The main currency of the anti-Clinton meme world is physical imperfection. Her head nods are declared signs of Parkinson’s in a YouTube video with more than 4 million views; pixilated crops of the light hitting her ear are scrutinized for signs of a secret debate earpiece. And then there’s the trove of unflattering — sometimes manipulated — images of the candidate, which are used so frequently in both the Trump and progressive anti-Hillary circles of the Internet that they’re almost their own reaction meme.

But the latest anti-Hillary meme to take hold in the Trump Internet is that Clinton is a secret alcoholic. Photos and video that, two months ago, were passed around as definitive proof that Clinton was hiding a debilitating neurological condition have been suddenly repurposed for the hot new claim that actually, Clinton was drunk the whole time. Mix that up with a tantalizing WikiLeaks email and a scoop from a dubious right-wing blog, and you start to understand how this, of all things, became this week’s way to question Clinton’s fitness for office — and bait her supporters online.

“I think you should call her and sober her up some,” wrote Clinton campaign Communications Director Jennifer Palmieri in an email to campaign chair John Podesta on Aug. 8, 2015, at about 4:30 p.m. on a Saturday — a remark that was interpreted as being about Clinton.

Sure, “sober her up” could just as easily refer to mood — based on context, the emails come days before Clinton turned over her private email server to investigators — and not a literal status of inebriation.

But that ambiguity of a once-private conversation hasn’t stopped a growing group of people from passing around the exchange as proof that Clinton has a debilitating drinking problem — she was drinking in the afternoon! The National Enquirer, a tabloid that published a big “exclusive” in 2014 claiming Clinton was going to secret rehab, cited the email as proof they were right all along.

That, and an anonymously sourced post from True Pundit on connecting a “Drunk Hillary” rumor to her behavior in a Cory Booker video from a June campaign stop effectively launched this long-simmering tabloid and conspiratorial YouTube video fodder fully into the Trump Internet world.

Drudge dedicated its homepage recently to a montage of photographs of Clinton drinking:

And the idea has started to weave its way into the list of insults that often precede her name on Trump Twitter:

Scott Adams went all-in on the idea on Monday, laying out his reasons for why he believes it isn’t okay to have a president who drinks alcohol, period. And his post highlights one of the main reasons this meme is so appealing to Trump supporters. Trump, whom Adams supports, does not drink alcohol at all. Adams’s post includes a zero-to-10-point scale to “assess” the risks he sees for each candidate, and he assigned the risk of Trump implementing some of the “racist/sexist/homophobic policies” he’s floated over the course of his campaign as a zero, and the fact that Clinton drinks alcohol as a “10.”

“I would argue that alcohol consumption is the biggest risk differential in this election,” he wrote. “We’re just blind to that risk because alcohol is socially acceptable.”

Adams’s cited evidence of Clinton’s drinking habits being a problem includes the video of the candidate collapsing at the 9/11 memorial service, while Clinton was fighting pneumonia, but now described by Adams as footage of Clinton “allegedly passing out drunk.”

“This meme strikes me a last ditch attempt on the right (especially the far-right) to build on the themes of Clinton’s presumed unfitness and presumed dishonesty,” Jennifer Piscopo, an assistant professor of political science at Occidental College in Los Angeles, wrote in an email. “Without any further signs of ill health from Clinton after the 9/11 incident, the conspiracy theory that she was hiding a grave illness lost its legs. So, the drunken/alcoholic meme tries to make this argument, using a different ‘ailment.’”

The current interest in “drunk Hillary” isn’t really near the peak of interest in “Hillary’s health,” according to a Google Trends comparison of the two search terms. “Hillary’s health” spiked in the week after Sept. 11, when her bout of pneumonia — and her campaign’s delay in disclosing it — really was a valid news story that drew attention from more than just anti-Clinton memers. It’s also a meme that the Trump campaign itself has promoted in ads, capitalizing on video of Clinton coughing or stumbling to claim she doesn’t have the “stamina” for the presidency.

But “drunk Hillary,” even with no reputable news story to latch onto, started to rise in search interest this fall. It overtook “Hillary’s health” in late October:

Like any conspiracy theory that catches an audience, there is a small grain of truth here: Clinton drinks, and she reportedly likes it. She has told a drinking contest anecdote in her campaign videos. On the trail, particularly in 2008, Clinton drank at several campaign stops, which was largely read as an effort to seem more relatable. “She likes to drink,” Amy Chozick, a New York Times reporter who covers Clinton, said to ABC earlier this year. ” We were on the campaign trail in 2008 and the press thought she was just taking shots to pander to voters in Pennsylvania. Um, no.”

Another WikiLeaks email shows that Clinton’s 2016 campaign staff viewed images of Clinton drinking in public as a boon, not a burden. They were a good way to show a candidate with a long history of being called cold and unrelatable “loosening up” a bit. In a September 2015 email with the subject line “Another crazy idea,” Neera Tanden suggested Clinton throw a staff party. “If some staff take pictures of her with a beer and letting loose to some music — that end up going viral and eventually on tv — so much the better,” she suggested. “The clubbing she did in Latin America as SoS was awesome.”

That email is now part of the meme too:

What’s completely unproven, despite the intensity of the claim from some Trump supporters, is that Clinton has a problem with drinking. A disease, like the ones at the heart of the “Hillary’s health” conspiracies, one that serves as a vehicle for her opponents to question her fitness to be president — and specifically, whether she should have control of the United States’ nuclear arsenal.

“It seems very plausible that memes circulating that show Clinton as having a drinking problem are to draw into question her fitness for the presidency, where ‘fitness’ is physical strength and a masculine quality,” wrote Meredith Conroy, an assistant professor of political science at California State University, in an email to The Intersect. The meme is a less-direct version of the various conspiracy theories about her physical health that have been distilled into Trump’s questioning of his opponent’s “stamina,” or her judgment.

Clinton is the first woman to come this close to being president, and that definitely has something to do with the prevalence and type of memes deriding her strength, appearance and judgment from her detractors — the Bernie vs. Hillary meme from the primaries is a really good example of that gendered scrutiny in action, as is the persistent scrutiny of Clinton’s attractiveness. But Conroy noted that it is hardly just Clinton whose masculinity has been scrutinized through memes this cycle: from “tiny hands” to now-normalized jokes about his hair, Trump’s masculinity has also failed to live up to the memers’ standards for the generic president of the United States.

“The current election cycle features two older candidates, not known for their physical fitness, and one candidate who is female, which is a biological and physical aberration from every election in our history,” Conroy wrote. That might explain the unusual prevalence and popularity of these memes, Conroy said. The stereotype of “presidential,” historically, has always been strong and male, she wrote. “And neither of these candidates fit that mold.”

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