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"Sanguinarium" is the sixth episode of the fourth season of The X-Files. Written by Vivian and Valerie Mayhew, it was directed by Kim Manners and premiered on the Fox network on November 10, 1996. The episode is a "Monster-of-the-week" story, independent of the series' mythology arc.


A series of bizarre murders in a hospital's plastic surgery unit lead Mulder and Scully to believe that witchcraft is somehow involved.


Everyone wants to be beautiful. And the Aesthetic Surgery Unit of Chicago's Greenwood Memorial Hospital can make anyone more attractive...for a price. For one patient thought to be undergoing a scalp-reduction the price is a grisly death, when Dr. Lloyd goes insane during surgery and performs a violent liposuction instead...and literally sucks the life blood out of the man.

Scully and Mulder are called in to investigate the doctor's unusual defense: demonic possession. Scully logically assumes the doctor's sleeping pill addiction caused a psychotic break. When Mulder discovers evidence of a pentagram--an occult symbol of protection-- on the floor of the operating room, he concludes that some kind of magic is at work. Scully is dubious, to put it mildly. Another surgeon goes into an uncontrollable frenzy, using a laser to burn through the flesh of a patient's face . Mulder discovers the mark of the pentagram on this body as well -- placed there by Nurse Waite, a practicing witch.

Dr. Franklyn admits that Nurse Waite worked at the clinic ten years earlier when similar deaths had occurred. Scully and Mulder search her house, finding a spooky den of candles, incense, herbs and witchy objects. But Nurse Waite is gone. She's lying in wait for Dr. Franklin; submerged in a tub full of gore in his bathroom. Her sneak knife attack fails, and she's arrested.

Before Nurse Waite can explain herself to Mulder, she dies horribly, vomiting hundreds of pins, in what Mulder recognizes from Nurse Waite's occult books as a classic case of death by hex.

Waite was trying to protect the patients...but against what or whom? Maybe Dr. Franklyn -- who smiles inscrutably as he levitates a few feet above his bed.

Putting all the clues together, Mulder deduces that Franklyn is a black magician. Cursed with the sin of vanity, Franklyn transforms his looks beyond the limits of surgery: using sorcery and human sacrifice. Ten years ago, he had escaped suspicion. Today, he manages to escape even Mulder. Mulder is too late to stop the final sacrifice that completes the spell. Dr. Franklyn slices off his own face, to disappear forever...

...And the classically handsome Dr. Hartman is welcomed aboard at a Los Angeles cosmetic surgery clinic.


Chicago; magic; possession; City of Angels Medical Center; Los Angeles

Background Information[]


  • The X-Files production staff received an enormous number of angry letters and e-mails from supporters of Wicca complaining about this episode.
  • Dr. Theresa Shannon was named after the actress Shannon Tweed.
  • "Sanguinarium" means "Place of Blood" in Latin. 'Sanguinary' means carnage, bloodthirsty or consisting of blood. Finally, 'Sanguinaria' means "Bloodroot".
  • Nurse Waite's name is most likely a reference to the 19th Century Occultist Arthur Edward Waite, whose name is still on Rider-Waite tarot decks.
  • Another interesting connection is between the name "Nurse Rebecca Waite" to "Rebecca Nurse", a character in Arthur Miller's "The Crucible" who is accused of witchcraft.
  • The book that Mulder reads and learns that witches can make people vomit needles is the Encyclopedia Of Witchcraft & Demonology by Russell H. Robbins.
  • The words written in blood on Dr. Franklin's mirror are "vanitas vanitatum" or "vanity of the vanities".


  • When Mulder and Scully are discussing the nurse's ingestion and subsequent vomiting of pins, Scully mentions pica which is a condition that makes people eat non-nutritious and non-edible things such as rocks, glass, metal, etc. Mulder then goes on to describe allotriophagy, which he suggests is a condition, possibly even a spell, that causes people to vomit things they never ingested in the first place. This is completely untrue. Allotriophagy is similar to pica in that it is defined as a depraved appetite or desire for improper food.
  • Mulder incorrectly identifies Roodmas as one of the four pagan seasonal holy days when, in fact, it is a traditional Feast of the Cross in certain Christian sects. The actual name of the pagan festival that coincides with Roodmas is Beltane, also known as May Eve.

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