As a side historical note, I am not sure Italian amari have anything to do with "patent medicine". Certainly they predate "patent medicine" (and the modern idea of "patent") of at least 4 centuries, possibly more. They originated in the form we know at least back in the early middle age, being traditionally produced by monks in monasteries lost in the Apennines or in the Alps.

They are usually based on herbs of different kinds, made according to quite complicated, time-consuming recipes which were kept relatively secret, changed and improved over and over in time. They are supposedly deriving from even earlier traditions (Romans, Greeks, many others) the monks preserved through the "dark age" and modified over centuries.

While properties of these drinks are often based on superstition, or just traditional believes, and certainly not scientifically proven, occasionally their (therapeutic, or of other kind) properties are real, not snake oil.

I am not sure how much big popular brands ("Averna", "Lucano", and others), available all over the world, are actually faithful to some of the thousands of traditional regional recipes (certainly they claim to be), but I would guess they were to some extent changed for mass production in the 50s and 60s, possibly to taste OK to the vast public (some of the handmade amari I tasted are way, way too strong, or way too bitter, I would say).

However, the word "amaro" equally refers to the "industrial" version of it, and the traditional small local products.

Interestingly, some monks still make them, to this day, and occasionally sell locally. You will find them, albeit not too frequently, on sale at stands in small village markets, or in stores that specialize in original, traditional, local products. Of course they tend to be pricey.




Snake oil: I'd say wine industry is just full of it?