When in 1579, comprehensive modernization of the hospital had started, along with it the chapel was reconstructed and enlarged. This was possible thanks to the financial support of Cardinal Antonio Maria Salviati. As paradox would have it, this outstanding philanthropist, who funded not only the Church and Hospital of San Giacomo in Augusta, but also a hospital found next to the Church of San Rocco, will be remembered by history not thanks to his merciful and pious deeds, but thanks to his cook and servant. This was none other than Cesare Ripa, the author of a true bestseller of that time, meaning Iconologia (1593) – translated into numerous European languages, iconographic dictionary of symbols and allegories, being for his contemporaries the basic source of becoming familiar with art and literature of the Baroque.

The simple, two-story, decorated with pilasters church façade, was designed by Carlo Maderno, the very same one who created the façade of the Vatican Basilica (San Pietro in Vaticano). Actually, he was the one who finalized it, since initially the church itself, as well as its interior was commissioned to another architect; it was Francesco Capriani da Volterra. This little-known builder, created a well-thought-out, refined in form work, which is worthy of our attention, especially since it was one of the first churches in Rome built on a plan of an ellipse.

In searching for magnificent works of the Baroque period, choosing among Gian Lorenzo Bernini, Francesco Borromini or Pietro da Cortona, we often forget that apart from them, there were many other talented, skilled and ambitious artists in Rome, who were not seen in the company of influential patrons and funders, were not members of known construction families, or due to many other reasons did not receive prestigious commissions, nevertheless they performed their work not only reliably but also with flair.

Clues indicating the patron of the church, St. James the Elder, are shells found in the façade – pilgrimage symbols, which were purchased in Compostela, the place of cult of this apostle in distant Spain, and they were added to clothing before starting the long trek back from the pilgrimage. The abutment of the church is topped off, by a nearly invisible from the street, coat of arms of Cardinal Antonio Maria Salviati. It is the only proof of the extensive engagement of this clergyman, striving to allow pilgrims coming from the North for the Jubilee Year of 1600 to find solace in suffering in the hospital and spiritual aid in the church. Interestingly enough the church was also enriched with rare in Rome at that time two (and not one) campaniles, found on the side of the apse – from the side of the street they are hidden, however they are well visible from the nearby Pincio Hill. Looking on from this place, we can see not only the strange, high bell towers, but also the green, moss-covered roof of the church. Like an armor it covers its body, which thanks to non-perpendicular placement in relation to the façade makes the church look like a turtle stretching out its neck to the left, in addition enriched on the carapace by two outgrowths (bell towers).

The interior based on a plan of an ellipse and adorned with pilasters with Corinthian capitols, was enriched by side chapels opening towards it, in the form of a three-piece triumphant arch. A similar in form, raised arch opens up onto the choir, accentuating and nobilitating it thus in this natural way. The altar found in the church is the work of Carlo Maderno, who obtained the building material (columns) from the nearby Mausoleum of Augustus. The whole was topped off with a decorative cornice, on which a flat, epileptic dome rests, in a refined and wholly original way filled with two rows of windows letting light inside. The frescos placed in it, not created until the XIX century depict The Glory of St. James.

We will not find too many interesting works of art in the church, since it fell victim to anti-clergy riots in 1849. Most of the works come from the XIX century. Nevertheless we will find here a few veritable pearls, testifying to the former rank of the church.

• Right at the enterance (first chapel on the right) an interesting paiting by Pomarancio (Cristoforo Roncalli) is found, the principal Roman mannerist, depicting The Resurrection (1602). This painter who was popular in Rome, with it, proved his talent to present dramatic, full of expression scenes.
• A relief altar found in the central chapel on the right (Cappella dei Miracoli) was made in 1716 by the then well-known French sculptor Pierre Le Gros. It show the saint hermit Francis of Paola, the founder of the Order of the Minims, praying to the painting of the Madonna and Child, built into the composition. There is a story connected with this paiting to which miraculous power is attributed (thus its name Our Lady of Miracles), and it is a story of a child saved from the waves of the Tiber. A woman, whose child fell into the river, prayed to the painting of the Madonna found in the city walls not far from the Church of Santa Maria del Popolo. The child was saved, while the inconspicuous image of the Madonna, was believed to be the cause of this miracle, and was transferred to a newly built chapel near the river. Since there, it was always susceptible to the Tiber flooding, it was once again relocated to the Church of San Giacomo in Augusta. In its place, a copy was placed in the chapel, but it also found its way to the nearby Church of Santa Maria dei Miracoli, which took its name (Our Lady of Miracles) from that very painting.

• Chapel of St. Joseph (third on the right), although it is devoted to Joseph, in the main altar there is a painting of The Baptism of Christ, painted by the Florentine, Domenico Cresti (Passignano). This presently, little-known Baroque painter, at the beginning of the XVII century was often employed by popes, cardinals and aristocrats, to decorate Roman churches and palaces. Today he is chiefly known as the author of portraits of Galileo and Michelangelo (Michelangelo Buonarroti).
• On the opposite side, in the Chapel of Our Lady of the Rosary, we will see a truly beautiful painting deserving our attention, The Adoration of the Shepherds (1626), painted by Antivenuto Grammatica. He is another of the forgotten Roman painters, in the past possessing his own workshop in which he even employed Caravaggio, during his first few years in Rome. The painting found in the chapel, is an example of the influence that Caravaggio had on Roman artists, after his paitings were unveiled in the Church of San Luigi degli Francesi. His Calling of St. Matthew moved Rome – all painters young and old alike tried to imitate the chiaroscuro dramaturgy, figures painted from live models, and his tendency for plebeianism. The Adoration of the Shepherds by Grammatica is an excellent example of this. It is a good idea to take a look at it, having previously seen two popular works of Caravaggio, found nearby, in the Basilica of Santa Maria del Popolo.

In the central chapel (on the left) we will find a monumental figure of the church patron – St. James the Elder. It was sculpted by Ippolito Buzzi, who in general aided the great sculptors and architects (including Gian Lorenzo Bernini), in decorating churches, fountains and palaces of the Eternal City. However, we have him to thank for something that seldom attracts attention, when admiring the collections of antique sculptures. Wanting to fulfill the expectations of his clients, among whom he counted Ludovico Ludovisi – the owner of a great collection of antique statues, he added limbs to the historical figures deteriorated by time, heads, chests, or other attributes. Sometimes these were, delicate corrections, sometimes far-reaching variations on the subject of antiquity – depending on the significance of the work and the amount of preserved parts. In this way he brought back the antique Roman sculptures to life, at the same time making the life of contemporary archeologists harder, whose hair stands up on their heads when analyzing the very common in the XVI and XVII centuries tendency to correct and supplement works of the past.