In the second half of the twentieth century we have witnessed the emergence of a new model of disease based on numerical deviations rather than symptoms and treated on a preventive basis before any overt signs of illness develop. This concept of treating healthy patients is not a recent product of genetic medicine but arose gradually in concert with the development and use of a set of safe, effective and highly marketable prescription drugs. Jeremy Greene uses the careers of an antihypertensive, an antidiabetic and a cholesterol reducing agent to show how this rather “insidious” paradigm shift in American health care has come about. Greene's historical journey starts with the development and introduction of the first palat-able pill for hypertension, chlorothiazide or Diuril® in 1958. Diuril, however, did not develop out of any targeted search for an antihypertensive therapy. The drug did not even have any connection with hypertension until it had left the company's research laboratories. Rather, Diuril was meant to start its career as a novel diuretic agent; as a product of Merck Sharp & Dohme's Renal Program. Diuretics were known to capture a substantial market with many therapeutic indications—though hypertension was not among them. The subsequent transformation of Diuril from a diuretic into an antihypertensive drug illustrates in a prototypic way the mutually constitutive processes of research, clinical practice and medical marketing in American medicine in the second half of the twentieth century. By the time of Diuril's launch, clinical research was clearly understood in explicit relation to marketing at Merck Sharp & Dohme (MSD). Clinical research was intended both to generate data for the more convincing promotion of Diuril and to serve as a promotional structure in itself. The marketeers divided clinician-researchers into a marketing structure with two concentric spheres. The outer ring involved lesser-known researchers of negligible influence, while the core consisted of a group of highly influential leaders in the field, who acted as models for their peers in their endorsement of a product. Diuril's road show, as Greene aptly calls the polished and penetrating promotion campaign, included symposia and publications featuring Diuril in peer-reviewed journals and the so-called “throwaway journals”, the medical newsmagazines and the firm's house organ. In addition, MSD marketing staff deployed journal advertisements, direct mail and sales representatives to visit individual doctors. As a visual aid and as part and parcel of a unidirectional gift economy, the company used an idealized dynamic image of fluid physiology, the iconic figure of the so-called “Diuril Man”. Moreover, MSD publicists set out to persuade some of the best-known science writers of the day to write special interest stories for publication in newspapers and newsmagazines. The ultimate objective of this information bombardment was to raise physician and consumer awareness of both drug and disease. To test the effect of the marketing strategy on everyday clinical practice, physicians’ prescribing habits were closely monitored. Going by the record-breaking sales of MSD's first blockbuster drug, the Diuril campaign worked out rather well, and would become a template for the promotion of therapeutic drugs in America. Greene calls it ironic that the subsequent decline and neglect of Diuril and its clones in the decades following their initial brand-name glory was due to the emergence of newer generations of hypertensive agents that used precisely the same promotional structure. But it was ever thus. Drug career cycles generally encompass three phases: first, an expanding use, accompanied by high expectations; then, rising criticism and disappointment; and finally contracting use and limited application. These phases need not be sequential: they often overlap. Drug promotion as rooted in both education and salesmanship can be regarded as an integral part of this cyclical economy of drug development and use, and in a broader sense the cyclical economy of American medicine. Another weakness of the book is the absence of a cross-cultural perspective. Are we confronted with a typical American development or, as the British poly-pill promotion at the end suggests, with a more universal therapeutic transition? In the process of circulating between bench, bedside and the public sphere not only the multiple identities of Diuril as a research object, medical tool and commodity changed but so did its handlers and the disease they tried to tame. After the introduction of Diuril, hypertension would become a category incommensurate with the hypertension that came before; the disease was redefined in terms of numerical thresholds and clinical guidelines ranging from mild, moderate up to severe. Subsequently, in following the conjugated careers of Orinase and diabetes as well as of Mevacor and cholesterol, Greene shows convincingly that our notions of diagnosis, prognosis and therapy co-evolve. I heartily recommend this book, which rightly emphasizes that the genesis of the pharmacotherapy of risk cannot be reduced simply to a clever marketing effort. It is important to realize that the everyday practice of “prescribing by numbers” has propagated a new moral economy of health values and a new set of surveillance structures with profound but still poorly understood implications for our health care at the dawn of predictive medicine.