In this gripping sequel to the acclaimed Mayhem, Sarah Pinborough continues the adventures of troubled Victorian forensics expert Dr. Thomas Bond. Haunted by the nerve-shattering events he endured during the Jack the Ripper and Thames Torso Killer investigations, Dr. Bond is trying to reestablish the normal routines of daily life. Aiding in his recovery is the growing possibility that his long-held affections for the recently widowed Juliana Harrington might finally be reciprocated. He begins to allow himself to dream of one day forming a family with her and her young boy.

Soon, however, a new suitor arrives in London, challenging the doctor's claims on Juliana's happiness. Worse, it seems the evil creature that Dr. Bond had wrestled with during the Ripper and Torso Killer investigations is back and stronger than ever.

As the corpses of murdered children begin to turn up in the Thames, the police surgeon finds himself once again in a life-and-death struggle with an uncanny, inexorable foe.