My impression is a 100 years ago doctors would have been comfortable with the idea that their patient was suffering from chronic bad health with no understood cause. And then with the rise of the psychology profession anything like that was deemed psychosomatic. Impotent? Psychosomatic! Gastrointestinal problems? Psychosomatic! Feel crappy with exercise intolerance? Psychosomatic! Over the last 40 years has seen some psychosomatic! problems actually turn out to be diagnosable medical problems.