Fun isn’t necessarily one of death metal’s chief attributes, but it’s one of the defining characteristics of 200 Stab Wounds; you don’t name your songs “Skin Milk” and “Stifling Stew” if you don’t enjoy playing around in the grotesque. (They say that the title “Release the Stench” was inspired by a bandmember slipping off his shoes in the van.) The Cleveland quartet’s 2021 debut, Slave to the Scalpel, was an immediately accessible album of gritty riffs and sinewy grooves in a cartoonishly gruesome sleeve, and it established 200 Stab Wounds within a new wave of death-metal bands like Creeping Death, Necrot, Undeath, and fellow Ohioans Sanguisugabogg—bands that use hardcore’s relentless forward thrust to power traditional death metal in the vein of genre heroes Cannibal Corpse and Bolt Thrower. The music is dark, ugly, compact, and covered in grime. If Blood Incantation’s brainy sound explores the cosmos, and Tomb Mold’s visionary approach pushes aesthetic frontiers, then 200 Stab Wounds’ sinister, concentrated music plumbs the Zodiac Killer’s basement.

Slave to the Scalpel was recorded before 200 Stab Wounds began playing live, and its songs occasionally suffered from not having been road tested; there’s a fine line between relentless and monotonous that not even the nastiest riff can overcome. In the years since, they’ve toured ceaselessly with death-metal legends like Obituary and Dying Fetus, and it’s clear that hearing songs like “Slowly We Rot” and “Born in Sodom” every night for weeks—and discovering how their own music fared before a skeptical crowd—helped 200 Stab Wounds figure out how to turn a great riff into a great song. On Manual Manic Procedures, they chop their sound to pieces and sew it back up into meticulously arranged music played with speed, precision, and obvious glee; they’re inflicting all those wounds as efficiently as possible, but you can sense them enjoying each and every thrust of the knife.

Right from the start, it’s clear that Manual Manic Procedures has been built to keep a crowd on its toes and a pit in perpetual motion. After an intro that recalls both “South of Heaven” and “For Whom the Bell Tolls,” the rhythm of opener “Hands of Eternity” changes five or six times in the span of a minute, from head-banging piston-pumping to thrashy swing to ’90s jock metal and back again; later in the song, they shift from a gallop into D-beat into a nu-metal drag. It’s nothing new for a metal band to combine subgenres, but making such a show of presenting the menu at the beginning of the meal shows the band’s fresh intent: Here are all the ways your body can and will respond to this record.

200 Stab Wounds pulls tricks like this throughout Manual Manic Procedures—setting patterns in motion, then upending them while you’re distracted by some musical sleight of hand. In “Defiled Gestation,” the missile scream of a pair of pinch harmonics flashes across the opening mid-tempo riff, and while you’re still partially blinded by the flare, the band pitches up the pace in mid-measure, launching into the song’s full-throttle attack a quarter-second or so earlier than it feels like they should. Even when they’re at cruising speed, they keep tinkering with the groove, finding new ways to voice the riff without losing momentum. Steve Buhl rips into “Release the Stench” with a melodic neon sneer of a solo that turns into a snarl before spinning out in aggression, his flailing knocking out the rest of the band and allowing them to reset the song as chopping sludge.

While these newly intricate arrangements could come off as a fussy overcorrection, the sophistication of the songwriting makes the changes mostly feel natural rather than forced or showy. The title track scrolls from knuckle-dragging X Games groove to staccato grindcore and then into old-school death-metal riffing so elegantly, you sense it more as a change in tone—wound-up testosterone and clenched-teeth tension giving way to ecstatic release—than form.

Andy Nelson’s rich, almost glossy production heightens the album’s fluidity. Without blowing the soundstage up to stadium proportions, the Weekend Nachos mastermind creates just enough space for the instruments to speak clearly to one another. The effect is like seeing being in a tiny club with a pristine sound system: When Buhl and Raymond MacDonald’s guitars chug together in “Gross Abuse,” the thickness is suffocating. They open things further in interlude “Led to the Chamber / Liquified,” whose light-blue keyboard melody haunts the track’s Argento abattoir synths like a naive specter. These are mostly subtle touches—minor adjustments to what was already a compelling aesthetic—that the band incorporates without sacrificing the swagger of Slave to the Scalpel.

At times, listening to Manual Manic Procedures can feel like being put through a death-metal HIIT workout: 25 reps of two-stepping, 25 reps around the circle pit, 25 reps of headbanging, Keep up, let’s empty the tank for the wall of death! But by offering themselves up to the blood of the crowd and allowing it to reshape how they fashion their music, 200 Stab Wounds makes their priorities clear. Manual Manic Procedures is vicious in its attitude and surgical in its precision, but at its pulpy core, it’s an album that wants you to dance.