The actual content has almost nothing to do with the dick jokes in the name and the back cover blurb. Instead, the inner front cover and inner flyleaf reprint a stripped down version of the new magic system from Vaginas Are Magic. In the new system, all spells are the same level, only a limited number can be cast, and there's a chance of failure with significant negative consequence on a bad roll. The book them segues into an introduction where Raggi discusses the types of horror that triggers him personally, and rants against the prudishness that tends to suppress graphic sexual and violent content.

The majority of the book is a spell list. Each is a two-page spread, with a full color painting depicting the spell on the left, and a description of the spell itself on the right. The spells are all over the place, but tend to be high concept, gory, and very powerful (with frequent world-breaking side effects -- it's not uncommon for a critical failure to result in something like the permanent loss of both the Sun and the Moon from the campaign, for instance). Magic is distinctly outsider, with those who use it unable to fit in with the normal world. The descriptions tend to more clever seeds than fully-detailed; the GM will have to make numerous judgment calls.

The book ends with a set of playtest rules for a potential new edition of Lamentations of the Flame Princess, which significantly revise how the game handles attacks, saves, and skills.

Rating this book is difficult. The impressive art, strong production values, and wildly creative spells have to be weighed against the complete lack of balance, and the general feeling that this is an incomplete rough draft rather than a finished product. Say 5/10.