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After Carcass' grind-filled debut, they managed to evolve their sound into more of a death metal feel and incorperated it into "Symphonies of Sickness".
The production is probably the most noticable different on a first listen, it is much more clear and effective for the genre than the debut. The "medical" song titles are still here, and the songs don't lose any of their brutality. The guitars grind out crushing riff after riff with an incredibly thick, low tone. Drums are not grindcore as much, and compliment the music very well, especially with the abunance of orgasmic blasts. Of course, the vocals are completely fucking killer and are such a refreshing change from typical death metal growl vocals (ie: Chris Barnes, Glen Benton). Another thing that I adore about this album is the amount of thrashy, headbangable parts. Just listen to "Reek of Putrefaction" at 2:05-2:16, then at that mark, the song kicks into an incredibly low and pounding riff. The whole album is filled with moments like this, and in my opinion, is a superior album to Heartwork. A definite keeper.