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After a flawed, but classic, debut -resplendent with uber-muddy 'production' and songs that sound like a back alley lobotomy clinic- Carcass upped the Grind/Death/Gore Metal stakes by releasing this writhing ugly behemoth. So what had they changed? Two main things. First the production job is clearer on this album, but its still a long shot from the clear as distilled alcohol sound of Heartwork. Second death metal influences have seeped in here: clear solos, longer songs and more mid and slow tempo sections can be found here. This allows Carcass to really open up creatively, and they take full advantage of the opportunity.
The album kicks of with one of the most ominous riffs ever scratched onto a bit of plastic. Carcass return to similar slow tempo atmosphere laden riffs at strategic points throughout the album into to ensure that the ripping violent sections are given their proper counter point that keep them scary and exciting and stop them becoming boring (as an album of pure grindcore can tend to become, for this listener at any rate), see the inspired beginning to ruptured in purulence for another good example.
The vocals on this album are what really hit you when you first give it a spin. Now if you’re a squeamish listener there's good news and bad news. The good news is you can't here the medical textbook lyrics (subject matter: death, decay, corpses and the consumption there of). The bad news is that the incomprehensible vocals are even more gruesome and knicker-soilingly morbid than the lyrics. You've got the classic grindcore dichotomous vocals on this album: high-pitched fast paced shrieks and bowel scraping low belches. There's also some of the mid paced, mid ranged grunts that became prevalent in their later work. So there's nothing particularly unusual about the style of these vocals, they are just done exceptionally well, and with enough variation to keep you off your guard for the next barrage of inhuman vocal carnage.
The drumming on this album ahs moved on from the monotonous blast by numbers style that many grind acts use. We've got (superficially) disordered fills and pounded midpaced skin battery as well. If you concentrate on the drumming when you listen to the album the inverted sense of rhythm and sudden, unexpected variations are enough to make you feel nauseous. Presumably this was exactly the effect Ken Owen was looking for.
The riffing is, like all the other aspects of this album, more varied than on Carcass' previous effort. Melody is present on this album in a way it wasn't before. There is even an embryonic sense of necrotic triumphalism in some of the riffs which (unfortunately) seems to have evaporated by the time the later albums were written.
The ten songs on this album are hymns to the ugly, nigh on surreal, utterly brutal fact of human mortality. The gore splattered lyrics reflect this, but they also have an element of tongue in cheek over the topness that keeps the album from self destructing in a spiral of morose morbidity. Where other bands mimic the lyrical content and even the stylistic innovations of Carcass none have managed to carry of the concept quite so well. Symphonies of Sickness is just that, a musical masterpiece that reflects upon, investigates, jokes about, masticates and excretes the subject of death and what happens to our fragile corpses there after.