"The Manufacture of Tangled Ivory" is a work that explores the history of altered piano: from early prepared piano sounds, through the techniques of musique concrete, to state-of-the-art computer manipulation. The piece utilises altered piano sounds, which have been sampled, prepared, detuned, digitally edited and manipulated. The work explores combinations of traditional and non-traditional techniques, such as contrasting detuned and microtonally tuned piano sounds with a traditionally notated score in three movements. In this case, each note in the score refers to a sample's position on a midi keyboard, and not to its actual sounding pitch. Multiple detuned scales are used, either one at a time, or by juxtaposing a different microtonal scale for each of several layers. Scales are constructed more by ear and from random detuning and pitch displacement than from ordered microtonal systems.

The work also incorporates samples of prepared piano and the computer equivalents of the techniques used in musique concrete. Thus, the sounds used span the history of altered piano techniques, ranging from the early years of prepared piano, through musique concrete techniques, to modern computer manipulation of the sounds.