Luther had been suffering from ill health for years, including Ménière's disease, vertigo, fainting, tinnitus, and a cataract in one eye. From 1531 to 1546, his health deteriorated further. The years of struggle with Rome, the antagonisms with and among his fellow reformers, and the scandal which ensued from the bigamy of the Philip of Hesse incident, in which Luther had played a leading role, all may have contributed. In 1536, he began to suffer from kidney and bladder stones, and arthritis, and an ear infection ruptured an ear drum. In December 1544, he began to feel the effects of angina.