after the manner of successful mortality; and the Knight of the Golden Spur had often to sit with helpless cushioned heel under the handsome loggia he had built for himself, overlooking the spacious gardens and lawn at the back of his palace.  (End of story)

Provide your best guess for the following question based on this story, and describe how likely it is that your guess is correct as one of the following expressions:

Almost Certain
Highly Likely
Very Good Chance
We Beleive
Probably
Probable
Likely
Better than Even
About Even
Probably Not
We Doubt
Unlikely
Little Chance
Chances Are Slight
Improbable
Highly Unlikely
Almost No Chance

Give ONLY the guess and your confidence, no other words or explanation. For example:

Guess: <most likely guess, as short as possible; not a complete sentence, just the guess!>
Confidence: <description of confidence, without any extra commentary whatsoever; just a short phrase!>

Here are a few examples of questions and answers:

Question: Was the secretary a humble man?
Guess: no
Confidence: <appropriate level of confidence in this guess>

Question: What kind of man was he?
Guess: a vain and pompous man
Confidence: <appropriate level of confidence in this guess>

Question: Was his palace ugly?
Guess: no
Confidence: <appropriate level of confidence in this guess>

Question: What was the name of it?
Guess: the Casa Gherardesca
Confidence: <appropriate level of confidence in this guess>

Question: What did his parent do for a living?
Guess: a miller
Confidence: <appropriate level of confidence in this guess>

Question: How did he make it to where is is now?
Guess: his own merit
Confidence: <appropriate level of confidence in this guess>

Question: Was he proud of this achievement?
Guess: yes
Confidence: <appropriate level of confidence in this guess>

Now answer the following question in the same format.

Question: What type of medical problem did he have?

gout