“Let food be thy medicine and medicine be thy food.” This famous quote is attributed to Hippocrates, the Father of Medicine. One formerly medicinal food that is still a staple in American cuisine is ketchup, or rather tomato ketchup, but it may not be what is exactly in our pantries today.

The food we know as ketchup was originally a fermented sauce containing fish entrails, meat and soybeans that came from southern China. Prior to modern methods of food preservation, most cultures relied on drying, salting and fermenting to preserve food.

The fermented fish sauce could survive long sea voyages without spoiling. In the 1700s, European traders were introduced to this salty, tangy sauce and grew to love it. They took it home and quickly adapted the original recipe to local ingredients and tastes. There was ketchup made from anchovy and stale beer, walnut ketchup, mushroom ketchup and ketchup made from fruits.

In 1812, James Meade was the first to create a tomato ketchup and by 1834, Ohio physician Dr. John Cook Bennett had created a tomato ketchup he sold as a medicine, eventually making a concentrated pill form. Cook claimed his ketchup could cure diarrhea, jaundice, indigestion and more.

Cook’s tomato ketchup was popular and quickly inspired copycats. Tomatoes were only in season two months of the year, so to meet demand, makers filled their ketchup with rotten tomatoes, adding harmful chemicals to maintain color and keep the finished product from spoiling. Ironically, what started as a fermented fish sauce popular for its ability to survive long sea voyages was now a chemical-laced medicine prone to spoilage. Not surprisingly, demand for this medicine died out by the early 1850s.

In 1857 Heinz introduced its new recipe for tomato ketchup, sold as a relish rather than a medicine. Their recipe used riper tomatoes with a higher pectin content and distilled vinegar to overcome the problem of preservation. The Heinz product was advertised as being made from superior materials in clean kitchens and free from drugs. To show they had nothing to hide, their ketchup was sold in their now iconic glass bottles, allowing the consumer to see exactly what they were buying. Tomato ketchup slowly grew in popularity to be the all-American condiment that we know and love today.

Although tomato ketchup’s popularity as a medicine was short lived, it may not have been such a far-fetched idea. Fermented foods are currently enjoying a resurgence in popularity, not as a preservation method, but for their health benefits. You can easily find recipes online for lacto-fermented ketchup claiming many of the same benefits as Dr. Cook’s medicinal ketchup. Perhaps someone will start marketing one of these recipes soon. Then we can enjoy telling ourselves it’s healthy to cover our fries in ketchup.

Crytal Kelly is a  feature writer for Bizarre Bytes with those unusual facts that you only need to know for Trivial Pursuit or Jeopardy or to stump your in-laws.