The History of Ketchup: From Medicine to the World’s Favorite Condiment

Few foods are as universally recognized as ketchup. Found on diner tables, fast food trays, and kitchen cupboards around the globe, the thick red sauce is often taken for granted as a simple accompaniment to fries or burgers. Yet ketchup’s story is anything but simple. Before it became the sweet tomato-based condiment we know today, ketchup was a fermented fish sauce, a staple of colonial trade, and even marketed as a medicine.

This journey from remedy to recipe tells us much about the history of food, global exchange, and the way culinary traditions evolve.

Origins: Ketchup Before Tomatoes

The earliest ancestor of ketchup has little to do with tomatoes. The word “ketchup” is thought to derive from the Hokkien Chinese word kôe-chiap or the Malay kicap (later anglicized as catchup or catsup), meaning a fermented fish brine. Traders in Southeast Asia during the 17th century encountered this salty, umami-rich sauce and brought it back to Europe.

In the ports of Malaya and Indonesia, British and Dutch sailors acquired a taste for the condiment and tried to recreate it at home. Without access to the original ingredients, they experimented with substitutes like anchovies, mushrooms, walnuts, and oysters. Early ketchup recipes in 18th-century England read more like instructions for soy or Worcestershire sauce than for anything involving tomatoes.

The Arrival of the Tomato

Tomatoes were long viewed with suspicion in Europe. As members of the nightshade family, they were once thought poisonous, and for centuries they were grown more as ornamental plants than as food. Only in the 18th century did tomatoes become widely accepted for eating, especially in Mediterranean cuisines.

By the early 19th century, American cooks began experimenting with tomato-based versions of ketchup. These were often homemade, with recipes varying from household to household. Tomato ketchup was tangier and sweeter than earlier fish or mushroom ketchups, and it quickly gained popularity in the United States.

Ketchup as Medicine

In a surprising twist, ketchup’s first major commercial breakthrough was not as a food, but as a medicine. In the 1830s, Dr. John Cook Bennett, an Ohio physician, promoted tomato ketchup as a cure for indigestion, jaundice, diarrhea, and even rheumatism. He claimed that tomatoes themselves contained medicinal properties, and that ketchup was an easy way to consume them.

Pharmaceutical companies capitalized on this idea, producing “tomato pills” that were essentially concentrated ketchup tablets. For several years, tomato ketchup was marketed in apothecaries and sold as a health tonic. Of course, the medical claims were unproven, and by the 1850s ketchup’s reputation as a medicine faded. But its popularity as a flavorful sauce was only just beginning.

Industrialization and Heinz

The late 19th century transformed ketchup from a homemade recipe into a mass-produced product. One of the biggest challenges early manufacturers faced was preservation. Before refrigeration, ketchup spoiled quickly, and many producers added dangerous preservatives like coal tar, boric acid, or even formalin.

This changed with Henry John Heinz, who in 1876 introduced his company’s iconic tomato ketchup. Heinz insisted on using ripe red tomatoes, vinegar, sugar, and spices — no harmful additives. His product was thicker, richer, and safer than competitors’, setting the standard for the ketchup we know today.

Heinz also pioneered modern branding and marketing. The “57 varieties” slogan and iconic glass bottle helped cement ketchup as a household staple. By the early 20th century, Heinz ketchup had become not just America’s favorite condiment but also a global export.

Ketchup Around the World

Although Heinz and its competitors dominated in the United States, ketchup took on new lives abroad. In the Philippines, banana ketchup became popular during World War II, when tomatoes were scarce but bananas were plentiful. Invented by Filipino food technologist Maria Orosa, banana ketchup remains a national favorite to this day.

In Japan, ketchup became a key ingredient in dishes like omurice (omelet rice) and Napolitan pasta, showing how a Western condiment could be adapted to local tastes. Across Europe, ketchup was incorporated into sauces, stews, and fast-food culture.

Today, ketchup is consumed in almost every country, though its flavors and uses vary. Some versions are sweeter, others spicier, but the balance of tangy, sweet, and savory has made it nearly universal.

Why Ketchup Endures

Ketchup’s enduring popularity comes from its balance of flavors. With sweetness from sugar, acidity from vinegar, umami from tomatoes, and aromatic spices, ketchup hits multiple taste receptors at once. Food scientists have even argued that ketchup approaches the rare category of “umami perfection,” which explains why it pairs so well with a variety of foods.

But ketchup is more than just flavor. It is also nostalgia, branding, and habit. For many, it recalls childhood meals, barbecues, and comfort food. Its bright red color and familiar taste make it both ordinary and indispensable.

From Apothecary to Fast Food Icon

The story of ketchup illustrates the strange paths that foods can take. Born as a Southeast Asian fish sauce, remade as a tomato tonic in 19th-century America, sold as medicine, then refined by industrial innovation, ketchup has mirrored global history — trade, colonialism, science, and consumer culture.

That a sauce once sold in pharmacies as a cure for indigestion now dominates supermarket shelves as a burger topping shows how food and culture evolve together. Ketchup is not just a condiment but a story of transformation, adaptation, and enduring appeal.

A Condiment with a Past

Today, ketchup may seem ordinary, but its past is anything but. Behind every squeeze bottle is a history that stretches from Asian markets to European kitchens, American pharmacies, and global fast food chains. Once marketed as a medicine and now the king of condiments, ketchup reminds us that even the most familiar foods can have extraordinary journeys.