Cleveland death metal legends-in-waiting 200 Stab Wounds have returned with Manual Manic Procedures, a superlative sophomore effort that follows 2021's Slave to the Scalpel, their tour de force debut. The new album is a brutal slab of old school death metal with a contemporary edge. Not for the faint-hearted, Manual Manic Procedures may well be the album that puts classic gore-themed ferocity back into the metal community's collective consciousness.

Slave to the Scalpel saw 200 Stab Wounds insinuate themselves into the minds of extreme metal fans, leading to praise from Pitchfork for their "unpretentious brilliance, pitch-black sense of humor" and an "aesthetic [that's] built around a chugging, groovy riff that stomps down a path of destruction." Manual Manic Procedures sees the band upping the ante both musically and lyrically.

"You tour and you grow as a band, and as people," says vocalist Steve Buhl. "We were working on the new album before the first one came out. But as far as sitting down and really putting it all together, we started in late 2022 because we were on tour so much. We signed to Metal Blade, and took a four or five month break. We took everything that we had, and put it all together and then obviously put lots of new stuff in there. And we worked our asses off on it."

The album's artwork--graphically depicting radical surgery on somebody who may or may not be conscious--is an immediate indicator of what this record is all about. No punches pulled, no holds barred, just blood-soaked death metal.

The first single is Manual Manic Procedures' opening track, "Hands of Eternity." Buhl explains that the song is about being trapped in your own mind, something most of us can relate to. "That song is a good example of where we want to go musically. The heavy riffs are there, but there's still a lot of good melody. It's not just crazy fucking blast beats and, 'riff riff riff.' It's more structured, groovy and melodic, but still heavy. That's one of my favorites."

The album's penultimate track, "Ride the Flatline," is the second drop before the album releases. It's an Ezra Cook-penned song inspired by a chemical spill in the Ohio River after a train derailed . "All the crazy chemicals caught fire," Buhl said. "The Ohio River goes into Lake Erie, which is where our water supply is. So the song comes from that really. But obviously, we put a little bit of animation into it, with someone getting run over by a train in the process and fucking exploding and shit."

Another standout aural atrocity is "Gross Abuse," which Buhl describes as a "basic death metal torture song. That song is so simple, heavy and groovy," he says. "It's a great song - it's heavy as fuck, just brutal - so we needed lyrics to match that," he says, of lyrics that include "Switch blade slides into the skull / Brain seeps out onto the floor / Violent killing, I need gore." The singer/guitarist adds, "It's your standard torture-fucking-murder-fucking-death metal song about killing somebody."

Manual Manic Procedures was demoed at Buhl's home studio, the frontman throwing a rough version together using a laptop and drum machine, before the band got together to finish it off. "I show up with finished songs, and then there'll be a couple of songs where we add things musically," Buhl says. "But as far as the lyrics go, Ezra [Cook, bass] and I split them pretty much 50/50 down the middle. It's that way because I like to focus more on music."

The themes on Manual Manic Procedures run the gamut of classic gore-metal horror subject matter, beloved to the band and their rapidly growing audience. "I'll feel what kind of vibe the song has, and what topic would fit for that particular song," Buhl explains. "The last song on the new record, 'Parricide,' is about someone going into a nursing home, and just blowing it up. The lyrics are about those type of corporations that don't really give a fuck about those people. It's all just a money grab."

200 Stab Wounds shot an incendiary live video for "Hands of Eternity" at a sold-out hometown show at the venue No Class, and a production video with storyline for "Gross Abuse." And with European and UK dates starting March, 2024, the foursome are looking forward to sharing their strength worldwide.

"We're glad that people like our band," Buhl says. "And I definitely feel people are going to love this record for sure. This album feels like it needed to happen, because we've had so many fucking things happen to us as a band since the last one came out. That's why we put out the "Masters of Morbidity" 45 last year. We were touring so much that we really didn't have time to put a record together that was really worth a shit." Until now.

Ultimately, for 200 Stab Wounds, it's all about creating art that they enjoy. "I know that if we like it, our fans will like it," says Buhl. "That's really all that matters to us. And if we keep touring, it's just gonna get bigger and bigger. Then everyone's happy, far as I'm concerned."

The songs on Manual Manic Procedures are not safe for work - perhaps unsafe most anywhere. But that's its dark charm in a world where even heavy music can play it too safely. 200 Stab Wounds have crafted Manual Manic Procedures for themselves and like-minded brethren: thrill-seekers, carnage cravers, horror fans, and aficionados of the most extreme metal. Above all, 200 Stab Wounds created a future death metal classic.