This is a fine and original study of the paradoxical relationship between declining mortality rates and rising morbidity rates among working men in late nineteenth-century Britain. Following Simon Szreter's argument, Riley provides new evidence of the positive effects of investment in the infrastructure of health services, understood as investing social capital to improve water, sanitation, and roads and to provide more medical and paramedical care for the whole population. Illnesses that were lethal at midcentury were not lethal forty years later. The period of illness lengthened, the illness recurred, but death was less likely. This is the meaning of the central contention, captured in the title Sick, Not Dead. Factors producing mortality declined but sickness rates rose. Readers should not be put off by the title, and occasionally the statistical evidence is too detailed. Nonetheless, this is a book full of insight and analytical force. Riley offers a corrective to the likes of F. B. Smith, whose view of Victorian health was a shade or two too dark.