The medical background of Hill's pamphlet extends further back than the seventeenth century and Burton's _Anatomy_. The ancient Greeks had theorized about hypochondria: hypochondriasis signified a disorder beneath (hypo) the gristle (chondria) and the disease was discussed principally in physiological terms. The belief that hypochondriasis was a somatic condition persisted until the second half of the seventeenth century at which time an innovation was made by Dr. Thomas Sydenham. In addition to showing that hypochondriasis and hysteria (thought previously by Sydenham to afflict women only) were the same disease, Sydenham noted that the external cause of both was a mental disturbance and not a physiological one. He also had a theory that the internal and immediate cause was a disorder of the animal spirits arising from a clot and resulting in pain, spasms, and bodily disorders. By attributing the onset of the malady to mental phenomena and not to obstructions of the spleen or viscera, Sydenham was moving towards a psychosomatic theory of hypochondriasis, one that was to be debated in the next century in England, Holland, and France.[6] Sydenham's influence on the physicians of the eighteenth century was profound: Cheyne in England, Boerhaave in Holland, La Mettrie in France. Once the theory of the nervous origins of hypochondria gained ground--here I merely note coincidence, not historical cause and effect--the disease became increasingly fashionable in England, particularly among the polite, the aristocratic, and the refined. Students of the drama will recall Scrub's denial in _The Beaux' Stratagem_ (1707) of the possibility that Archer has the spleen and Mrs. Sullen's interjection, "I thought that distemper had been only proper to people of quality."