Ketchup was originally used as a fermented fish sauce for preserving and flavoring food in southern China, dating back to at least 300 B.C. It contained no tomatoes whatsoever. Over the centuries, it morphed into a mushroom-based British condiment, then briefly became a patent medicine sold in pill form, before finally becoming the tomato sauce sitting in 97 percent of American homes today.
A Chinese Fish Sauce, Not a Tomato Condiment
The earliest versions of ketchup were fermented pastes made from fish entrails, meat byproducts, and soybeans. Chinese texts documented these pastes as far back as 300 B.C. Speakers of the Southern Min dialect called the fish sauce “ge-thcup” or “koe-cheup,” and it served a practical purpose: fermentation made it shelf-stable and easy to store on long ocean voyages. Think of it as closer to modern-day fish sauce or soy sauce than anything you’d put on a burger.
The word “ketchup” itself traces directly to this Hokkien dialect term. A Hokkien-to-English dictionary compiled by missionaries in 1873 lists pronunciations like “kôe-chiap” in one subdialect and “kê-chiap” in another. There’s a popular folk etymology in Hong Kong claiming the word comes from Cantonese “ke jiap,” meaning “eggplant sauce,” but linguists have debunked this. The name was attached to a fish sauce centuries before anyone thought to add tomatoes.
How It Jumped to Europe
British traders stationed at a trading post in Bengkulu, on the Indonesian island of Sumatra, in the 1690s are the likely bridge between Asian fish sauce and European kitchens. A 1732 recipe titled “Ketchup in Paste” specifically referenced “Bencoulin in the East Indies” as its origin, and historians believe this is how the word first entered English.
Once British cooks got hold of the concept, they ran with it in entirely new directions. Most ketchup recipes in the 1600s and 1700s were built around fish, oysters, mushrooms, or walnuts. Mushroom ketchup became especially popular in colonial-era kitchens. These sauces were thin, dark, and savory, used the way you might use Worcestershire sauce today. Mushroom ketchup is still made in England and remains a niche ingredient in traditional British cooking.
The First Tomato Ketchup
Tomatoes didn’t enter the picture until 1812, when a Philadelphia physician named Dr. James Mease published the first known recipe for tomato-based ketchup. He called tomatoes “love apples” and described a process of slicing them thin, layering them with salt, letting them sit for 24 hours, then simmering the mixture with mace and allspice. Each bottle got two cloves of raw shallots and half a gill of brandy before being corked tight and stored in a cool place.
Mease’s recipe was a far cry from the sweet, smooth ketchup of today. It was chunkier, spiced differently, and preserved with brandy rather than vinegar and sugar. But it established the idea that tomatoes could be the base of a ketchup, setting the stage for what came next.
When Ketchup Was Sold as Medicine
Here’s where the story takes its strangest turn. In 1834, an Ohio physician named Dr. John Cook Bennett began marketing tomato ketchup as a cure for diarrhea, jaundice, and indigestion. He sold it in concentrated pill form, and the idea caught on quickly. Tomatoes were still somewhat exotic in American diets, and Bennett capitalized on that novelty by positioning them as a health food with near-magical properties.
The ketchup-as-medicine trend grew throughout the 1830s and 1840s, but it also attracted opportunists. By the 1850s, snake oil salesmen were claiming that ketchup pills could cure broken bones. The claims became so absurd that the market collapsed under its own weight. To make matters worse, many of the “tomato pills” being sold contained zero actual tomatoes. The whole episode foreshadowed the broader problem of unregulated patent medicines in America, which wasn’t addressed until the Pure Food and Drugs Act of 1906 cracked down on dangerous and fraudulent products.
From Medicine Cabinet to Dinner Table
After the pill craze fizzled, tomato ketchup settled into its role as a condiment. Commercial production ramped up in the second half of the 1800s, with manufacturers experimenting with vinegar, sugar, and spices to create a smoother, sweeter sauce that could last on store shelves. The addition of vinegar as a preservative was key. Earlier ketchup recipes had relied on fermentation or alcohol to prevent spoilage, but vinegar gave the sauce a longer shelf life and the tangy flavor profile that became its signature.
By the time H.J. Heinz began selling his version in 1876, the basic formula was locked in: tomatoes, vinegar, sugar, salt, and spices. The sauce that started as fermented fish guts in ancient China, passed through a mushroom phase in Georgian England, and briefly masqueraded as medicine in antebellum Ohio had finally become the ketchup we recognize today.