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Growing up, ours was always the same .... essentially a tomato concoction to which meat was often, but not always, added.
Dice some onion and garlic and sweat it down in olive oil in the pan in which you'll make the gravy. When transparent, but not browned, add some tomatoes. If you can find them use San Marzanos. If not, you may have to add some sugar. Just a dash to cut any overly acidic bite.
Let that all simmer for a few hours until reduced by half. Add some tomato paste to thicken it if need be.
Add herbs (my mother always used dried hebs, I prefer fresh). Basil, oregano, and parsley. Add a judicious amount of salt and pepper now, too, but remember you can add seasoning later, after it reduces more, so go easy. Let the gravy cook another hour or so. If it gets too thick, cut it with water or red wine.
If you want to add meat, we always brown it first and then add it to the gravy. You can add the meat raw if you want, but that results in lots more fat and a sorta 'greasy' gravy. Meat commonly added is meatballs or sausage. On occasion, other meats were added .... bracciole, left over steak or roast, chicken, even ...... rabbit ..... pork ..... whatever you feel like. There are recipes for the fabricated items (meatballs, bracciole, etc.), but I won't go into them here.
One favorite of mine was pork skin. The butcher (back when there **were** butchers) would coat the meat side with herbs and pine nuts ... maybe sultanas or currants, too .... and roll it into a jelly roll and tie it. This went into the gravy early and cooked for the whole time. It then got removed, the twine cut, and it was sliced. It was not enough to make a meal of, but it was a wonderful little treat to go with your macaroni. And it added a wonderful flavor to the gravy. **That** was special!
Sunday macaroni was always a primo piatti .... with meat and veggies as the secundo.
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