"Sanguinarium" is the sixth episode of the fourth season of the American science fiction television series The X-Files. "Sanguinarium" was written by newcomers Vivian and Valerie Mayhew and directed by Kim Manners, and is a "Monster-of-the-Week" story, a stand-alone plot which is unconnected to the series' wider mythology. It first aired in the United States on November 10, 1996 on the Fox network, earning a Nielsen rating of 11.1 and being seen by 19.85 million viewers upon its initial broadcast. The show centers on FBI special agents Fox Mulder (David Duchovny) and Dana Scully (Gillian Anderson) who work on cases linked to the paranormal, called X-Files. In "Sanguinarium", bizarre murders in a hospital's plastic surgery unit lead Mulder and Scully to suspect a supernatural force may be responsible. As the uncontrolled killings continue, Mulder discovers a link between the victims' dates of birth and key dates on the witchcraft calendar. The episode started as a spec script written by two fans of the series. It features several references to real life witchcraft sources. "Sanguinarium" received mixed reviews from critics; negative criticism was given to the number of inconsistencies in the plot. The episode's use of gore also drew a mixed reaction; some critics felt that the gore helped, while others felt that "Sanguinarium" relied too heavily on it to cover up weaknesses in its storyline. Plot During a routine liposuction operation in Winnetka, Illinois, Dr. Harrison Lloyd (John Juliani) suddenly begins to remove so much fat from a patient that the patient dies. Following the unusual experience, Lloyd tells Fox Mulder (David Duchovny) that he killed the patient because he was possessed. Dana Scully (Gillian Anderson) is skeptical about Lloyd's claims, believing he's only making it up to escape legal consequences. Mulder inspects the operation room and discovers a pentagram burned into the floor; he begins to suspect that witchcraft might have played a part in the crime. Meanwhile, the staff at Lloyd's clinic are shocked when another plastic surgeon, Dr. Ilaqua (Paul Raskin), murders an elderly patient by burning a hole through her cheek and neck with a surgical laser, severing her brain stem. Scully interviews Ilaqua, who claims that he cannot remember anything of the incident. Mulder's suspicions are strengthened when he reviews the tape of the second murder, and he sees a pentagram-like pattern on the stomach of the victim. Worried by the events, the hospital coordinator,