They call him Jack the Ripper. The truth is an institution.

In the fog-choked warrens of 1888 Whitechapel, a terror stalks the streets. But the gruesome murders are not the work of a lone madman. They are "procedures"—calculated acts of surgery performed by The Order, a secret cabal of London's most powerful men who believe society is a disease, and they are the cure.

Dr. Edward Strathmore, a brilliant surgeon and solicitor, was once their promising new member, his ambition blinding him to their monstrous philosophy. But after witnessing an unspeakable atrocity, he flees with the one thing that can expose them all: a secret ledger documenting every victim and every killer.

Now a fugitive hunted by the very men he once served, Strathmore's only allies are the ghost of a murdered friend and a resilient woman from the streets who has her own reasons for seeking revenge. To bring down an enemy cloaked in power and privilege, he must not only survive the city's dark underbelly but also confront the darkness they have awakened within him.