In the cholera epidemics of 1832, 1848, 1849 and 1853, St. James' Parish suffered somewhat, but on the average decidedly less than London as a whole. In 1854, however, the reverse was the case. The inquiry committee estimated that in this year the fatal attacks in St. James' Parish were probably not less than 700, and from this estimate compiled a cholera death rate, during 17 weeks under consideration, of 220 per 10,000 living in the parish, which was far above the highest in any other district. In the adjoining sub-district of Hanover Square the ratio was 9; and in the Charing Cross district of St. Martin's-in-the-Fields (including a hospital) it was 33. In 1848-1849 the cholera mortality in St. James' Parish had been only 15 per 10,000 inhabitants. Within the parish itself, the disease in 1854 was very unequally distributed. In the St. James Square district, the cholera mortality was only 16 per 10,000, while in the Golden Square district it was 217 and in the Berwick Street district 212. It was plain that there had been a special cholera area, a localized circumscribed district. This was eventually minutely studied in the most painstaking fashion as to population, industries, previous sanitary history, meteorological conditions and other general phenomena common to London as a whole, with the result that it was found to have shared with the rest of London a previous long continued absence of rain, a high state of temperature both of the air and of the Thames, an unusual stagnation of the lower strata of the atmosphere, highly favorable to its acquisition of impurity, and although it was impossible to fix the precise share which each of the conditions enumerated might separately have had in favoring the spread of cholera, the whole history of that malady, as well as of the epidemic of 1854 and indeed of the plague of past epochs, justifies the supposition that their combined operation, either by favoring a general impurity in the air or in some other way, concurred in a decided manner, last summer and autumn (1854) to give temporary activity to the special causes of that disease. The inquiry committee did not, however, rest satisfied with these vague speculations and conclusions, but as previously shown in the history of this local outbreak, the resulting mortality was so disproportioned to that in the rest of the metropolis and more particularly to that in the immediately surrounding districts, that we must seek more narrowly and locally for some peculiar conditions, which may help to explain this serious visitation.