I don't feel like the City of R'lyeh effect of doing damage when the opponent is insane works very well with the new insanity mechanism; if every round below zero sanity has a fifty percent chance of killing them anyway, it doesn't feel like it matters much if you do ten plus arcane damage. Also not sure if its a bug or a feature but even if you get an S ranking you can't progress to the next level if you died
 "Necronomicon - Book of Dead Names"){kind=icon}
 "Tiny Jukebox"){kind=icon}