In my last Report, when the cholera had scarcely subsided, when men’s minds were full of apprehension on the subject, and when it seemed only too possible that, with the recurrence of autumn, we might again suffer from its invasion, I was unwilling to dwell too pointedly on the wonderful pertinacity with which that disease fixes itself on particular localities, and tends to re-appear in them on each new occasion of its rise. Believing that no extemporaneous measures could counteract these local preferences of the epidemic, I refrained from a course which would have produced no good result (unless indeed it had depopulated certain spots of the City), and which might have caused unavailing and hurtful alarm. Now, however, I think it right to tell you that the local predilections of this dreadful disease are so marked and so obstinate, that we may almost certainly predict in what parts of the metropolis it would tend to arise on any renewed visitation. We may anticipate that at any such time its latent power of destruction will kindle again in the districts, the streets, the houses, perhaps even in the very rooms, where it recently prevailed, _unless the determining local conditions shall previously have been annulled_. It would be ridiculous if I should pretend to carry you into any medical consideration of this subject, or should make my present Report the vehicle of a professional argument; but I may very briefly acquaint you with such generalisations as will justify you in pursuing a particular course with respect to the haunts of cholera. While doing so, I hope your Hon. Court will believe that I have devoted to this very serious subject the best consideration of which I am capable, and have done my utmost to arrive at conclusions which may be fruitful of practical good.