Aging King George III of England is exhibiting signs of madness, a problem little understood in 1788. As the monarch alternates between bouts of confusion and near-violent outbursts of temper, his hapless doctors attempt the ineffectual cures of the day. Meanwhile, Queen Charlotte and Prime Minister William Pitt the Younger attempt to prevent the king's political enemies, led by the Prince of Wales, from usurping the throne.

The year is 1888 and the Whitechapel murders continue to ravage the East End of London. Fate has brought together an unlikely alliance who must put aside their differences and unite to end the autumn of terror.