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The YouTube channel Charred Thermos is a channel exclusively focused on Bloodborne lore, primarily the literary sources, historical figures and events that inspired the story, characters, items and settings of the game.

[wiki] The True Story of Bloodborne Video Series

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The True Story of Bloodborne Series

[Youtube] Bloodborne Lore - The True Story of Bloodborne Part I: Inspirations Bloodborne is a massive allegory that has evaded our understanding for years. In this episode, we reveal the real-life inspirations of the game and explain the true meaning of the term “Paleblood.”

[Youtube] Bloodborne Lore - The True Story of Bloodborne Part II: The Healing Blood Explained Less than a minute into the opening cutscene of Bloodborne, the player-character is lying on an operating table and given a strange substance that makes everything hazy and then causes us to pass out. In this episode, we review the evidence that indicates the Healing Blood is meant to represent the powerful anesthetics of the Victorian era.

[Youtube] Bloodborne Lore - The True Story of Bloodborne Part III: The Beastly Scourge Explained There's a good amount of evidence indicating the Scourge of Beasts plaguing Yharnam is linked to the Healing Blood. But if we take a close look at clues in the game and influential source material, it becomes clear that Yharnam is experiencing a plague of addiction.

[Youtube] Bloodborne Lore - The True Story of Bloodborne Part IV: Byrgenwerth & The Betrayal In this episode, we reveal the real-life origins of the College of Byrgenwerth and Provost Willem...and explain the symbolic meaning of Laurence's betrayal.

[Youtube] Bloodborne Lore - The True Story of Bloodborne Part V: Mensis & The Medical Metaphor The School of Mensis was drawn straight from the medical history books of Great Britain. And as we'll see from certain enemies and key pieces of attire, Yahar'gul is Bloodborne's hub of anatomical dissection.

[Youtube] Bloodborne Lore - The True Story of Bloodborne Part VI: The Healing Church Hidden details in the architecture and aesthetics of Bloodborne help us make a bold conclusion: The Healing Church is meant to represent the Royal Infirmary of Edinburgh during the Victorian Era.

[Youtube] Bloodborne Lore - The True Story of Bloodborne Part VII: Laurence & Ludwig From Software drew upon two Victorian-era medical figures to craft Laurence and Ludwig, fallen heroes of the Healing Church. Laurence is tied to chemist and physician Horace Wells, who experimented with ether and chloroform, which served as the basis for Bloodborne's intoxicating Healing Blood. Ludwig, meanwhile, is a highly distorted version of famed surgeon Joseph Lister. The River of Blood flowing from Ludwig's lair in the Hunter's Nightmare—and the mountain of corpses therein—reflect the thousands of successful surgeries that Lister performed in the 1800s, none more important to Bloodborne's story that his surgery on author and poet William Ernest Henley.

[Youtube] Bloodborne Lore - The True Story of Bloodborne Part VIII: Hemwick Hemwick's reputation is that of a village dedicated to the burning of bodies and crushing of human bones to make Bone Marrow Ash. But a handful of easy-to-dismiss details help us see that Hemwick is a clever reinterpretation of the Victorian workhouse.

[Youtube] Bloodborne Lore - The True Story of Bloodborne Part IX: Cathedral Ward Under its facade of sacred statuary and architecture, Cathedral Ward bears the hallmarks of a prison—from its patrolling guards to its shackled inmates. The clues are there if we waft our way through the incense. In this episode, we'll examine why From Software treated Cathedral Ward as a sort of holy prison, and why Bloodborne's designers opted to give Laurence's organization a religious affiliation.

[Youtube] Bloodborne Lore - The True Story of Bloodborne Part X: The Real Yharnam Although there's a common assumption that Bloodborne is set in a distorted version of 1800s London, the game contains a host of historical, architectural and geographical clues that indicate Yharnam was inspired by the Scottish capital Edinburgh.

[Youtube] Bloodborne Lore - The True Story of Bloodborne, Part XI: Cainhurst Castle Cainhurst and its inhabitants play a supporting role in Bloodborne's Victorian medical metaphor. From the design and names of certain enemies, to Annalise's fixation on bearing a child, to the cryptic statues and symbols of the forsaken castle, we learn that the corrupt blood of Cainhurst is a metaphor for chloroform, a competing surgical anesthetic to ether, which we've previously established was the inspiration for the Healing Church's Healing Blood. Chloroform's use in pain-free childbirth in the Victorian period is subtly referenced throughout Cainhurst.

[Youtube] Bloodborne Lore - The True Story of Bloodborne, Part XII-A: The Great Ones In the great debate over what constitutes a Great One in the Bloodborne universe, players have relied on a hodgepodge of sources: item descriptions, Playstation trophies, the type of fluids that creatures bleed, the tier of coldblood that some bosses drop...and gut feelings. In this episode, we discuss a new method for identifying and comprehending the Great Ones. We look to their design and what it means within the context of the game's medical metaphor.

[Youtube] Bloodborne Lore - The True Story of Bloodborne, Part XII-B: The Great Ones Explained As we discovered in Part XII-A, the Great Ones appear to be designed as things found within the human body. In this episode, we answer the question, "Why?" The concept of insight serves as a bridge between the Great Ones and Bloodborne's medical metaphor, while the real-life inspiration for the Mensis Cage helps us solidify our conclusion about the true nature of the Great Ones in the game's hidden narrative.

[Youtube] Bloodborne Lore - The True Story of Bloodborne, Part XII-C: Great Ones Addendum Additional information about the physical appearance of the Moon Presence helps to build upon the theory put forth in Part XII-A, that the Great Ones were designed as things found within the human body. There appears to be another wrinkle: At least a portion of their anatomically inspired designs seem to be associated with pregnancy or childbirth. This idea segues into a short summary of Oedon.

[Youtube] Bloodborne Lore - The True Story of Bloodborne, Part XIII: Attempts at Greatness If the true Great Ones represent features found within the human body, what should we make of the nightmarish bosses that aren't Great Ones? What do they symbolize in the game's overarching medical metaphor? In this episode, I argue that the game's research institutions—Byrgenwerth, the Healing Church and the Church's subordinate organizations, the School of Mensis and The Choir—depict various time periods and medical research practices of the pre-Victorian and Victorian era. Their unsuccessful efforts to achieve cosmic greatness are displayed in their unique attempted Great Ones: Rom, the Living Failures, The One Reborn and the Celestial Emissary.

[Youtube] Bloodborne Lore - The True Story of Bloodborne, Part XIV: The Hunters Dissected In this series, we've seen how Bloodborne represents the evolution of medical science and practice in the 1700s and 1800s. But in this episode, we discuss a possible origin source of the game's central medical metaphor, if not the of the entire game itself. We have to dissect the Hunters and their atrocities to remove this secret.

TRANSCRIPT

An Agony of Effort, Part II - The Thick, Sweet Mystery (The Healing Blood Explained) | Google Docs Link

The Healing Blood is arguably the central feature of the game Bloodborne. But what exactly is it? There are clues woven into the game to help us figure this out—none more important than those in the opening cutscene. Less than a minute into the game, we find ourselves on an operating table in a clinic, stretched out on our backs. We’re administered a strange substance and suddenly everything gets hazy. In seconds, we’re passed out. As lore enthusiasts and players, we can simply tell ourselves, “Oh, that’s just the strange, cosmic effect of the ‘Healing Blood.’” But let’s just keep it simple: If you were on an operating table, what substance would cause you to lose consciousness? From Software is treating the Healing Blood as a proxy for anesthesia.

In the next 20 minutes, I’ll lay out a raft of evidence that the Healing Blood is meant to represent the potent anesthetics of the Victorian era—and that the game Bloodborne is likely a massive drug-induced nightmare. Stick with me and see if you agree.

In the first video of this series, I discussed how the lives and works of Victorian authors William Ernest Henley and Robert Louis Stevenson serve as the foundation of the game. I noted in the opening video that in his 1875 poems titled “Hospital Sketches,” Henley repeatedly made mention of the powerful anesthetics of the mid to late 1800s. And if we examine the Healing Blood through the lens of the medical metaphor that permeates Bloodborne, we find abundant evidence that this substance is based upon the real-world consumption and application of a Victorian-era anesthetic: It’s ether.

Diethyl ether rose to prominence in the Victorian era thanks to the discovery of its potent pain-killing and invigorating properties. Beginning in the 1840s, ether became a leading anesthetic for major medical procedures, but it also became a recreational drug in many parts of Europe in the latter half of the century. It remained popular among the lower classes in Eastern Europe, particularly in Poland, well into the 20th century. Ether provides a strong, rapidly onsetting inebriation. And because of its powerful pain suppressing qualities, it was considered a “universal cure” by Polish peasants. Ether can be consumed like alcohol, but the inebriating effects are far stronger, and ether imparts a unique sense of euphoria. These characteristics accurately describe the effects of Bloodborne’s Healing Blood, which, like ether, is considered by the masses as a sort of panacea or cure-all. It’s no surprise, then, that in Yharnam, the Healing Blood—according to the Pungent Blood Cocktail—is more intoxicating than alcohol.

The Pungent Blood Cocktail, thanks to its name, also helps us identify one of the most important elements connecting the Healing Blood to ether: It’s the smell. Ether is renowned for its “sweet” smell, so much so that it was originally called the “sweet oil of vitriol,” the term vitriol referring to the glassy look of liquid ether. Ether, when consumed in liquid form, continues to emanate a potent smell from the drinker even days after consumption, slowly dissipating through breath and the skin and penetrating everything around, including clothing, fabrics and even wood. In communities in which ether drinking was common, churches and other public spaces were said to smell of ether for days after large gatherings.

The evidence, as we can see, begins to paint a picture. In ether, we have a highly intoxicating substance that provides a euphoric effect, is considered a universal cure, and has a sweet, potent smell. This sounds just like the Healing Blood. As you might have deduced, the smell is particularly relevant. Bloodborne’s hunters, the heaviest users of the Healing Blood, are said to have a distinctive smell. We receive this piece of information from multiple sources. Gascoigne’s daughter, through her window in Central Yharnam, tells the player, “I don't know your voice, but I do know that smell... Are you a hunter?” Arianna notices the smell of the player when we first encounter her in Cathedral Ward. "Oh, my,” she says, “what a queer scent... But I'd take it over the stench of blood and beasts any day.” The chapel dweller in Oedon Chapel indicates that hunters have a unique smell, saying, “Oh... you must be... a hunter. Very sorry, the incense must've masked your scent." Because hunters are the heaviest users of the sweet-smelling Healing Blood, it stands to reason that the hunters’ unique scent results directly from blood use. One strong piece of evidence of the olfactory effect of the Healing Blood comes from Gascoigne himself. During his boss fight, Gascoigne says, “What’s that smell? The sweet blood, oh, it sings to me. It’s enough to make a man sick.”

Aside from the fact that ether consumption can cause extreme nausea and vomiting, Gascoigne refers to the blood as sweet smelling. This all reinforces the idea that ether is the real-life inspiration for the Healing Blood.

The definitive proof that ether is the basis for the Healing Blood comes from Robert Louis Stevenson and his Gothic horror tale, “The Strange Case of Dr. Jekyll and Mr. Hyde.” The story serves as the basis for both the beastly transformation in Bloodborne and the mythos of the Healing Blood. In Stevenson’s short story, Dr. Jekyll is a reputable doctor and chemist in London in the mid 1800s. As a medical scholar, he’s dedicated himself to “the furtherance of knowledge [and] the relief of sorrow and suffering.” In short, he wants to create substances that will heal people. In his experiments with various chemical agents, Jekyll discovers that some agents possess powerful inebriating effects that he cannot resist. He eventually creates a potent serum that gives him great pleasure but results in a grisly transformation into Mr. Hyde, a manifestation of Jekyll’s basest instincts. Stevenson’s story, not surprisingly, has long been considered a parable of the dangers of substance abuse. It’s rumored he wrote the story after a period of experimentation with cocaine himself. But there’s a critical detail that helps us confirm that the story served as the inspiration for the Healing Blood, and that ether is indeed the real-life substance upon which the Blood is based. The popular and extremely likely theory among literary historians is that Stevenson authored “Jekyll and Hyde” after learning of the tragic tale of Horace Wells.

Wells was an American dentist in the 1840s who began using nitrous oxide, or laughing gas, on patients during what otherwise would be painful dental procedures. He was also one of the first medical professionals to experiment with ether. In 1845, Wells attempted to demonstrate the value of nitrous oxide as a surgical anesthetic in a presentation to the Massachusetts General Hospital. Unfortunately for Wells, the gas likely had been incorrectly administered to the patient—a man who was an overweight alcoholic upon whom a longer exposure would have been required. The patient groaned during the procedure, leading physicians in the audience to scoff and dismiss Wells as a quack. So dejected by the failed demonstration was Wells that within three years he had shuttered his dental practice, abandoned his wife and infant son, moved to New York and began experimenting first with ether and then with chloroform, testing them on himself. Wells developed an addiction to the substances and experienced significant behavioral changes. After rushing into the street and throwing sulfuric acid on the clothing of two prostitutes, his second such violent outburst in a week, Wells was committed to New York’s Tombs Prison. After sobering up and coming to his senses while incarcerated, Wells was overcome with guilt. Somehow, he was able to secure a temporary release to retrieve personal items from his home, including his shaving kit. Wells used the opportunity to smuggle a razor and bottle of chloroform into his cell upon his return. He gave himself a final dose of chloroform and used the razor to slice his femoral artery, bleeding to death in his cell.

In Stevenson’s “Jekyll and Hyde,” Dr. Jekyll becomes addicted to his serum, requiring larger and larger doses to produce desired effects. When transformed into Mr. Hyde, he exhibits violent behavior, including knocking over a young girl and later beating a man to death with a cane. In a period of clarity, Jekyll pens a lengthy confession note before permanently transforming into Hyde. In the end, Jekyll locks himself in his laboratory and kills himself with poison as two men attempt to break down the door. The comparisons can’t be missed. Jekyll becomes addicted to a chemical concoction, physically transforms, exhibits violent behavior and commits suicide, just like Horace Wells became addicted to ether and chloroform, experienced major behavioral transformation, engaged in violent acts and ultimately committed suicide. Ether, a chemical agent used by doctors, was the substance that hooked Horace Wells. The serum that produced Mr. Hyde was an agent compounded by a chemist and doctor, Henry Jekyll. Within Bloodborne, as we’ve shown, the Healing Blood is exceptionally similar to ether. And just like ether did with Horace Wells and an ether-like substance did with Dr. Jekyll, the ether-like Healing Blood in Bloodborne is behind the beastly transformation that has taken over Yharnam. From Software based the Healing Blood off of “Jekyll and Hyde,” which itself was based on Horace Wells. And as we’ll see in the fourth video and what is perhaps the most mind-blowing lore discovery of the series, Laurence, the founder of the Healing Church was directly inspired by Horace Wells and Dr. Jekyll. You will definitely want to check that out.

Although consumed commonly in liquid form in the 1800s, ether was used in medical and recreational capacities as a vapor, which was inhaled. In the 1840s and 50s, physicians would douse a handkerchief or napkin in ether or chloroform and hold it close to the nose of the patient until they passed out. But the practice was rather inartful and could kill the patient if they were overexposed. So doctors turned to more advanced methods of administering the anesthetic. One such method was invented by the former partner of Horace Wells, a man named William T.G. Morton, who crafted a device called an etherizer.

The etherizer contained a sponge soaked in ether that would vaporize once the container was placed in warm water. If it hadn’t occurred to you already, the etherizer bears a striking resemblance to an item in Bloodborne: the Numbing Mist.

The comparisons are easy to make. The containers, of course, are virtually identical. And something that causes “numbing” would be an anesthetic. But within the Numbing Mist vial we can see a glassy liquid, much like ether, evaporating into a mist or vapor, just as we would see with an etherizer. Kudos to reddit user Smashrican, who points out that if we look at the Numbing Mist, it’s possible to make out what appears to be a vaporous form of Ebrietas, Daughter of the Cosmos, facing to the right side of the vial. In case you can’t immediately make it out, we’re looking at her not head-on or from a profile point of view, but sort of in between. She’s leaning at a 45-degree angle. The bright, wispy features at the top of the sphere are her wings, the bright mass in the center of the vial just above the liquid is her lower body, and her left arm is hanging down and touching the liquid just to the right of her lower body. The slightly horizontal swoosh on the right side of the sphere is the end of one of her two large tentacles, which is partially obscured on the far right but appears to continue upward along the curvature of the vial. It makes good sense that this is Ebrietas for two reasons. As is well known, the name Ebrietas is almost certainly inspired by the word “inebriation” meaning drunkenness. Ebrietas is the left-behind Great One. Drunkenness and addiction are the left behind plague of anesthesia use and abuse. We’ll return to this concept in later videos. But in this image, Ebrietas is shown as vapor emerging from what appears to be a vial of liquid ether. She is depicted as the literal child of liquid ether. Her name is Ebrietas, Daughter of the Cosmos. In the 1800s, a common term for the cosmos was “the aether,” spelled A-E-T-H-E-R but pronounced the same as ether, the anesthetic. What we might be witnessing here is Ebrietas, meaning an addiction to intoxicants, is being borne from ether, the anesthetic, and the aether, meaning the cosmos. It’s a homophone to help us connect the anesthetic ether to the cosmos. It’s very clever.

By the middle of the 19th century, ether had quickly become the world’s leading general anesthetic after American and Scottish physicians in the 1840s discovered its application in surgical procedures. The first patient to receive ether as a surgical anesthetic was a man named Gilbert Abbott. In Boston in 1846, Abbott had part of a tumor removed from his neck. The affair was closely scrutinized, because physicians worldwide had been longing for a sufficient anesthetic to perform pain-free surgeries. Abbott was tied to a chair for the surgery in order to remain upright so as to not choke on his own blood.

In Bloodborne, the player character almost immediately encounters a man named Gilbert who came to Yharnam to treat an unknown illness. Gilbert received the Healing Blood, presumably in Iosefka's Clinic, which is littered with restraining chairs, just like the one used for Gilbert Abbott’s surgery. Observers of Abbott’s surgery quickly realized that ether was a successful surgical anesthetic. When doctors asked Abbott how he felt after he regained consciousness following the procedure, Abbott replied, “Feels as if my neck’s been scratched,” as if to say, “Eh, it was just a scratch.” In Bloodborne, our acquaintance Gilbert eventually succumbs to the Healing Blood and transforms into a beast, specifically a Beast Patient. When killed, he drops the Clawmark Rune, scratches and all.

While the Clawmark rune of course looks like scratch marks, if we look at it through the medical metaphor lens, we can see that it looks remarkably similar to a surgical incision that has been stitched up. The diagonal line can be viewed as the surgical incision. The vertical lines, hence, are the sutures or surgical thread stitching the wound together. Our friend Gilbert is meant to represent Gilbert Abbott, the first person to undergo surgery under the influence of ether. As we’ve seen with the Hunter Rune and now the Clawmark Rune, the artwork of the Caryll Runes will tie into surgery and other medical and scientific concepts, which I’ll discuss from time to time.

If you’re still skeptical that the Healing Blood is a proxy for Victorian-era anesthesia, this will probably change your mind. In the opening cutscene of the game, we’re administered the Healing Blood and seem to drift off into a dream-like state. We awaken in this haze, flat on our back on the operating table, unable to move. We pan the room from our first-person viewpoint. After the Scourge Beast retreats in flames, the glowing Messengers emerge from beneath the table and begin crawling over the player-character. It’s hard to see how this scene wasn’t influenced by the work of English artist Richard Tennant Cooper.

Cooper is a little-known figure who was born in 1885 in Tonbridge in southeastern England. He trained as an artist in France and appears to have spent much of his early adult life in London and Paris, cities that were no strangers to mass disease and death. Cooper completed most of his known works following his service in the British Army during World War I. These life experiences influenced Cooper’s paintings, which fixate on disease, urban decay, war and the macabre face of modern medicine.

As we can see here, the opening cutscene of the game was undoubtedly drawn from Cooper’s haunting work titled, “An Unconscious Naked Man Lying on a Table Being Attacked by Little Demons Armed with Surgical Instruments; Representing the Effects of Chloroform on the Human Body.” The painting was inspired by Cooper’s own experience undergoing an appendicitis operation, for which he was administered chloroform. As we discussed in the first video of this series, Henley’s works also were inspired by his experience of surgery under the effects of chloroform. From Software, in drawing from Cooper’s painting to craft the opening cutscene, is telling us that the Healing Blood is meant to represent Victorian-era anesthetics, like chloroform and ether.

To sum up, in this video, we’ve established that the Healing Blood shares the inebriating, addictive and panacea-like qualities of ether, as well as its unique sweet smell. It was the chemical compound that led physician Horace Wells down a path of transformation, addiction and suicide, serving as the basis for Robert Louis Stevenson’s “The Strange Case of Dr. Jekyll and Mr. Hyde,” which we can see is extremely similar to the beast-like change we observe in Bloodborne. Finally, we’ve seen that art based on the effects of chloroform was used to craft the opening cutscene of the game. Taking all this evidence into consideration, we can confidently say that Bloodborne’s Healing Blood is meant to represent the highly intoxicating, highly addictive anesthetics of the Victorian era, and that the administration of the Healing Blood in the opening cutscene is meant to represent the start of an anesthetic hallucination or dream that began when we, the player-character, were lying on the operating table in the clinic.

In the next video, we can build upon this conclusion to see how the Beastly Scourge of Yharnam is in fact meant to represent the loss of one’s humanity to addiction.

An Agony of Effort, Part III - The Animal Within (The Beastly Scourge) | Google Docs Link

Transformation and how it pertains to the people, bosses and enemies of Bloodborne remains one of the game’s most misunderstood concepts. But thanks to several items, Caryll runes, key pieces of dialogue and a close inspection of some real-life literary source material, we have everything we need to understand what’s happening in Yharnam. As we established in the previous video, the Healing Blood is meant to represent the highly intoxicating and addictive anesthetics of the Victorian era, specifically ether and chloroform. When we combine that vital piece of information with the evidence we find in the game relating to beastly transformation, we’ll see that the Beastly Scourge of Yharnam is in fact a plague of addiction.

By all accounts, the Scourge of Beasts has swept through Yharnam despite the best efforts to eradicate it. The hunting of beasts hasn’t stopped the scourge. Quarantining people hasn’t stopped it. Burning part of the city to the ground hasn’t stopped it. It just keeps popping up. We learn from the Charred Hunter set that the scourge seems to have first emerged in Old Yharnam. Once the streets of Old Yharnam were overrun with beasts, the hunters of the Healing Church were left with little choice but to set the old district aflame. But the scourge persisted, spreading into Central Yharnam, which is now overrun with Scourge Beasts and Huntsmen in various stages of transformation. The Church has closed the bridge to Cathedral Ward, hoping to stop the spread of the scourge, but that too has failed. Beasts have overtaken the buildings of even Upper Cathedral Ward. Something about this plague is different. It’s not just transmitting from person to person like a disease. Everyone is changing, even the most devout followers of the Church who have sealed themselves away from the masses.

So what the heck is going on here? A bit of basic observation leads us to believe that the Beastly Scourge is caused by the Healing Blood. As we can conclude with just a little wandering through the city, there are two things we quickly associate with Yharnam—it’s crawling with beasts, and it’s overflowing with the Healing Blood. But there are several items in Bloodborne that help us solidify this connection. The description of the Blood Vial tells us that “most Yharnamites are heavy users of blood.” Most Yharnamites are either dead or beasts, so it’s safe to say the blood is somehow associated with this. This correlation between blood use and beasthood is much more strongly reinforced by the Reiterpallasch trick weapon. According to its description, “The old nobles, long-time imbibers of blood, are no strangers to the sanguine plague.” Here, we have a sanguine or blood plague that is associated with the emergence and disposal of beasts. But much more importantly, the item indicates in no uncertain terms that this beastly plague is related to the long-term or excessive imbibing of blood.

We also can look to the Ailing Loran Root Chalice. Its description states, “There are trace remains of medical procedures in parts of ailing Loran. Whether these were attempts to control the scourge of the beast, or the cause of the outbreak, is unknown.” In Japanese, the word “treatment” or “care” is used instead of procedure. This tells us that the common medical treatment of Loran might have caused the scourge rather than controlled it.

The implication in both the Reiterpallasch and the Ailing Loran Root Chalice is that it’s the blood, an intoxicating substance that’s used as a medicinal treatment, that’s responsible for the Scourge. Our natural instinct as players and lore hunters is to immediately think, “OK, there’s something mystical or cosmic about this blood that’s causing ordinary men and women to transform into beasts.” But there’s no evidence on the back end to support that idea. It’s not that mysterious or complicated. From Software is doing what writers have done for thousands of years: They’re just using a metaphor here.

To wrap our heads around this, it’s helpful to look at what Bloodborne game director Hidetaka Miyazaki said about it in his 2015 interview with Future Press:

“The urge to transform into a beast is in conflict with the basic sense of humanity we all have. That humanity serves as a kind of shackle, keeping the transformation in its place. The stronger the shackle keeping that urge to transform in place is, the larger the recoil once that shackle is finally broken. The results cause you to transform into a larger creature, or a more twisted one.”

There are a couple of things to unpack here. First, Miyazaki is telling us that transformation is ultimately the loss of one’s basic sense of humanity. This is absolutely critical. It’s the loss of one’s sense of humanity that causes the transformation. Second, Miyazaki is saying that people with the strongest will, meaning the greatest ability to retain their sense of humanity for as long as possible, become the biggest, most deformed creatures. Think Amelia, the Blood-Starved Beast and the Cleric Beast. So, what causes a person to lose their humanity? While there are several ways we see this play out in the game, in this video we’ll focus on the main cause: It’s addiction. This is the type of transformation we observe in all beast-like creatures. As we noted earlier, we’re given a smattering of clues throughout the game telling us that the Beastly Scourge is somehow linked to the Healing Blood. The strong implication is that the people of Yharnam, even the most strong-willed people of all, like Laurence and Amelia, can’t resist the temptation of the intoxicating Healing Blood. They become hooked on the blood, and their humanity is lost. The shackle is broken. The transformation into another creature ensues.

The item that’s most helpful to understanding beastly transformation is the Clawmark Rune. This rune is dropped by Gilbert following his beastly transformation, and by the NPC enemy in the Hunter’s Nightmare who wields the Beast Claw. The Clawmark Rune description states, “The ‘Clawmark’ is an impulse to seek the warmth of blood like a beast. Although the difference is subtle, Runesmith Caryll describes the ‘Beast’ as a horrific and unwelcome instinct deep within the hearts of men, while ‘Clawmark’ is an alluring invitation to accept this very nature.” What does this mean? The Clawmark Rune makes clear that all men have an inner beastly instinct, or Beast, that is constrained or subdued. That’s exactly what Miyazaki was saying in his Drained of Blood interview. If a person accepts this “alluring invitation,” the beast takes over and one’s humanity is lost.

As we’ve discussed in this series, the short story “The Strange Case of Dr. Jekyll and Mr. Hyde” by Victorian author Robert Louis Stevenson helped shape the mythos of the Healing Blood. And not surprisingly, the story is also at the core of the beastly scourge. At the conclusion of “Jekyll and Hyde,” Stevenson provides Jekyll’s written testimony. It’s essentially a searing self-critique in which the doctor discloses an ongoing battle within himself. As a result of this inner conflict, Jekyll concludes that there is a “thorough and primitive duality of man,” or what he calls “a dreadful shipwreck: that man is not truly one, but truly two.” Man, in Jekyll’s telling, is a moral and intellectual creature in constant conflict with a desire to partake in forbidden pleasures. Jekyll is a doctor and chemist whose life work has been the creation of healing substances. But as his work progressed, concocting new medicinal treatments, he began using “certain agents I found to have the power to shake and pluck back that fleshly vestment, even as a wind might toss the curtains of a pavilion.” More simply stated, he discovered compounds that caused such a powerful high that it shed his “fleshly vestment”—meaning his humanity. Jekyll eventually confesses that as he consumed greater amounts of his concoction, he could no longer control the transformation into Hyde. “All things therefore seemed to point to this,” Jekyll writes, “that I was slowly losing hold of my original and better self, and becoming slowly incorporated with my second and worse.” Jekyll was losing his fight with addiction. He explicitly describes his evil alter ego as a beast, referring to Hyde as “the animal within me licking the chops of memory,” one that had been “chained down, [but] began to growl for licence.” In essence, Jekyll’s addictive serum was the Clawmark. Mr. Hyde was the beast.

The Clawmark Rune is dropped by Gilbert, a character that—as we discussed in the last video—is meant to represent Gilbert Abbott, the first man to undergo surgery under the effects of ether. This inspiration only reinforces our understanding of Clawmark and Beast. Clawmark refers to the ability of intoxicants, such as ether, to make someone into a beast. Ether is a highly intoxicating, highly addictive drug. By getting that first taste of ether’s powerful effects, man may then succumb to the “alluring invitation” or, in Japanese, the “inescapable temptation” of ether or other addictive intoxicants. These intoxicants are the Clawmark, or the temptation, whereas the Beast is one’s inner beastliness that is unleashed by succumbing to addiction. With addiction, a man loses his humanity and his self-control. He’ll give up anything and everything for more of the addictive substance or activity. This is exactly what we see in Bloodborne with the Healing Blood, which is just like ether. The Healing Blood is a highly intoxicating, highly addictive substance. As men abuse it, they lose their humanity and transform into beasts.

The situation in Old Yharnam helps us see how addiction to the Healing Blood is the Scourge. As we learn from the Antidote item, Ashen Blood was a “baffling sickness” that ravaged Old Yharnam long ago.

Based on what we know of the Victorian era and its real-life plagues, there’s reason to suspect that Ashen Blood was inspired by cholera. In 1832 and again in 1840, catastrophic outbreaks of cholera ravaged the district of Edinburgh known as Old Town. That’s undoubtedly where Old Yharnam, which is referred to in Japanese as simply the Old Town District, gets its name. Although Edinburgh’s Old Town wasn’t sealed off and burned, the area was slowly abandoned in favor of New Town in the wake of epidemics of the early to mid-1800s. Cholera is a waterborne disease that causes severe dehydration through intense diarrhea. Dehydration occurs so quickly and dramatically with cholera that the blood literally thickens. That’s likely where the name Ashen Blood comes from—it’s blood that has been dried out or dehydrated such that we could figuratively consider it dry as ash.

Cholera was nicknamed “the blue terror” because victims’ skin often would turn dark blue, which is why the Beast Patients that we find in Old Yharnam have dark bluish-black fur and females excrete a dark bluish-black or purplish-black substance. As we learn from their item description, Antidotes were used to treat Ashen Blood, which “triggered the spread of the Beastly Scourge.” But how could Ashen Blood have triggered the Beastly Scourge? Simple: It wasn’t the Ashen Blood that caused the transformation; it was addiction to the Healing Blood that did that. After the Ashen Blood sickness took over Old Yharnam, the Healing Church stepped in with its powerful treatment: the Healing Blood. It put the Old Yharnamites into a state of euphoria, craving more of the substance. The Healing Blood didn't necessarily cure the Ashen Blood illness. It just created a new problem.

If we look again at cholera, likely the inspiration for Ashen Blood, we can find a good example of this playing out in real life. Before medications and even basic remedies like saline solution were available to combat the disease and its most potent symptom, diarrhea, the common treatment for cholera was opium, which possesses natural antidiarrheal properties. In the West, that meant using opium tinctures, such as laudanum, or even heating small doses of opium to produce an intoxicating vapor. These doses were referred to as “opium pills.” This could be what the Antidotes represent, or the Antidotes could represent something benign like salicin, a precursor to Aspirin, discovered by Scottish physician Thomas John MacLagan in the mid

1800s. MacLagan used salicin as a fever reducer for cholera and typhus. But just like the Antidotes only provided short-term relief from Ashen Blood, salicin or even opium and poppy-based medicines didn’t cure cholera—they just temporarily alleviated discomfort. In Old Yharnam, people sick with Ashen Blood took the Antidote pills to temporarily relieve discomfort, but it wasn’t a cure. So they turned to the Healing Blood, but it didn’t work either. It just hooked the Old Yharnamites on a powerful, intoxicating and highly addictive substance. It was the addiction that cost them their humanity. It was the addiction that transformed them into beasts. In Old Yharnam, residents specifically became Beast Patients because they were already sick with Ashen Blood.

We know that the Scourge of Beasts isn’t a traditional disease, thanks to several items we can acquire. The Old Hunters would tightly tie the Old Hunter armbands to prevent infection by the Scourge, but as the item description states, “Of course, the idea that the scourge was infectious was pure hearsay.” That’s why adorning the Old Hunter Gloves with brass or tying tourniquet-like belts on the Old Hunter Trousers were useless superstitions. Addiction isn’t infectious or contagious. It comes from within. It’s the same reason why the Scourge has persisted despite the endless hunting, the burning of Old Yarnham and the retreating to higher and higher areas within Yharnam. It’s not contagious; it comes from within.

Drug abuse and addiction are themes that permeate the game. They’re at the center of the Healing Church, as we hear directly from the mouth of its leading cleric, Vicar Amelia. If the player approaches her in the Grand Cathedral but remains far enough away to avoid triggering the fight, we find her kneeling and repeating a mantra-like prayer at the altar. “Beware the frailty of men,” she says. “Their wills are weak, minds young. The foul beasts will dangle nectar and lure the meek into the depths. Remain wary of the frailty of men.” The words of this prayer underscore the entirety of the Scourge of Beasts. Men innately are weak-willed and will follow nectar, meaning intoxicating, tempting substances, into the depths—literally and figuratively.

This is what the opening cutscene of the game is trying to tell us: that through addiction, we will follow “foul beasts…into the depths.” In the introductory cutscene, we’re administered the Healing Blood, an intoxicating and addictive substance, that causes us to drift into a dream-like state. In this haze, a Scourge Beast emerges from a pool of blood in the floor, reaching out its claw to us to beckon us to the depths from whence it emerged. It wants us to drown in the addictive blood. It reaches out its claw because it is trying to get its claws into us—this is the Clawmark. We’re able to resist its temptation, for now. But can we resist the pull of the Healing Blood forever? Laurence, the first vicar and founder of the Healing Church, could not. We see a visual depiction of this very thing within the item called Laurence’s Skull. Laurence’s human skull, lost long ago, is shown sinking into a pool of blood ringed by his church shawl.

All of this conveys the same message. The Blood is the substance that we’re supposed to fear. The substance that makes us drunk. The substance that, as Master Willem warned, is the undoing of men. It’s the substance that causes us to lose our humanity and succumb to our inner beastliness. The Scourge is addiction.

There is a second way to understand Clawmark and Beast, even though addiction remains at their core. Whereas the Beastly Scourge most commonly is connected with the everyday use and abuse of the Healing Blood and thus addiction, blood drunkenness, or what I’ll call bloodlust, is caused not by consumption of the Healing Blood but instead, by brutality. We see this exemplified in “The Strange Case of Dr. Jekyll and Mr. Hyde,” and in several items and pieces of dialogue in the game.

In “Jekyll and Hyde,” the evil Mr. Hyde is responsible for a savage murder and has gone on the lam. In Jekyll’s final testimony, he writes, “Hyde in danger of his life was a creature new to me; shaken with inordinate anger, strung to the pitch of murder, lusting to inflict pain.” Jekyll’s inner beast was brought about by abuse of a drug, but the inner beast was sustained by this violence…this bloodlust. Of all the items in Bloodborne that help us see the role of bloodlust and transformation, the most important is the Eye of a Blood Drunk Hunter.

This item, which we must obtain to access the Hunter’s Nightmare is a “pupil [that] is collapsed and turned to mush, indicating the onset of the scourge of beasts.” This indicates in no uncertain terms that blood drunkenness is associated with the onset of the Scourge of Beasts. But the Old Hunters that we find in the Hunters Nightmare, those who are afflicted with blood drunkenness, aren’t worshiping at the altar of Laurence or indulgently gulping down the Healing Blood. They’re in some sort of eternal purgatory mercilessly slaughtering Beast Patients, seemingly innocent creatures who are trembling with fear. Hunters who go blood drunk aren’t drunk in the sense of consuming an addictive substance, such as the Healing Blood. They’re addicted to the hunt, the drawing of blood from beasts; they’re in the ravages of bloodlust. It’s just like Djura tells us if we continue to slaughter the beasts of Old Yharnam: “It’s you. You’re the beast. Just think about what you’re doing. It’s utter madness.” Eileen the Crow is even more explicit when she tells us, “Few hunters can resist the intoxication of the hunt. Look at you, you sorry drunk. I’ll string you up like the filthy beast you are.”

Aside from the Old Hunters of the Nightmare, Father Gascoigne serves as the best illustration of this bloodlust. As Eileen tells us, Gascoigne is “falling apart.” He’s been driven mad by the hunt—chopping up bodies like a frantic anatomist—such that by the time we find him in the Tomb of Oedon, he’s already started to lose his humanity and is showing outward signs of beastliness. He turns to us and flashes his fangs.

The item description for Gascoigne’s Gloves and Trousers reinforces this idea, stating that these garments “are tainted by the pungent beastly stench that eats away at Gascoigne.” The smell of beasts—the former humans that he’s carved up by the hundreds—is eating away at his humanity. This violent bloodlust has rendered him unable to distinguish friend from foe. Like a violent drunk of the Victorian era, Gascoigne has abandoned his children and beaten his wife to death, having been driven mad by his lust for beast blood.

When we encounter Gascoigne in the Tomb of Oedon, it’s important to recognize that he’s not in the process of killing a live beast; he’s mutilating a beast corpse. The kill is no longer enough. His thirst for beast blood requires him to first decapitate the beast, then bury his ax in the chest of the beast, causing blood to spray all over his face and cloak. As I’ll explain in much greater depth in the next video, Bloodborne’s hunters are meant to represent the surgeons and anatomists of the Victorian era. Gascoigne, who loses his humanity to bloodlust, is supposed to represent a mindless surgeon who amputates limbs without hesitation, or a ruthless anatomist who dissects cadavers for medical research. Gascoigne, like other blooddrunk hunters, is meant to represent the heartless medical practitioner who has lost his humanity to brutality. He views the patient or the cadaver on the table as no longer human; just a lifeless slab of meat with no more dignity or individuality than a rotting deer carcass.

In this regard, the Clawmark rune can be seen as the alluring invitation for the incising anatomist or surgeon to “seek the warmth of blood.” The brutal desire to slice open bodies causes these physicians to lose their humanity, just as we see with Gascoigne. The symbol of the Clawmark rune—a surgical incision that has been stitched up—makes more sense now.

This revelation, that hunters’ bloodlust or brutality is what turns them into beasts, allows us to understand the third and final meaning of beastliness in Bloodborne. If hunters are the surgeons and anatomists of the Victorian era, and the hunter’s job is to hack and slice their way through beasts, then beasts also can be understood to mean surgical patients and cadavers. The Beast Patients in Old Yharnam and the Hunter’s Nightmare help to solidify this conclusion. Gascoigne, bearing the attire and weapons of early hunters, is meant to represent primitive surgery or dissection. As I said, we’ll cover this in much greater depth in the next video.

Now that we understand the true nature of the Healing Blood and the Beastly Scourge, we’re able to unlock door after door in the Bloodborne universe. In the next video, we’ll start to examine how the life of William Ernest Henley and his surgery at the Royal Infirmary of Edinburgh gave rise to every institution in Bloodborne, from the Healing Church, to the College of Byrgenwerth and the School of Mensis. We’ll focus first on Byrgenwerth and the betrayal. As we move forward from there, I’ll explain the origins of major figures in the game, including Master Willem, Laurence and Ludwig. It’ll be fascinating to peel back these layers of the lore.

An Agony of Effort, Part IV - Of Graves and Gardens (Byrgenwerth & The Betrayal) | Google Docs Link

If you’ve ever wondered how Laurence, Willem and Byrgenwerth got their names—and what the College of Byrgenwerth is really meant to represent—you’re in luck. Today, I’ll explain all of that.

In this video series, I’ve argued that the lives and works of Victorian authors William Ernest Henley and Robert Louis Stevenson played a foundational role in the story of Bloodborne. I’m well aware that, to many people, this seems far-fetched and weird—and if you’re still skeptical about this idea, I completely understand. But if you’ll give me five minutes, I think I can change your mind and your entire outlook on the game Bloodborne.

First, a very, very brief recap. William Ernest Henley was an English author, literary critic and poet who was born in 1849. He suffered his entire life from tuberculosis of the bones, and in 1873 traveled from London to Scotland to undergo an experimental surgery at the Royal Infirmary of Edinburgh, one of Great Britain’s leading hospitals. The 28 poems that Henley composed about his stay in the Royal Infirmary would be combined into a collection called “In Hospital,” which appears to have had an influential role in the development of Bloodborne’s story. From Software drew upon Henley’s experiences in Edinburgh, a city that was a hotbed of medical study and surgical advancement throughout the Victorian era, to shape much of the world we experience in Bloodborne. As we’ll see in this video and the following two episodes of this series, every major institution in the game—from Byrgenwerth, to the Healing Church, to the School of Mensis, to Cainhurst—was inspired by the real-life institutions of the Edinburgh medical community in the 18th and 19th centuries. These organizations represent the evolution of medical science and practice over the course of the Victorian era. With that in mind, let’s get to the good stuff.

The College of Byrgenwerth is Bloodborne’s place of learning. Believe it or not, its name is directly connected to William Ernest Henley. Henley grew up in Gloucester, England, and in his teenage years was educated at the Crypt Grammar School, commonly called the Crypt School.

How does that connect to Byrgenwerth? Well while the term “werth” is just an Old English suffix applied to place names, the word “byrgen” is an Old English word meaning burial place or grave. Thus, we have Henley’s Crypt School and Master Willem’s College of the Grave. This is a subtle but strong piece of evidence connecting Henley to the game.

Master Willem didn’t get his name from William Ernest Henley, though. And the College of Byrgenwerth isn’t based on Henley’s childhood school. As I said before, almost everything in Bloodborne is rooted in the Edinburgh medical community because that’s where Henley came for his surgery, where he spent nearly two years in recovery and where he met and became friends with Robert Louis Stevenson.

OK, if Master Willem didn’t get his name from William Ernest Henley, then where did it come from? We can thank two other Williams for this inspiration. We learn from the Rune Workshop Tool that Master Willem’s title was “provost.” The title seems appropriate, considering the honorific “provost” is typically assigned to the head of instruction at an institution of higher learning. But within the city of Edinburgh—where Henley’s surgery and recovery took place—and in the major cities of Scotland more generally, the title “provost” means something completely different. For more than 400 years, Edinburgh has appointed or elected a Lord Provost to serve as a figurehead of the city government. It’s the equivalent of the Lord Mayor of London. In 1869, a man named William Law became Lord Provost of Edinburgh.

In his single term in office, Law’s most significant accomplishment was authorizing the relocation of the Royal Infirmary from its old spot on Infirmary Street to its new site on a street called Lauriston Place. This relocation took place 10 years later in 1879. The Royal Infirmary in the mid 1800s became the leading place for medical study in Edinburgh and perhaps in all of Great Britain. It essentially supplanted the University of Edinburgh Medical School as the city’s heart of medical scholarship. This is what Laurence’s break from Byrgenwerth is meant to represent—it’s the evolution of medical science in the 19th century within Edinburgh; it’s the abandonment of old ways and the embrace of more advanced methods of surgical research and practice, which included the use of cutting-edge anesthetics like ether and chloroform, which I noted in the second video were the inspiration for Bloodborne’s Healing Blood.

Master Willem appears to derive his name in part from Lord Provost William Law, while Laurence derives his name, at least in part, from the new site of the Royal Infirmary of Edinburgh, Lauriston Place. I say “in part” because Willem and Laurence’s names are very likely derived from other sources as well, which we’ll discuss shortly.

The College of Byrgenwerth under Master Willem is meant to represent the old medical establishment of Edinburgh of the late 1700s, specifically the University of Edinburgh Medical School, which operated out of what was known as the “Old College” building. To confirm this connection between Willem and Byrgenwerth and the University of Edinburgh medical school, we can begin by looking at some architectural similarities. In addition to its striking domed roof, the Old College’s windows and brickwork are somewhat similar to that of Byrgenwerth, while its hand railings that ring the Old College’s inner quad are almost exactly like those that form the lakeside walls of Byrgenwerth.

But that’s really the weakest evidence. Let’s talk about the important stuff. At the University of Edinburgh medical school, scholars of the Old College were deeply focused on chemistry and pathology as a means to gain medical knowledge or insight. This was especially true of William Cullen, a titan of the Scottish Enlightenment who was professor of chemistry and medicine at the University of Edinburgh as well as a lecturer at the Royal Infirmary of Edinburgh in the late 1700s.

Cullen was particularly interested in the central nervous system and proposed a theory that the nervous system was composed of four main elements, including the brain and spinal cord, the muscle fibers, and the sensory and membranous nerves. This is important. While Master Willem derives his “provost” title from William Law, his name Willem almost certainly is a nod to William Cullen. Let’s examine why.

In Bloodborne, if we kill Master Willem, he drops the highest tier of the Eye Rune. The rune states, “Eyes symbolize the truth Master Willem sought in his research. Disillusioned by the limits of human intellect, Master Willem looked to beings from higher planes for guidance, and sought to line his brain with eyes in order to elevate his thoughts.” The Eye Rune description tells us that Master Willem was trying to alter his mind to elevate his thoughts and reach a higher plane. As weird as this might sound, Willem was trying to get high. Figuratively speaking, so was William Cullen, the chemist and medical researcher. According to the University of Edinburgh medical school archives, in the late 1700s, the physicians of the medical school “established a botanic garden for the study of medicinal plants, and this gave the base for the development of studies in pharmacology and chemistry. By 1764, the numbers of medical students were so great that a new 200-seat anatomy theatre was built in the College Garden.” Let’s think about Byrgenwerth. What are the enemies we encounter there and only there that would correspond to this description of the Old College and its botanic garden? First, we have the Garden of Eyes. It’s right there in the name.

Beyond the name, though, we can see that the creature’s head is essentially a brain with many fly-like eyes on it. It’s wearing a tattered hospital gown. These details tell us that these creatures likely represent the real-life patients who would have been given experimental drugs of the late 1700s in order for physicians to gain insight, or eyes on the inside, meaning an understanding of the effects of pharmaceuticals on the brain or nervous system. Its fly-like appearance denotes death and disease, but more specifically it could imply typhus, a disease spread by flies, fleas, ticks and lice. It was a disease that plagued the major cities of Great Britain in the 17 and 1800s which the medical establishment struggled to combat. This enemy also indicates that Master Willem, like the students of the Old College at the University of Edinburgh, was trying to “line his brain with eyes” by studying pharmacology. Master Willem, as we know from the Caryll Rune Tool, didn’t want to use blood to gain insight. He would have been proud of Caryll for using the runes, which are etched into one’s mind. How would you impact the brain that way? Pharmaceuticals.

Second, we can turn to another type of enemy at Byrgenwerth: the Fluorescent Flower. Again, it’s right there in the name. This non-humanoid kin enemy is a giant walking representation of the central nervous system, primarily the spinal cord. Its legs likely are stylized ribs, while the glowing stems are activated nerves. The teeth running the length of the spine and the fireball that shoots from the flower bud, to me, signify pain, but that’s just my intuition. So, we have Gardens of Eyes and Fluorescent Flowers, creatures that are only found at Byrgenwerth in the main game. One is a giant brain, and the other is a massive walking spinal cord with nerves. The botanic gardens of the University of Edinburgh medical school and Cullen’s focus on the central nervous system are the influences here.

Finally, let’s look at the last type of enemy we encounter at Byrgenwerth: the Brain Sucker. The Brain Sucker possesses a long, flowing head that resembles a luminescent nightcap. But it’s likely modeled off microscopic parasites carried by flies, either those that land in bacteria-ridden feces or flies that bite.

Parasites enter a human’s bloodstream and may eventually penetrate the central nervous system, which, in many diseases, can cause neurological problems such as confusion or changes to one’s personality or behavior. The Brain Sucker enemy also will pounce on the player-character, latch onto our head and drain us of Insight. The enemy itself is a brain parasite.

To recap, we have Gardens of Eyes that are eye-covered brains with a fly-like appearance. We have the Fluorescent Flower, which looks like a walking spinal cord. And we have Brain Suckers, which are humanoid manifestations of parasites that infect the nervous system. Everything here ties back to William Cullen, the scholar of the central nervous system who, as a chemist, founded a botanic garden for medicinal study at the University of Edinburgh medical school. There’s really no doubt what’s going on here.

If that weren’t enough evidence that this is what Byrgenwerth is supposed to depict, let’s hammer it home with a couple more revelations. When we find Master Willem on the balcony overlooking the Moonside Lake, he’s holding a staff. At the end of the staff, the metal has been molded into a pattern of what appear to be flower bulbs. We see this same feature on the belts of the attire set belonging to the Choir.

As we learn from the Blindfold Cap, the members of the Choir are “scholars who continue the work that began at Byrgenwerth.” This unique flower-bud feature seems to be the clearest link between them. Could this symbolize the work that began at Byrgenwerth and continued with the Choir? In a word, yes. We see a very similar flower bulb appearance, unsurprisingly, in the ritual material item, the Coldblood Flower Bulb. The Coldblood Flower Bulb is related to Tomb Mold and Coldblood Flowerbuds, all of which are meant to depict the poppy flower, and thus opium.

Opium use became popular in the United Kingdom in the late 18th century, primarily through its application in the pharmaceuticals laudanum and morphine. These would have been the drugs that William Cullen and his contemporaries would have studied and used, and they’re all derived from botanic sources. The things growing out of the back of Master Willem’s neck are meant to be mushrooms, various types of which possess psychoactive agents that medical scholars would have been studying at that time. Everything here gets back to the University of Edinburgh medical school under the direction of William Cullen.

To recap, Byrgenwerth—the College of the Grave—is a direct connection to William Ernest Henley, who attended the Crypt Grammar School as a young man. Byrgenwerth represents the University of Edinburgh Medical School with its botanic gardens and university garden anatomy theater. And Master Willem represents William Cullen, a medical scholar and researcher of pharmaceuticals of the late 1700s in Edinburgh. As I’ve said and will continue to say, the life and works of William Ernest Henley and Robert Louis Stevenson are the soul of Bloodborne. In the next video, which I admit is my favorite of the series, we’ll carve up the mysterious School of Mensis and their realm, Yahar’gul Unseen Village. There’s much insight to be gained.

An Agony of Effort, Part V - Occult & Tragic (The School of Mensis & Yahar’gul) | Google Docs Link

The most sinister organization in all of Bloodborne, the School of Mensis, conducts its seemingly occult rituals in the hidden village of Yahar’gul. But as we’ll see in this episode, Mensis was pulled straight from the medical history books of Great Britain. Today, we’ll expose this real-life nightmare ritual.

Throughout this series, I’ve suggested that Bloodborne’s settings and institutions are based upon the real-world medical community and evolution of medical science in Edinburgh, Scotland over the course of the Victorian era. The city was the bellwether of surgical knowledge in that period. In the previous video, I pointed out the abundant evidence indicating that the College of Byrgenwerth was modeled upon the University of Edinburgh Medical School in the late 1700s, which operated out of the Old College Building. As we’ll see today, the School of Mensis represents the real-life next step in this evolution of medical science and practice.

In Bloodborne, Laurence breaks from Byrgenwerth and his former master, Provost Willem, to found the Healing Church in Yharnam. The Healing Church itself becomes divided between two schools of thought. Laurence and the Choir focus on using the Healing Blood and experimentation to gain knowledge, while the School of Mensis, under the direction of Micolash, relies on what seem to be the dark arts that involve kidnapping people and using their bodies for nefarious means. The Mensis method, although it’s highly dramatized, matches exactly what we see in Edinburgh in the early to mid 1800s. The city became the world’s epicenter of anatomical research, which meant Edinburgh was the cadaver capital of the world. To fully understand this, we first have to take an extensive look at Yahar’gul Unseen Village. A courtesy warning: This section will contain images of dissected bodies.

Much like in Central Yharnam, with its carts and wagons filled to the brim with caskets, Yahar’gul is filled with cabs and wagons, presumably those used to transport captives or bodies. I think it’s fair to say that the common assumption in the lore community when it comes to Yahar’gul is that it’s the place where all manner of foul human experiments proceed at the hands of the School of Mensis. We know from the Yahar’gul armor set and the Mensis Cage that Mensis founded and controls this area. The thinking goes that bodies, or perhaps even living subjects, would be brought to the hidden village for use in the surreptitious Ritual of Mensis, an occult process that we never directly observe and no one fully understands. In terms of the in-game lore, that’s probably the correct assumption. That’s what From Software wants us to think. But in terms of the inspiration for Yahar’gul, for the School of Mensis and for what’s actually happening here, we can look to the morbid realities of Victorian life—or, more appropriately, Victorian death.

The School of Mensis is meant to represent Edinburgh’s prolific anatomists of the early 1800s—the scholars, surgeons and physicians who dissected bodies for medical study.

Dissection of bodies, of course, goes back thousands of years, but so-called anatomists were the anatomical researchers of the 18th and 19th centuries who learned about the human body by dissecting cadavers, preserving organs and diseased tissues, and presenting their findings in medical schools and lecture halls. Anatomists, whether they were associated with an established medical school or just serving as independently operating instructors, could make a comfortable living in the major cities of Europe and Great Britain. It wasn’t uncommon in the early to mid 1800s for anatomy instructors to take on 30 to 50 students in a given year, training them on the organs and systems of the body, as well as basic surgical practices. An anatomist who could regularly obtain bodies for his students to dissect and preserve could command larger enrollments and thus earn more money and notoriety. This led to great competition for students in cities such as Paris, London and Edinburgh. That’s why the members of the School of Mensis wear the Student Uniform and why their main hub outside of Yahar’gul is the Lecture Building, with its laboratories and lecture theaters. They’re mimicking these medical schools of the Victorian Era, specifically the University of Edinburgh Medical School.

Cadaver dissection became increasingly commonplace in the United Kingdom in the mid-18th century after the Murder Act of 1752 changed the laws around capital punishment. A man convicted of murder would be denied burial and instead would be put to death and could have his body turned over to anatomy schools of the major cities. This is what we’re supposed to take away from the Butcher attire set. It’s obviously the mask of a Medieval or Renaissance executioner, and the set indicates as much: We learn from the Butcher attire description that the Madaras Twins, who wore the butcher set, “became hunters, and brought back and dissected their beast prey, in order to support the villagers in their forbidden research.” The “prey” of real-life executioners were men convicted of capital offenses who could be hanged and then dissected as part of forbidden research, meaning medical research. The butcher mask, because of its similarity to an executioner’s hood, is supposed to help us see this association with executed criminals and dissection, whereas the Butcher garb—with its sullied apron—is similar to what an early anatomist would wear. Most importantly, though, thanks to the Butcher attire description, From Software is associating hunters with anatomists, and beasts with cadavers. I mentioned this exact thing in Part III of this series when discussing Gascoigne and his bloodlust.

Even amid all the disease and mass death of pre-Victorian and Victorian England and Scotland, the rules were very strict about which bodies could be dissected. In addition to the bodies of convicted murderers, the only other classes of corpses eligible for dissection were those of dead orphaned children or prisoners who died while incarcerated. Anatomists—those who operated independently or in small research groups—needed more bodies to perform their dissections than they could legally obtain. As a result, they would employ less-than-reputable gentlemen to obtain the goods of their trade. This was what made Edinburgh the world’s most infamous city for body snatching and corpse selling, which included the unthinkable Burke and Hare murders that sent Scotland into a panic in 1828.

William Burke and William Hare were lowlife laborers looking to make a buck by any means possible after the harvesting season had come to an end. Hare had rented out a room to an elderly man who died still owing him 4 Great British Pounds. Now unable to collect, Hare figured he’d make the money back by exploiting Edinburgh’s demand for cadavers. Hare set out to sell the man’s body to the medical school at the University of Edinburgh, but on the way he was redirected to local anatomist Robert Knox, who purchased the corpse for a little more than 7 pounds. Seeing a money-making opportunity with little sign of slowing, Burke and Hare killed 16 people in Edinburgh over a 10-month stretch. So as to not scar the bodies or create evidence, they typically got their victims drunk and then suffocated them—callously murdering even old women, and children with mental disabilities. Each subsequent victim went to the anatomist Robert Knox for about 10 pounds apiece until their scheme was uncovered and the men were tried and convicted. Burke was hanged and, in great irony, his body was dissected, while Hare, who had turned state’s evidence, was exiled from the country and never seen again.

While Burke and Hare committed murder in order to sell bodies to anatomists, the unsanctioned acquisition of corpses throughout the United Kingdom was more commonly associated with body snatching. Body snatchers, sometimes referred to as “resurrectionists,” typically operated under the cover of night, looking to pilfer freshly covered graves and sell the recently deceased body to a local anatomist for a respectable sum of money. Resurrectionists would break open one end of a coffin and loop a rope around the body to drag it out. That’s what the Yahar’gul hunter set is meant to depict, with rope prominently displayed around the neck of the dark, hooded attire. It’s described as the garb of night-stalking “kidnappers” with rope to restrain their foes. Although we never see them do it, Yahar’gul hunters would have been the figures in Bloodborne who steal the bodily contents of coffins and graves, slinking back to Yahar’gul with their corporeal plunder.

If the Yahar’gul hunters are actually supposed to be body snatchers, then what about the enemies named Kidnappers? They literally snatch the player and take you to Yahar’gul—notably after they’ve killed you.

This enemy leaves little doubt: The Kidnappers are “burkers,” a name given to men who killed people and sold their bodies to anatomists. The name, as you’d assume, was inspired by William Burke of the Burke and Hare murders. Bloodborne’s Kidnappers kill people, or at least severely incapacitate them, toss their bodies into a bag and deliver their remains to the Hypogean Gaol, the keep under Yahar’gul, a realm overseen by Micolash and his uniform-clad students. This is just like what took place in the major cities of Scotland and England in the early to mid 1800s.

Something that’s puzzled players over the years are the chains we find wrapped around caskets throughout Yharnam. At least in the early game, I think we’re supposed to believe that the chains are there to keep something inside the caskets from escaping. But based on what we observe in Yahar’gul—and based on everything we’ve just discussed—it makes much more sense that the chains were there to keep the Yahar’gul hunters out. Yharnamites didn’t want their dead bodies to be defiled.

There’s historical precedent for these kinds of security measures. To protect their dead loved ones from body snatchers, the well-to-do of England and Scotland would bury bodies at far greater depths or would just opt to build vaults instead. As I posted recently on the Bloodborne subreddit, the wealthy of the Victorian era would even set up contraptions known as cemetery guns that would fire if grave robbers tripped a booby trap. We see these cemetery guns all throughout the Hunter’s Nightmare, which just further reinforces the idea that Bloodborne is indeed rooted in Victorian death, body snatching and anatomical dissection as I’ve been describing throughout this series.

People also would employ iron cages known as mortsafes. The example of a mortsafe I show here on the right is from the Greyfriars Kirkyard cemetery in none other than Edinburgh. It’s immediately adjacent to the Royal Infirmary. The iron-barred carriages we find in Yahar’gul might very well be mortsafes on wheels. As we can see on this damaged wagon, the front and back walls of the wagon are actually shaped like gravestones with iron frames, fused together onto a carriage.

If you’re still not sure about this connection between Victorian anatomists and Yahar’gul, let’s clear this up. It’s incredibly noteworthy that when we return to Yahar’gul after the red moon rises, we find caskets shuffling along the ground, filled with reanimated body parts. These enemies are appropriately named Cramped Caskets. When we think about the enemies we encounter in this area, Yahar’gul is populated predominantly by Cramped Caskets, Eye Collectors, Kidnappers, Undead Scourge Beasts and finally, the boss of the area, The One Reborn. These enemies are either amalgamations of dead bodies or body parts—or are responsible for the collection of bodies and body parts. All together, they reinforce the influence that cadavers and anatomical dissection played in the development of the School of Mensis. Without question, this organization was drawn from the real-life anatomists and medical scholars of Edinburgh in the Victorian era.

We haven’t discussed it yet, but you might be wondering where we get the name Mensis. Most lore hunters seem to get this only partly right. Mensis, as most lore hunters know, is a term we’re led to believe means “of the moon.” That’s not quite right. The Latin word “mensis” means “month” and it’s where we get the word menstrual, as in a woman’s monthly cycle, much like the monthly lunar cycle. The term is supposed to make us associate the Ritual of Mensis with the Blood Moon. I think that’s a correct, albeit incomplete interpretation. In Latin, and in romance languages deriving from Latin, the root word has another meaning. “Mense” in French and “mensa” in Italian can refer to tables. If we think about it this way, the School of Mensis is the School of the Table, as in operating table or dissection table. The School of Mensis, meaning the School of the Dissecting Table, can be understood as a representation of the real-life anatomy and medical schools of Edinburgh.

The Ritual of Mensis is one we never see conducted, and we’re left to wonder what it entailed. Based on what we’ve established in this episode, I believe the Ritual of Mensis is a metaphor for anatomical dissection. There’s a much longer explanation for my thinking on this, which I’ll share in the final episodes of the series, but for now, let’s look at perhaps the single-most compelling piece of evidence in all of Yahar’gul. In order to fully advance through Yahar’gul Unseen Village, we have to defeat the One Reborn. From there, in the Advent Plaza, we can scale a set of stairs and enter an enclosed room filled with the mummified corpses of the School of Mensis. Here, we find their bodies tightly packed together in extremely steep rows of seats.

Most lore hunters would naturally assume this is some sort of mysterious or occult ritual positioning or something. But as I’ve said throughout this series, we have to view Bloodborne through the lens of the medical metaphor that permeates the game. When we do that here, we can see why they’re positioned this way. The mummified bodies are packed together as we would see in an operating or anatomy theater of the Victorian Age. These theaters were designed to maximize the top-down viewing space for medical students who were observing a surgical operation or dissection. The heads of the Mensis scholars are tilted at strange angles which really has nothing to do with the heavy Mensis Cage helmets they’re wearing; it’s to represent the craning necks and leaning bodies of the onlooking medical students observing an operation or dissection. This is the School of Mensis, after all.

For me, the strangest thing in this room has always been the beaming moonlight illuminating Micolash’s corpse. If you look at the ceiling, you realize there’s no opening to the roof that would allow moonlight to come through. It’s just moonlight emanating seemingly out of nowhere. Then it dawned on me. Because we now know that the Ritual of Mensis (also known as the Ritual of the Table) is dissection, and we’re standing in an anatomy or operating theater, the “moonlight” we see in this room is meant to be the light of a surgical lamp. Micolash is the leading scholar who is positioned in the center of the theater and would have been performing the dissection. From this, we can infer that the Pale Moon is a metaphorical representation of a surgical lamp, while the red moon, or Blood Moon, is the lamp splattered with blood during the ritual, or operation. There’s more to discuss on this topic, but I’ll return to it in a later episode.

If we operate under the assumption that the Ritual of Mensis is anatomical dissection, then the lore note that states, “The Mensis ritual must be stopped, lest we all become beasts,” now takes on a new meaning. “Mensis’s practice of kidnapping and dissecting us is rendering us beasts, or cadavers. If it doesn’t stop, we’re all going to die this way.”

Before we wrap this episode, you might be wondering “Where do we get the name Yahar’gul?” I don’t have a complete answer to this one, but I’m very confident that the suffix is supposed to refer to a “ghoul.” Ghoul can mean ghostly or morbid, but it owes its origins to an ancient Arabic myth. The ghoul was a humanoid beastly creature, widely considered a demon, that robbed graves and fed off the flesh of the dead. It’s easy to understand how Victorian anatomists, with their association to grave robbing and dissection, could be considered ghouls.

In the next video, we’ll take a closer look at the Healing Church and see how its attire sets and its home in Upper Cathedral Ward were drawn from the halls of the Royal Infirmary of Edinburgh.

An Agony of Effort, Part VI - Holy and High (The Healing Church) | Google Docs Link

There’s a medical metaphor sewn into the fabric of Bloodborne, woven from real-life Victorian-era medical science and practice. Aside from major settings in the game, including Iosefka’s Clinic and the Research Hall with their overt medical overtones, we see this influence on countless items. From the Accursed Brew, displaying an orbitoclast used for lobotomy operations, to the Gem Workshop Tool, which was based upon an 1800s petit tourniquet, to almost all consumables, which resemble the druggist jars of the 19th century, to the Poison Knife, which is described as “sharp as a surgeon’s blade…used by special doctors,” Victorian era medicine shows up again and again and again in Bloodborne.

As we’ll see in this episode, Laurence’s Healing Church is a tapestry of medical imagery and verbiage. It’s our gateway drug to this medical metaphor.

I’ve argued throughout this series that Bloodborne was inspired primarily by the city of Edinburgh, Scotland, which was the epicenter of medical and surgical advancement in the 19th century. I’ve also argued that Edinburgh played such an inspirational role because I believe From Software used the personal story of Victorian author and poet William Ernest Henley as partial inspiration for the game. Henley sought and received life-saving treatment for tuberculosis within the halls of the Royal Infirmary of Edinburgh. It’s also where he formed a close friendship with one of history’s greatest storytellers, Robert Louis Stevenson. The literary works of Stevenson and Henley undoubtedly influenced several characters in the game, as well as its Healing Blood and Beastly Scourge. As we’ll reveal later in this episode, there is some subtle but amazing evidence that the Healing Church was based upon the Royal Infirmary of Edinburgh in the late 1800s. I don’t see how this is merely coincidental.

Before we start shoveling deep into the lore of the Healing Church, it’s helpful to look at some of the surface-level elements to truly see how From Software made a concerted effort to imbue Victorian medicine into the game Bloodborne. In previous videos of this series, I’ve pointed out just a few of the ways that From Software and game director Hidetaka Miyazaki used hunters as a metaphorical representation of Victorian surgeons and anatomists. Within the Healing Church, these examples are much more obvious. As we learn fairly quickly in Bloodborne, the Healing Church is explicitly described as a medical institution. Aside from the Healing Blood and its curative reputation, we learn that the Church is staffed by Black Church Hunters who are called “elementary doctors,” and White Church Hunters, who are simply called “doctors.” Importantly, the Black and White Church Hunters wear Surgical Gloves. These pieces of attire represent just a few of the ways that hunters are characterized as doctors, but the Surgical Gloves are the item that most directly compares the hunt to surgery or dissection, stating “The Church engages in a hunt in a medical capacity.” The gloves also appear to allude to the hunter’s visceral attack, comparing it to surgery—reaching into the host's bosom as if to remove a cancer. From Software didn’t just accidentally come up with these comparisons—they did this deliberately and with an intent to tell a certain story.

The White Church Hunters are described as superiors to the Black Church Hunters, as if they’re more sophisticated or advanced. This is a direct parallel to the evolution of medical practice and medical attire in the 1800s. In his 2007 article in the American Medical Association Journal of Ethics, NYU professor of surgery Dr. Mark Hochburg explained why black was the clothing color of choice for doctors well into the Victorian period.

Physicians dressed themselves in black…until the late 19th century. Black attire was, and is, considered formal…..Consequently until about 1900, physicians wore black for their patient interactions since medical encounters were thought of as serious and formal matters.

We see this phenomenon depicted in artwork of the 1600s to 1800s, from Rembrandt’s Anatomy Lesson of Dr. Nicolaes Tulp to Thomas Eakins’ The Gross Clinic. In both pieces, nearly 200 years apart, anatomists and surgeons are clad almost entirely in black.

Dr. Hochburg’s review of black medical garb also noted its religious associations. “Clergymen also dressed in black,” he wrote, “which indicated the solemn nature of their role in encounters with parishioners. An additional or alternative possibility for the dark garb might be that until the late 19th century, seeking medical advice was usually a last resort and frequently a precursor to death. Until the last third of the 1800s, an encounter with a physician rarely benefited the patient.”

Changes in medical philosophy and medical science ushered in a change in attire. Thomas Eakins’ Gross Clinic, showing surgeons in black suits, was painted in 1875. But just 14 years later, Eakins painted the piece we saw in the last video, The Agnew Clinic.

We can see the shift in attire in less than two decades, as Agnew and his staff are dressed in all white when performing the surgery. White smocks, gowns, caps and sheets came to represent cleanliness, which coincided with the development of antiseptic and later aseptic surgical techniques that were rooted in decontamination and disinfecting of the operating space.

The attire sets of the White Church Hunters and the Choir, the highest-ranking members of the church, collectively indicate this evolution of medical science in real life, as well as the embrace of science within the Healing Church.

The White Church Hunters are “specialists of experimentally backed blood” who believe that the use of medicine is a “method for research.” Members of the Choir, meanwhile, are described by their attire as “scholars.” From Software is using the attire of the White Church Hunters and the Choir to mirror the changes of the 1800s, when scholarship and research became the foundation of modern medicine at the same time that surgical practices shifted away from brutal hack-and-slash affairs toward pain-free, sanitary operations. Within the Healing Church sets, the shift from black to white and the increasing complexity in the attire design from the simple Black Church Hunter uniform to the highly intricate Choir gown are aesthetic representations of this evolution.

Earlier, I alluded to the connection between the Healing Church and the Royal Infirmary of Edinburgh. Throughout this series, I’ve displayed images of the Old Royal Infirmary on Lauriston Place, a building that still stands although it hasn’t housed the city’s main hospital for about two decades. This wasn’t the hospital building where William Ernest Henley underwent surgery and spent two years in recovery. He was treated at the previous Royal Infirmary on Infirmary Street, which ceased operations in 1879 and was destroyed several years later. Few images remain of the former facility. Instead, the images I’ve shown are of the Old Royal Infirmary that operated from 1879 until 2003. Nevertheless, the Royal Infirmary throughout the 1800s was perhaps the world’s leading surgical hospital and was literally on the cutting edge when it came to surgical innovation, and the adoption of modern anesthesia and sanitation methods that dramatically improved the survival rate of patients. If, as we discussed in previous videos, the College of Byrgenwerth is meant to represent the University of Edinburgh Medical School at the Old College Building in the late 1700s, and the School of Mensis is supposed to represent the University of Edinburgh in the early 1800s with its reliance on anatomical dissection, then the Healing Church is meant to represent the Royal Infirmary with its adoption of powerful anesthetics like ether and chloroform, which as we’ve discussed are exactly like the highly intoxicating and addictive Healing Blood of the Healing Church.

There are several very clever design choices that From Software made to help us see this connection between the Royal Infirmary and the Healing Church. Individually, they might not be that convincing. But taken together, it’s hard to see this as anything other than deliberate. Let’s take a look at these architectural and aesthetic clues.

When we ascend the great staircase in Cathedral Ward, we come to the massive double doors of the Grand Cathedral. Aside from the ornamentation on the doors, one of the more unique elements of this doorway is its shape. It’s not rectangular, nor is it not an arch. It contains these distinctive angular insets on the corners of the door frame and the doors themselves. We see this same motif on the doors of the Royal Infirmary of Edinburgh, shown here in 1999. The motif isn’t just isolated to the main entrance, though. We see it in this archway in the lobby of the Old Royal Infirmary, this time with virtually identical dimensions as those of the doors to the Grand Cathedral. We see it in a side hallway connected to the lobby. The architect of the Old Royal Infirmary, David Bryce, ensured that this pattern was incorporated throughout the facility. The main doors of the Old Royal Infirmary eventually were given glass windows, but for decades the outer doors were towering pieces of wood, as shown in this image taken in 1897. I’m probably reading too much into this, and it’s not something I’m relying on as a key piece of evidence, but I thought I’d point it out nonetheless. When we look at these wooden doors of the Old Royal Infirmary, a certain pattern jumps out to me. I think it’s interesting that just outside the doors of the Grand Cathedral in Bloodborne, we encounter two Church Servants who are wielding massive wooden gibbets with this exact pattern. Might be nothing, might be something. Interesting either way. But let’s continue.

In Bloodborne, when we enter the Grand Cathedral, we can see that the sides of the entryway are lined with stone plaques engraved with illegible text. We can speculate that these might display some sort of holy scripture or teachings of Laurence, but we don’t receive any evidence to indicate what this text might be. Within the lobby of the Old Royal Infirmary, the walls are lined with plaques containing the names of donors to the hospital. Again, might be nothing, might be something. But let’s continue.

The Grand Cathedral is just one facility in the larger complex of buildings belonging to the Healing Church. We have to ascend Oedon Chapel to access Upper Cathedral Ward. Here, we find two more interesting pieces of evidence linking the Church to the Old Royal Infirmary. The first is the Orphanage. Surrounding the Orphanage are Celestial Larvae. The name Orphanage would imply that whoever or whatever gave birth to these creatures is either dead, ascended or missing, rendering these creatures orphans. When the Old Royal Infirmary opened on Lauriston Place in 1879, it housed Edinburgh’s first dedicated maternity hospital. The maternity hospital was opened with the keen understanding that poverty in the Scottish capital was threatening the lives of expectant mothers, new mothers and their children. Unwed mothers gave up their children in maternity hospitals that were sometimes referred to as “Foundling Asylums.” This could explain the name of the Orphanage and its presence as a room within the larger Upper Cathedral Ward area.

Immediately adjacent to the Orphanage in Upper Cathedral Ward is the great hall, with its large chandelier. It’s important to note the chandelier, because when we enter the great hall, a scourge beast sends the chandelier crashing to the floor, plunging the entire space into darkness. This darkness hides one of the most distinctive features connecting the great hall to the Royal Infirmary. As we observed in photos earlier in this episode, the floors in the Old Royal Infirmary have a striking black-and-white chessboard pattern. It’s something you can’t miss. Within the great hall of Upper Cathedral Ward, if we light up the room with our torch, we can see that the floors there contain a black-and-white chessboard pattern. Intriguing, right?

Let’s look at one final piece of evidence, perhaps the most compelling of them all. As we discussed before, the Healing Church is a massive complex of buildings in Cathedral Ward. The heart of the Healing Church is the Grand Cathedral. After we reach the top of Oedon Chapel, we can cross the bridge over to Upper Cathedral Ward. Although it’s difficult to see how they’re connected based on this image, we can cross from Upper Cathedral Ward back over to the loftiest part of the Grand Cathedral, where we find the Lumenflower Garden. As we see in this image, behind the massive Grand Cathedral is a steeple-topped tower that kind of looms hazily in the background during the base game. It isn’t until the DLC when we’re able to access the Hunter’s Nightmare that we come to learn that this tower is the Healing Church’s Research Hall, a giant facility filled with patients, beds, operating rooms and cases full of medicine jars. It’s a hospital or infirmary. If you’re able to find just the right angle in the base game, you can get a clearer view of the Research Hall. In addition to its steeple-topped roof, the building is a clock tower, just like the steeple-topped main building of the Old Royal Infirmary of Edinburgh. There are certainly other hospitals around the world with clock towers—not a ton, but some. But when we take all this evidence together, it gets harder and harder to discount these factors as purely coincidental. The evidence points to the same conclusion: The Healing Church was based on the Old Royal Infirmary of Edinburgh in the latter half of the 19th century.

I had planned to include a section in this episode explaining the real-life inspirations for Laurence and Ludwig, but in the process, I realized it’d make this episode too long for one sitting. With that in mind, in the next episode, we’ll see how two of the Healing Church’s towering figures were based upon two physicians of the Victorian era: One known for his work with anesthetics, the other renowned for his surgical innovations. It’s fascinating to see how From Software turned these men into monsters.

An Agony of Effort, Part VII - The Vicar & The Blade (Laurence & Ludwig) | Google Docs Link

Laurence and Ludwig, fallen heroes of the Healing Church, are perhaps the most tragic figures in a story populated almost entirely with tragic figures. Although From Software exercised literary license in crafting these characters, they weren’t cut from whole cloth. Based on what we’ve discussed in this series, as well as some additional evidence we’ll reveal today, we can say with confidence that From Software drew inspiration from two historical figures—and the literary adaptation of one of those figures—to give life to these two foundational members of the Healing Church.

Before we can reveal the real-life inspirations for these characters, we have to briefly recall several key points I’ve made in this series.

Point 1: Healing Church = Royal Infirmary In Part VI of this series, we discussed the ways in which the Healing Church serves as a parallel to the Royal Infirmary of Edinburgh, arguably the world’s leading surgical hospital of the 19th century. It’s where Victorian author and poet William Ernest Henley sought and received treatment for tuberculosis in 1873, and where he became friends with famed author Robert Louis Stevenson. As I’ve argued throughout this series, From Software used Henley’s personal story and the literary works of both Stevenson and Henley to develop the main story of Bloodborne and several of its leading characters.

Point 2: Hunters = Surgeons Throughout this series, and especially in Part VI, I’ve shown how From Software portrayed hunters as a metaphor for Victorian surgeons and anatomists, none more explicitly than the Healing Church hunters who are explicitly described as doctors. This is the core tenet of the game’s medical metaphor.

And finally, Point 3: Healing Blood = Anesthesia In Part II of this series, I laid out the evidence showing that the Healing Blood, the central item in the game and the basis for the Healing Church, is meant to represent the intoxicating and addictive anesthetics of the Victorian era, primarily ether and chloroform.

When we view hunters as Victorian surgeons, the Healing Blood as an 1800s anesthetic, and the Healing Church as the Royal Infirmary of Edinburgh, other pieces start to fall into place fairly quickly. With that said, let’s turn our attention first to Laurence, the first vicar and founder of the Healing Church, then we can move on to Ludwig.

As we discussed in the second video of this series, Robert Louis Stevenson’s Gothic horror tale, “The Strange Case of Dr. Jekyll and Mr. Hyde” served as the basis for the Healing Blood. In Stevenson’s short story, doctor and chemist Henry Jekyll experiments with chemical agents in his attempt to create curative substances. But in the process, he discovers certain agents that possess intoxicating, addictive properties that he can’t resist, and one of his concoctions transforms him into the repugnant Edward Hyde. Stevenson almost certainly based his story on the unsettling tale of American dentist and chemist Horace Wells, who experimented with ether and chloroform in the late 1840s, which caused a violent behavioral transformation and prompted him to take his own life.

In “The Strange Case of Dr. Jekyll and Mr. Hyde,” Stevenson describes Mr. Hyde not just by his violent and antisocial behavior but by his unique appearance which is completely different from Dr. Jekyll’s. Although popular adaptations of the story later depicted Hyde as a sleek and flamboyant figure—somewhat like Gehrman during his boss fight—in the original tale Hyde is referred to much differently. Stevenson characterizes Hyde as a troglodyte, meaning a cave man or primitive ancestor to humans. Stevenson describes Hyde three times as “ape-like” in appearance. That’s how Hyde was depicted in the 1931 film “Dr. Jekyll and Mr. Hyde.”

This is what we’re supposed to see in Laurence’s beastly skull in the Grand Cathedral, with its uniquely simian appearance. Unlike the Scourge Beasts or even Vicar Amelia and their canine physiognomy, Laurence’s transformed skull matches the description of the ape-like Mr. Hyde. Lore hunter JSF pointed out this detail years ago, but wasn’t sure what it might mean. It was and is an important observation. As I’ve repeatedly said and shown in this series, Stevenson’s “Jekyll and Hyde” was the inspiration for the Healing Blood. But critically, this detail allows us to understand that the ape-like Mr. Hyde, a beastly figure into which Dr. Jekyll transformed, was almost certainly the inspiration for Laurence. As we just noted, the theory is that Robert Louis Stevenson based his characters Dr. Jekyll and Mr. Hyde upon Horace Wells, a pioneer of early anesthesia. If we start to connect the dots, we could argue that Laurence—the founder of the Healing Church and its champion of the anesthesia-like Healing Blood—was indirectly inspired by Horace Wells, a real-life physician driven to darkness and death by his addiction to ether and chloroform. We discussed in Part 4 of this series that Laurence got his name, in part, from Lauriston Place, a street in Edinburgh where the Royal Infirmary was relocated in 1879. This makes perfect sense, considering the Healing Church was inspired by the Royal Infirmary. But we can now look at two naming inspirations side by side: From Lauriston and Horace, we get Laurence.

Although there’s this ape-like physical skull that we associate with Laurence that remains in the waking world on the altar of the Grand Cathedral, his soul or consciousness is manifested in the Hunter’s Nightmare as the burning corpse of a Cleric Beast. We find this corpse resting on the altar of the Nightmare Cathedral.

It’s not surprising that many people have suggested that Laurence’s statuesque appearance is similar to Michelangelo’s Pieta, which depicts Mary cradling the dead body of Christ. Laurence of course is a Christ-like figure in some superficial ways, in that he sought to save humanity with the power of divine blood that possibly could help them transcend their human bonds and ascend to another plane of existence, just as Christ’s blood in the form of his martyrdom provides spiritual salvation and delivery to heaven for his followers. But Pieta isn’t the direct artistic inspiration for Laurence’s pose in the Nightmare Cathedral. Instead, just like pretty much everything else in the game, the inspiration comes from Edinburgh’s medical community in the 1800s. Housed in the Surgeon’ Hall anatomical museum is a plaster cast titled “From Nature” or “Cast From Nature.”

Although the work was inspired by Pieta, the piece is not Renaissance art. It’s a plaster cast of a partially dissected body, as captured by Edinburgh anatomist John Goodsir in 1845. Flaps of incised skin are folded back on the upper chest. We can see much greater similarity between Laurence and “From Nature” than we can between Laurence and Pieta, from the protruding ribs, to the back-leaning head to the identical positioning of the arms and legs. Not to mention, there’s no Mary figure in either “From Nature” or the altar containing Laurence’s cleric beast body. The only major difference is the direction they’re facing. This further reinforces Bloodborne’s use of the term “beast” to represent dissected bodies, or cadavers, also known as bodies drained of blood, while further underscoring the point I’ve been trying to make throughout this series: Bloodborne is meant to depict the nightmarish experience of Victorian-era illness and disease and the dehumanizing nature of medical research, surgery and addiction. The Edinburgh medical community, as well as the lives and works of William Ernest Henley and Robert Louis Stevenson are the soul of Bloodborne. This just further reinforces this conclusion.

Before we finish this section on Laurence, let’s examine one more thing. One of the more confusing items in the game is the key item called Laurence’s Skull. The item description is a swirling tempest of seeming contradictions: “Skull of Laurence, first vicar of the Healing Church. In reality he became the first cleric beast, and his human skull only exists within the Nightmare. The skull is a symbol of Laurence's past, and what he failed to protect. He is destined to seek his skull, but even if he found it, it could never restore his memories.”

This item description is exceptionally difficult to follow, but we’ll give it a try. At some point in the Bloodborne universe, Laurence was a scholar at Byrgenwerth. He discovered a special medium, the Old Blood, that had remarkable properties. It alleviated pain and provided a euphoric intoxication. He saw great promise in the substance and wanted to bring it to the masses, which was a noble aspiration. But the Healing Blood that he crafted was too seductive. Just like Dr. Henry Jekyll, Laurence was unable to resist the temptation of the intoxicating substances he had refined. He lost himself in the drug and transformed into something else. Just like Dr. Jekyll permanently transformed into the ape-like creature Edward Hyde, Laurence transformed into an ape-like beast whose skull we find on the altar of the Grand Cathedral. Laurence, the man, was forever lost when this beastly transformation occurred. He could never transform back into his human form. When the item Laurence’s Skull tells us “the skull is a symbol of Laurence's past, and what he failed to protect,” it means the past is Laurence’s human past, and what he failed to protect was his humanity. In “Jekyll and Hyde,” Dr. Jekyll had relied on a serum to transform him into Hyde, and another serum to transform him back into Jekyll. But eventually, the latter serum stopped working. The fading remnant of Dr. Jekyll’s consciousness within the physical form of Edward Hyde was trying to formulate a serum so that he could transform back into his human self, but it was never going to be possible. Laurence, his consciousness trapped in the Hunter’s Nightmare, is destined to seek his human skull, a symbol of his past, a symbol of his humanity, the thing he failed to protect. But it no longer exists in the waking world. In that world, there is no Laurence anymore. There are no human remains of Laurence. There’s just a skull of an ape-like beast that Laurence became. That’s what the item Laurence’s Skull means.

Ludwig, the Holy Blade With Laurence’s origins made much more clear, we can turn our focus to Ludwig. We learn from the Yharnam Hunter attire and the Sword Hunter Badge that Ludwig was the first hunter of the Church, therefore he would have come after the Old Hunters of Gehrman’s era. Let’s recall two of our main premises that we discussed earlier: 1) Bloodborne’s hunters are metaphorical representations of Victorian era surgeons, and 2) the Healing Church is meant to represent the Old Royal Infirmary of Edinburgh. If these assumptions are accurate—if what I’ve argued throughout this series is true—then there should be clear-cut evidence substantiating this: That the real-life parallel for Ludwig would have had to have been a surgeon from the Royal Infirmary of Edinburgh in the Victorian era. Furthermore, if my insistence that the personal story and poetry of William Ernest Henley was indeed a major influence on the game Bloodborne, then we should expect to see a linkage between Henley’s poems from “In Hospital”—the book of poetry about his two-year stay at the Royal Infirmary—and Ludwig, a character inspired by a real-life surgeon of the Infirmary. Guess what? We do.

There are two vital pieces of information that allow us to pinpoint the true inspiration for Ludwig. The first piece comes from Bloodborne; the second comes from Henley’s poetry. Let’s start with the evidence from within the game. It’s an item that we don’t directly associate with Ludwig by name. But it’s obviously an item exclusively affiliated with Ludwig. It’s the Hunter Chief Emblem. The Hunter Chief Emblem is an item that provides the player easier access to Cathedral Ward, the home of the Healing Church, in the early game. But the emblem’s practical application is virtually irrelevant here. It’s the item name and description that are important. Let’s talk about the item name first. There are two important things to keep in mind about the word “chief.” First, throughout all of Bloodborne, the word “chief” appears only once: It’s in the Hunter Chief Emblem. It’s not in any item descriptions, lore notes or pieces of dialogue. It’s only on the Hunter Chief Emblem. Second, the lore hunter Last Protagonist confirms in his exhaustive Japanese retranslations that the word “chief” is correct, meaning there wasn’t a mistranslation in the original version, or some other more appropriate term that should’ve been used instead. The word “chief” in Hunter Chief Emblem is accurate.

Both of these are HUGELY important, as we’ll see momentarily. As for the item description, it states, “The main gate is shut tight on nights of the hunt, and could only be opened from the other side with this emblem. In other words, the captain's return, and this emblem, determined the end of the hunt.” The item bears an emblem we’re led to believe is the icon the Healing Church. We see this emblem on the Cathedral Ward gate, and we can see that it is almost identical to the Communion Rune, which we see throughout the Healing Church’s Research Hall. This tells us that the Hunter Chief Emblem belonged to the captain of the Healing Church hunters, not just any band of hunters. It didn’t belong to Gehrman’s Old Hunters or the Powder Kegs. This belonged to the captain or chief of the Healing Church hunters. Although the Sword Hunter Badge tells us that “Ludwig was the first of many Healing Church hunters to come,” within Bloodborne, there is only one figure who is named or alluded to as the leader of the Healing Church hunters: It’s Ludwig. We know from the Yharnam Hunter attire that Ludwig recruited hunters, implying he organized, trained and equipped them. We learn from the Radiant Sword Hunter Badge that this key item was carried by Ludwig’s successors or heirs to his will, suggesting that they venerated him as a leader. The spoken words of Ludwig, the Holy Blade, solidify this conclusion. After we defeat Ludwig in the Hunter’s Nightmare, he asks “Are my church hunters the honorable Spartans I hoped they would be?” as if they were his disciples or soldiers. He’s clearly being depicted as the leader or captain of these Healing Church hunters. It makes sense, then, that Ludwig, the first Healing Church hunter and commander of these “honorable Spartans” is the Hunter Chief to whom the Hunter Chief Emblem first belonged. Even if it was handed down over the generations, Ludwig is the only hunter we can individually identify as the owner of this emblem at some point in the history of Bloodborne.

With that in mind, we can turn to the other critical piece of evidence, this time within the literary works of William Ernest Henley. As we discussed in much greater detail in the first video of this series, Henley spent two years in the Royal Infirmary of Edinburgh, from 1873 to 1875, where he underwent successful surgery on his right leg to remove infected tissue caused by tuberculosis of the bone. He wrote more than two dozen poems that were later consolidated into a book of poetry titled “In Hospital,” which captured his experience undergoing Victorian era surgery and his lengthy recovery in the Royal Infirmary. In three different poems from “In Hospital,” Henley refers to an unnamed surgeon at the Royal Infirmary as “The Chief.” He even titles one of the poems as simply “The Chief,” and dedicates this piece entirely to this surgeon. He describes this person as “the professor” who makes rounds with nurses, surgical staff and medical students scurrying along behind him, following his every word and instruction. As multiple literary historians have confirmed, and as basic logic would lead us to conclude, the surgeon that Henley referred to as “the Chief” was Sir Joseph Lister, chair of clinical surgery at the Royal Infirmary from 1869 to 1877. I realize that sounds extremely odd based on the figure we encounter Ludwig, the Accursed in the Hunter’s Nightmare. But stick with me for a few minutes and I think you’ll be surprised.

It’s not an overstatement that Joseph Lister was arguably the most important surgeon of the 19th century and remains one of the leading figures of medicine in the last 300 years. Lister developed and popularized what was known as the antiseptic surgical technique that revolutionized the preparation of surgical spaces and disinfecting of incisions. As head of surgery at the Royal Infirmary of Edinburgh, Lister also brought on a host of Nightingale Nurses, those who were formally trained in the nursing profession. These changes under Lister represented a period of modernization and improvement in the quality of medical care and surgery that had never been seen in a major hospital, and it triggered a mass transformation in medical care in the United Kingdom, Europe and America. Lister also ushered in a period of heavy reliance upon the new, seemingly miraculous anesthetics of his day, which further emphasized the Royal Infirmary’s step into the modern era. These anesthetics, ether and chloroform, are the Royal Infirmary’s version of the Healing Church’s Healing Blood.

Lister performed the surgery that saved William Ernest Henley’s right leg from amputation. As head of surgery at the Royal Infirmary at the time, and as Henley describes in his poems from “In Hospital,” Lister made rounds in the Infirmary to appraise surgical incisions and oversee the application of fresh bandages, soaked in carbolic acid. In the poem titled “Staff-Nurse: Old Style,” Henley says of the infirmary’s matronly nurse, “They say ‘The Chief’ himself is half-afraid of her.”. In the poem titled “Clinical,” Henley writes:

“Hustles the Class! And they ring themselves Round the first bed, where the Chief (His dressers and clerks at attention), Bends in inspection already.

Because we know that Henley repeatedly referred to Joseph Lister as “The Chief,” and because we know that Bloodborne’s hunters are meant to represent Victorian era surgeons, we can confirm that the Hunter Chief refers to Lister. And because we know that the Hunter Chief is Ludwig, we can deduce that Lister was the inspiration for Ludwig.

It’s clever that the Hunter Chief Emblem is a piece of cloth, or handkerchief. Surgeons in the mid to late 1800s would have had two uses for cloth handkerchiefs. Prior to the surgery, they would douse a handkerchief with ether or chloroform and hold it by the patient’s nose to administer the anesthetic. This would have started the surgery. Once the surgery was complete, the doctor would use the cloth to wipe the blood from his hands. That’s why, according to the Hunter Chief Emblem item description, the presentation of the Hunter Chief Emblem signifies the end of the hunt. It’s the end of the surgical operation.

In the base game of Bloodborne, we find the NPC named Edgar in the Nightmare of Mensis. He’s wearing the Student Uniform and wielding Ludwig’s Holy Blade and the Rosmarinus—and yes, that’s the correct pronunciation. Edgar’s wielding of these weapons is meant to have us associate the Holy Blade with the Rosmarinus. Let’s examine why.

Joseph Lister, of course, was best known for his antiseptic method, which involved dousing bandages in carbolic acid, or phenol, and cleaning his hands and surgical tools in phenol as well. But he was famous for spraying vaporized carbolic acid in the surgery room in an effort to disinfect the air. The device he used was called a Listerizer, which is what Bloodborne used as the basis for the Rosmarinus, which is said to spray “a cloud of sacred mist.” Lister eventually abandoned use of the sprayer because it didn’t have any impact on infections and, ironically, it just badly irritated the eyes and sinuses of the surgical staff. I think that’s why the item description of the Rosmarinus includes the line, “Oh, fair maiden, why is it that you weep?” We’re meant to associate the Rosmarinus, much like the Listerizer, with Ludwig’s Holy Blade and thus Ludwig, who is based upon Joseph Lister. Both weapons are Healing Church weapons. As I’ve noted in this video and throughout this series, the Healing Church was based on the Royal Infirmary, which is where Lister developed and utilized the Rosmarinus-like Listerizer.

There’s some additional evidence to support the conclusion that Ludwig was inspired by Joseph Lister. First, let’s look at Ludwig’s Holy Blade. Lister, who inspired Ludwig, was a leading surgeon. The weapon of a surgeon, of course, would be a scalpel. Ludwig’s Holy Blade, as noted in its item description, is a silver sword. Silver was the preferred metal for early scalpels. It’s resistant to oxidation and is one of the least chemically reactive metals known to man, making it a valuable material in early medicine. We can think of Ludwig’s Holy Blade as Lister’s silver scalpel. We’ll come back to the item description for Ludwig’s Holy Blade in just a few minutes, because there’s another interesting takeaway.

All of Ludwig’s dialogue also appears to relate to Joseph Lister, often drawn from the verses of William Ernest Henley’s “In Hospital” collection. When we enter Ludwig’s arena in the Hunter’s Nightmare, we encounter something that no other boss in the game receives: a spoken introduction. A bloodied corpse speaks to us, warning of the approaching monster.

“An unsightly beast... A great terror looms! Ahh... Ludwig the Accursed is coming. Have mercy... Have mercy upon us…”

Note the nature of this dialogue. The corpse is warning us of Ludwig’s approach. He says “Ludwig the Accursed is coming.” This text and From Software’s decision to include this sort of a boss introduction scene seems to be modeled off of the first paragraph of Henley’s poem titled “Clinical,” which is dedicated in its entirety to Joseph Lister. And just like the introduction of Ludwig, which speaks of this oncoming, looming figure, Clinical begins with the approach of the intimidating chief surgeon.

Through the corridor’s echoes, Louder and nearer Comes a great shuffling of feet. Quick, every one of you, Strighten your quilts, and be decent! Here’s the Professor.

Although Lister would become one of the most influential and transformative figures in the history of surgical practice, he wasn’t without his critics during his lifetime. Among them were his Scottish contemporary James Young Simpson, as well as American surgeon Samuel Gross. We saw Gross and his assistants in action in the previous video, in the painting by Thomas Eakins, titled Gross Clinic. Unlike Lister and his surgical assistants who practiced with great attention to cleanliness and disinfection, Gross roundly rejected Lister’s antiseptic method. He, and many other physicians, didn’t put any stock into the germ theory of disease, which Lister had embraced after studying the work of French scientist Louis Pasteur. This context allows us to understand Ludwig’s dialogue after the player has defeated him, assuming we’re wearing church attire. Ludwig asks us:

“Tell me, good hunter of the Church, Have you seen the light? Are my Church Hunters the honorable Spartans I hoped they would be?”

Whether we answer yes or no, Ludwig mentions his critics. If we say yes, he responds, “Ah, good...that is a relief. To know I did not suffer such denigration for nothing.” If we say no, he responds, “Oh, my. Just as I feared. Then a beast-possessed degenerate was I, as my detractors made eminently clear.”

Before we finish with Ludwig, it’s important to jump back to Ludwig’s Holy Blade. There’s one other big takeaway. The item description tells us that the Healing Church workshop of Ludwig departed from the ways of Gehrman’s Old Hunter Workshop. This indicates to us that the character Gehrman, as the first hunter and founder of the Old Workshop, likely represents more primitive surgical techniques in the decades if not century prior to Joseph Lister. For a good while, I wondered whether Gehrman was supposed to mirror Sir Robert Liston, a legendary and at times infamous surgeon of Edinburgh who practiced in the decades before the arrival of anesthetics.

Liston, not to be confused with Joseph Lister, was a leading surgeon of the early 1800s and taught at the University of Edinburgh medical school where he mentored the next generation of surgeons including Joseph Lister and a man we’ll discuss in an upcoming video, James Young Simpson. Liston was known for his flamboyance, confidence and—most importantly—speed. Surgeries prior to the antiseptic method, and prior to Victorian anesthesia, had to be performed quickly if the patient were to stand any chance of survival. Death from blood loss of course was a significant concern, but infection was the major killer. The longer a wound remained open, the more likely it was to turn septic. Liston reportedly was able to amputate a leg within three minutes and reveled in the challenge. It’s perhaps no coincidence that an old hunter technique was quickening, as we see in the item, Old Hunter Bone. It improves the speed of the hunter. The item itself appears to be a femur that has been severed, as in an amputated leg. Looking at Gehrman’s weapon, the Burial Blade, we naturally see a scythe that he uses to behead the player-character in the so-called “Yharnam Sunrise” ending. But the artwork for the Burial Blade depicts the untricked weapon’s handle as the bones of the lower leg. It’s supposed to look like a limb that’s been amputated, a Liston special. Also note that the Old Hunter Trousers contain a double belt wrapped around the leg to prevent beast blood from creeping up the leg. It’s also meant to depict a tourniquet belt that would’ve limited blood loss during an amputation.

I now believe that this is just supposed to link Gehrman with the old surgeons who would have performed amputations, not necessarily Robert Liston in specific. There are a few reasons why I changed my mind on this relationship, which I’ll discuss in the final videos of this series.

In the next video, we’ll take a closer look at the village of Hemwick. Although Hemwick and its charnel lane are often overlooked for their lore significance, we’ll see how they strongly reinforce Bloodborne’s connection to the work of William Ernest Henley. The village of Hemwick is not what it seems.

An Agony of Effort, Part VIII - The Hamlet of the Confined (Hemwick) | Google Docs Link

Hemwick, with its charnel lane, has long been viewed as a grim village dedicated to the collection and burning of corpses, but there’s reason to suspect that we’ve fallen for many of From Software’s misdirection techniques that hide the true nature of Hemwick. Some players appear to fixate on the word “char” in charnel, as well as the word “ash” from the Bone Marrow Ash that’s produced in Hemwick. Relying on these two terms, some lore enthusiasts conclude that Hemwick must be a sprawling crematorium. But as many others have pointed out on reddit and in comments of numerous lore videos, a charnel or charnel house isn’t a place where bodies are burned; it’s a place where bones are stored, such as a burial vault or small catacomb. And as I’ll show today, while Hemwick might seem like a long-doomed industrial village dedicated to burning bodies, it’s actually a heavily stylized depiction of the Victorian workhouse.

As I’ve done in most episodes of this series, I want to take a moment to set the scene for this video. Hemwick has a reputation for being the least lore intensive area of the game, and for good reason. It lacks the depth of characters, lore notes and dialogue that give other areas a lore significance and vibrancy that we just don’t experience in Hemwick. We’ll see that reflected in this episode both in terms of its short runtime and fewer major discoveries to share. But there are several interesting things to go over. With that, let’s get going.

To briefly refresh, I’ve argued that From Software used the personal story and literary works of Victorian author and poet William Ernest Henley in shaping the story, settings and some characters of Bloodborne. If you recall from the first episode, Henley spent two years in the Royal Infirmary of Edinburgh after undergoing an experimental surgery to save his right leg from amputation as the result of complications from tubercular arthritis. He captured his two-year stay in a 28-poem book titled “In Hospital.” In the first poem, titled “Enter Patient,” Henley described the Royal Infirmary as “half-workhouse, and half-jail.” As we’ll see in this episode on Hemwick and the next episode on Cathedral Ward, this description from Henely’s poem appears to have shaped From Software’s design choices on Hemwick’s and Cathedral Ward’s settings, enemies and tiny details that we might otherwise discount as inconsequential. Let’s lock ourselves into Hemwick first.

A feature of urban life in 19th century England and Scotland, workhouses were state-run institutions designed to house the poor and provide a source of employment. Although poor houses and workhouses had been in use for hundreds of years, demand exploded in the early 1800s following the Napoleanic wars and after technological advancements in agriculture prompted mass migration of rural farm workers to the major cities of the United Kingdom. The role of the workhouse changed dramatically following the passage of the New Poor Act of 1834 that attempted to discourage able-bodied citizens from taking advantage of existing welfare programs.

Although designed to ease the burden on the taxpayer while also providing much-needed relief to the poor, workhouses quickly devolved into hellish compounds where men and women, children and the elderly, were cramped into run-down facilities where they were essentially forced into servitude and slavery. As noted in the encyclopedic resource, the Britannica:

“...During the 18th century, workhouses tended to degenerate into mixed receptacles where every type of pauper, whether needy or criminal, young or old, infirm, healthy, or insane, was dumped. These workhouses were difficult to distinguish from houses of correction. According to prevailing social conditions, their inmates might be let out to contractors or kept idle to prevent competition on the labour market.”

While the living conditions of workhouses could be inhumane, working conditions were even harsher. Workhouse occupants would be required to complete low-skilled but physically taxing labor in exchange for food and housing. Tasks included breaking rocks, plucking feathers and picking oakum—essentially pulling apart braided rope with their fingers for hours on end. But one common workhouse task in particular is emphasized in Hemwick, although with a major twist. Workhouse inmates would be required to take animal bones and crush them into powder called bone meal fertilizer. This product is still in use today, but in the early 1800s it was a process done by hand. In Bloodborne, Hemwick is best known for its Bone Marrow Ash, a substance that improves the damage of our quicksilver bullets. We’re led to believe that the women of Hemwick produce this Bone Marrow Ash from the crushed bones of dead Yharnamites. But it’s quite likely that the Bone Marrow Ash is a direct nod to the bone meal fertilizer produced in the Victorian workhouse.

I’ve occasionally seen and heard players describe Hemwick as a farming village, thanks to some of the weapons we see the enemies wielding and one of the more distinctive structures we find there. But these elements actually support the workhouse concept. As we ascend higher up into Hemwick, we come across a stable. In addition to the body of a dead horse, we find hunter corpses alongside the Grave Women enemies hiding in the dark. Stables and barns were often used as makeshift lodgings in workhouses and poor farms. In an 1857 article in the British newspaper the Illustrated USK Observer, a journalist documented a visit by the Lord Mayor of London to the West London Workhouse to view the living conditions. The Lord Mayor and his associates found that the men’s casual ward consisted of a 12-stall stable, as shown here in a wood engraving, much like we observe within Hemwick.

The article in the USK Observer painted a grim portrait of the inhabitants living in squalid conditions.

“The poor creatures, in answer to inquiries made of them, stated that upon entering the building a small portion of bread had been given them, but that it was the custom to turn them out in the morning without anything to eat, unless they first broke a certain quantity of stones, of which there was a large heap in the yard. The Lord Mayor and his friends next entered an adjoining cattle-shed, where they found two destitute females huddled together in a rug, lying on the bare ground, almost perished with cold, and without either fire or food.”

By the late 1800s, England’s workhouses were almost entirely populated by the elderly. The artist Hubert von Herkomer captured this reality in his 1878 engraving, titled “A Scene at the Westminster Union,” which displayed a gathering of old women in the St. James Workhouse of London. These visuals might very well have served as the design influence for the Lonely Old Woman of Central Yharnam, who we can send to Oedon Chapel. We’ll talk about her and the chapel in the next video.

Although there are some elements of Hemwick that borrow generally from Victorian workhouses, I think there’s also evidence that the Grave Women were inspired by the female inmates of the United Kingdom’s Magdalene Asylums or Magdalene Laundries, as they were also known. Some players have pointed out the presence of ventilation pipes in the walls and stonework of Hemwick, which implied the existence of fires within buildings or perhaps underground. While many people believe this is smoke from underground fires, as if bodies were being burned there, I believe it’s supposed to be steam—as in, steam from laundering clothes.

The Magdalene Asylums or Magdalene Laundries were workhouse-prisons initially designed to house and reform prostitutes and women who bore children out of wedlock. The asylums emerged in the late 18th century in England, Scotland and Ireland before eventually popping up in the United States and Canada in the 1800s. The term asylum didn’t necessarily connote mental disability or illness—the name was more a reference to the perceived moral or social unfitness of the women who were sent there. Aside from prostitutes, the asylums were occupied by women whose husbands had abandoned them or women who struggled with excessive drinking or substance abuse. Edinburgh, which I’ve repeatedly suggested is the real-life parallel to Yharnam, was home to at least four Magdalene Asylums, including the Royal Magdalene Asylum, founded in 1797.

Magdalene Asylums were designed with rehabilitation in mind, such that women could learn skills necessary to work as house servants or even in certain industrial settings. Learning to launder and sew clothes would provide women with skills that could translate to employment after their release. Although some of the institutions paid women a small wage for their work, manual labor was often a condition of their stay, and the asylum’s provision of laundry services for outside clients generated the revenue necessary to fund the asylums. As the laundries grew in popularity, their populations swelled to include young girls and women who were deemed—often without any evidence or medical examination—insane or unfit for life in society. The rehabilitation and training aspects were minimized, particularly in the asylums of Ireland, which became characterized as prisons for slave labor. An estimated 30,000 women were incarcerated in Ireland’s laundries.

There are a few pieces of evidence that lead me to the conclusion that the Grave Women are modeled off of the inmates of the Magdalene Asylums. As we’ve discussed, Magdalene Laundries were initially designed to be places of incarceration for prostitutes and morally corrupt women. Within pre-Victorian and Victorian prisons, incarcerated prostitutes would be forced into manual labor, such as beating hemp with large wooden mallets. Artist William Hogarth’s 1732 engraving titled “A Harlot’s Progress,” depicts prostitutes set to manual labor in Bridewell, a former palace of Henry VIII that was converted to a prison. But hemp beating also was a routine task required of workhouse inmates, as we see on this 1830s British poster showing older male inmates pounding away at hemp with large wooden mallets. I think we can say with confidence that this is why many of the Hemwick Grave Women we encounter are carrying this weapon.

But there’s more to it than that. As researcher Dr. Jo Thor noted in her 2019 study of Scotland’s Magdalene Asylums, “Occupants were trained in the typical household duties required of a servant: sewing, laundry, cleaning, cooking and gardening.” The weapons that the Hemwick Grave Women carry reflect these duties. Aside from the hemp-beating hammers, they carry a butcher knife, a hand-held sickle, and a two-handed trowel. Each of these items would be used in either cooking or gardening. The trowel’s hot iron appearance, I think, is a misdirection effect, as are the fire bombs that some Grave Women carry. It’s an effort on From Software’s part to get us to associate Hemwick with fire and thus the burning of corpses to make Bone Marrow Ash. This in turn masks the real-life inspiration for the area.

It’s also worth noting that we see the garden trowel displayed prominently within Hemwick’s entryway, cast in metal in a massive sculpture. Importantly, this is a sculpture of a robed woman. Because of its size and prominent placement, the sculpture is an indication to the player that this area is associated with women and the work they do, just as the Magdalene Asylum is a workhouse intended for and populated exclusively by women.

Next, we can look to the naming decisions. It’s worth noting that the Magdalene Laundries throughout Great Britain were designed specifically for so-called “fallen women.” This was the exact term used in the earliest publications related to these facilities. Fallen is a term in English that can mean fallen from grace, but it also can imply killed or dead. It’s possible the name “Grave Women” is a twist on “fallen women” of the asylums. I’m not gonna die on that hill, but I think it’s a possibility.

But where do we get the name “Hemwick”? I think this is actually one of the least mysterious naming decisions in the game. “Wick” is just an English suffix that can mean “district” or “hamlet.” The word “hem,” meanwhile, can refer to the folding and stitching of clothing, as in sewing, one of the primary tasks required of Magdalene Asylum inmates. I think that’s where the name derives part of its meaning. But “hem” also means to enclose or confine, as in “to hem in.” As From Software loves to do, Hemwick appears to be a double entendre that means both “the Hamlet of Clothes Hemming” and “Hamlet of the Confined.” It captures the two overarching characteristics of the Magdalene Asylum: women’s work and incarceration. In summation, the Village of Hemwick is meant to reflect the grim penitentiary workhouse, a fixture of the Victorian era associated with despair and captivity. In this regard, Hemwick the workhouse is like Henley’s description of the Royal Infirmary as a workhouse—a grim hospital, associated with illness, despair and captivity.

One final note: We technically enter Hemwick Village once we enter the small cavern to the left of the Grand Cathedral. We emerge into a forest filled with rifle-wielding Huntsmen and dogs. As we discussed in the section on Yahar’gul, body snatching in Edinburgh was a significant medical and cultural phenomenon that served as the inspiration for Yahar’gul and the School of Mensis. With that in mind, we can make sense of the role of the riflemen and dogs at the Hemwick graveyard. They’re not there to keep the hunter from accessing the village of Hemwick. They’re there to prevent the School of Mensis from digging up the bodies of dead Hemwick villagers in the graveyard.

In the next video, we’ll see how Henley’s description of the Royal Infirmary as “half workhouse and half jail” extends to Cathedral Ward. Once you see what Cathedral Ward is truly meant to represent, you’ll never see it the same way again.

An Agony of Effort, Part IX - The Prison Ward (Cathedral Ward) | Google Docs Link

Cathedral Ward is the heart of the city of Yharnam and the seat of power of the Healing Church. But as we’ll see in this episode, the religious iconography and architecture of Cathedral Ward is an elegant illusion, hiding a dark truth: Under its sprawling churchyard facade, Cathedral Ward was designed as a prison.

Once we defeat Gascoigne in the Tomb of Oedon, we’re able to proceed to Cathedral Ward. A cutscene welcomes the player to the first of two structures named for houses of worship. We begin our journey here, in Oedon Chapel, and our quest line in this area ends within the stained glass walls of the Grand Cathedral. It’s easy to let these sanctuaries of Cathedral Ward and the district’s bounty of sacred statuary frame our conception of the area. But if we’re observant and intentional about not letting the religious connotations of Cathedral Ward cloud our judgment, we start to see some unusual details—some of them glaring, some of them subtle. Let’s start with two of the more obvious details, then we’ll zoom in on the items that are easy to overlook.

From Oedon Chapel, we have two pathways at our disposal. Regardless of the exit we choose, we quickly encounter the main type of enemy of Cathedral Ward: the Church Servant. In our first playthrough, encountering this enemy can be fascinating and alarming. Unlike the beastly creatures we’ve come across thus far, the Church Servants are towering ghostly figures with dark, dead eyes. For now, it’s not really important to wonder what these creatures are—whether they’re Pthumerians or something else—it’s the aspects of their design that are key. There are slight variations in the design of the different Church Servants, but we encounter two iterations of servants regardless of the path we take in Cathedral Ward. One is hooded and carrying a staff; the other dons a wide-brimmed hat and carries a staff and a lantern. A bell can be found hanging from the necks of both servants. These details are giveaways, letting us know right away that the Church Servants are based upon the night watchmen or bellmen of the 17 and 1800s.

The night watchman became a fixture of urban settings in Europe and the British Isles in the 11th and 12 centuries and remained part of city life until the 19th century. Although we wouldn’t consider them law enforcement by today’s standards, the watchman patrolled city streets and sounded the alarm in the event of danger, be it crimes or—much more importantly—fires. Watchmen were sometimes simply called bellmen because they would carry a bell and let it ring out when disaster struck. I’ve seen many players speculate about the significance of the Church Servants’ bells, assigning them a spiritual value or tying them to the Beckoning Bell or other bell items in the game. I don’t think it’s that complicated; I think they’re just intended to symbolize the bell of a night watchman.

Lightly armed, the watchman wasn’t a deterrent to criminal activity, but the role served as a sort of precursor to more formalized policing practices that were adopted in the 18th and 19th centuries. In Great Britain, the first professional police force was the Bow Street Runners of London, formed in 1749 and shown here in a photo taken around 1800. The runners would phase out after the formation of the London Metropolitan Police Force in 1829. While watchmen aren’t a perfect analog for law enforcement, I still think this is what we’re supposed to see when we examine the Church Servants. Most of the Church Servants act as patrolling constables, walking designated paths through Cathedral Ward with a lantern and polearm, or some other sort of weapon, as if they were walking their beat on city streets. But as we make our way up the staircase to the Grand Cathedral, we come across two unique servants who aren’t found anywhere else in the game. They’re armed with what are known as a gibbet or gibbeting, an item synonymous with capital punishment. A gibbet can be a gallows from which a person could be hanged by the neck, or it could be a cross for crucifixion or even scaffolding to hoist a cage in which victims would slowly die, of either starvation or exposure. These Church Servants also have a unique impalement attack during which they lift the player off the ground and appear to receive the same invigoration effect as the hunter does when performing a visceral attack. Thanks to their all-black attire, their impalement attack and their gibbet-like weapon, these Church Servants seem a lot like executioners, or perhaps maybe black-robed magistrates who could sentence a man to death. Taken all together, the Church Servants in their various forms appear to represent the entirety of the Victorian justice system, from the patrolling constable to the magistrate or executioner.

These features alone certainly don’t indicate to us that Cathedral Ward is a prison, but it helps us reorient our thinking and get us into the mindset of viewing this area from the perspective of crime and law enforcement. To take the next step, we can look at another more easily discernible piece of evidence.

When we exit Oedon Chapel and attempt to explore Cathedral Ward, we’re stopped in our tracks fairly quickly. We discover that the ward is locked up tight, sealed by two large metal gates. We learn that if we wanna get inside, we’ll have to find a way to sneak in or we’ll have to obtain the right security credentials. If we’re willing to spend the Blood Echoes for it, we can purchase the Hunter Chief Emblem, which grants us access through the main gate of Cathedral Ward. The Hunter Chief Emblem specifically states that the main gate to Cathedral Ward is “shut tight,” as if the player wouldn’t notice this obvious fact. It’s almost as though it’s being emphasized to draw our attention to it. Additionally, the title or position is interesting. The emblem belonged to the chief, a title given to the highest ranking law enforcement officers, be it a chief of police in the United States or Chief Inspector in the United Kingdom. These details, that the gates that are “shut tight” and only the emblem of the chief will grant us access, inch us a little bit closer toward this idea of Cathedral Ward as a prison.

Ironically, it’s the small details on the biggest figures that help us see this prison connection most clearly. Let’s turn our focus to the Church Giants. It’s easy to assume that the Church Giants are simply oversized versions of the Church Servants. They have similar ghostly faces and long, lean limbs. They wear wide-brimmed hats, as well. But the Church Giants are not at all like the Church Servants if we look closely. First, pay attention to the condition of their clothing. The shorter servants are by far the most well dressed of all humanoid enemies in the game. Their hats are crisp and well shaped. Their clothes are perfectly fitting without a wrinkle, stain or tear. The Church Giants, by contrast, are bruised and bandaged, their clothing stained and in tatters. The edges of their hats are fraying. Whereas the servants’ bells are hanging from their neck on a slim leather band, the giants’ bells are crudely attached with a ruddy chain tied to a length of rope. If the Church Servants are modeled off the night watchmen who ultimately became modern day police, the Church Giants are the sick prisoners of the Victorian era. Again, let’s focus on the details. When we look at all of the giants, whether in Cathedral Ward or in the cavern beneath Iosefka’s Clinic, we can observe shackle rings around their ankles. The ax-wielding giants in Cathedral Ward make a loud clanking noise as they slowly traipse around the grounds. This implies the sound of chains that would bind their legs together. There’s also a unique giant in Cathedral Ward not far from where we obtain the monocular. This giant wields what players often refer to as a wrecking or demolition ball. But it’s not; it’s a prisoner’s ball and chain attached to his wrist. He just happens to use it as a weapon.

We find further evidence that Cathedral Ward is meant to represent a prison when we’re able to access the circular plaza at the foot of the grand staircase. Two Church Giants walk the grounds here, and a large monument stands at the center of the plaza. It took me a long time to see the relevance of this area. It struck me as odd that From Software took the extra step to mention this area in the item description for the Hunter Chief Emblem. The item specifically names this area as “the round plaza” leading to the “Great Cathedral.” I was finally able to put a few clues together, and then it clicked. This space is modeled off of the panopticon, a prison design concept by Victorian-era philosopher Jeremy Bentham. The panopticon would allow a single guard to monitor dozens if not hundreds of inmates from a central station or tower.

If we ascend a building on the edge of the plaza, a top-down view helps us to see this comparison more clearly.

I’d understand your hesitation to embrace this comparison, considering it might seem like I’m basing it only on the fact that the panopticon is in the shape of a circle and this is a round plaza. But there are two additional details that sealed the deal for me. First, as shown in this image, there’s a lore note that we can read while overlooking this panopticon area. It reads, “A watchman of Byrgenwerth guards the gate with a password, the sacred adage of the Grand Cathedral." Finding a note here, which we’d have to read while overlooking this area, that includes the terms “watchman” and “guards” and “gate” is no mistake. The language of this note is designed to orient our perception of this area and associate it with watchmen or guards, as in prison guards. This is masterful placement of a clue that almost nobody will catch.

Second, when we return to the plaza after the Blood Moon, we find the Church Giants seemingly asleep. In our panopticon circle, the two giants are kneeling at the outermost ring. I never thought anything of their positioning until I came across images of Jeremy Bentham’s panopticon design proposal. The Giants are found in the same posture that prisoners would have been expected to assume during mandatory sacred services, kneeling in their cells along the outer ring of the panopticon, which we see in here.

The panopticon was never built, but the philosophy that drove its design—strict isolation of all prisoners and heavy doses of religious reflection—took root in the United Kingdom and United States in the late 19th century. The juxtaposition of religion and punitive incarceration are palpable here in Cathedral Ward.

You might be wondering, “Why would Cathedral Ward be designed as a prison, staffed with watchmen and populated with towering inmates?” For that, we can thank our main influence for Bloodborne, William Ernest Henley. As we discussed in the last video, which explored Hemwick, Henley spent two years at the Royal Infirmary of Edinburgh in the 1870s. In the book of poems he composed about his surgery and recovery, Henley described the Royal Infirmary as “half-workhouse, and half-jail.” As we saw in the previous episode, Hemwick shares many characteristics of the Victorian workhouse, while Cathedral Ward is much more like a jail. As I’ve said before, the life and works of William Ernest Henley are the soul of Bloodborne.

Something we haven’t yet discussed in this series seems appropriate to bring up now. It’s a question I asked myself repeatedly during the research and analysis process for this series: Why did From Software decide to make it the Healing Church? It seems strange, considering the other organizations within Bloodborne were designed as academic in nature, such as the College of Byrgenwerth and the School of Mensis. Why, then, would Laurence’s institution receive this unique religious identification? Eventually I learned the answer: It’s because Henley did it.

As I just mentioned and as I laid out in Part VI, the Healing Church was based on the Royal Infirmary of Edinburgh. Unlike Byrgenwerth and the School of Mensis, which were inspired by the evolution of medical research at the University of Edinburgh Medical School across the pre-Victorian and Victorian era, the Healing Church wasn’t based on a place of learning, per se. It was based on a place of healing: the Royal Infirmary. But the Healing Church’s religious connotations almost certainly go back to William Ernest Henley’s literary work. Throughout the 28 poems of “In Hospital,” the diction Henley applied to his care providers at the Royal Infirmary was laden with religious simile, adjective and analogy. The terms he selected included piety, religious, pray, Jesuit, faith, Philistine, hymn, saint, rapture, quaker-like, pious and Catechist. In Henley’s telling, his nurses and physicians may as well have been ministers and sisters of a healing faith. From Software’s decision to call it the Healing Church and setting its headquarters in Cathedral Ward makes sense. The term “ward” can mean a borough or district of a city, but the term is more commonly applied to hospital departments, such as the maternity ward, the burn ward or the trauma ward. Because the Healing Church was based upon the Royal Infirmary of Edinburgh, one of Scotland’s leading hospitals, the term “Cathedral Ward” seems even more relevant.

Earlier, when I referred to the Church Giants as the “sick” prisoners of the Victorian era, I didn’t explain why I used the term “sick.” Now that we’ve established that Cathedral Ward was inspired by the prison-hospital description of Henley, we can take one final look at the Church Giants to see how this comparison was executed in the game. While the faces of the Church Servants are sallow and ghostly, their skin is smooth and their eyes are dark but visible. It’s completely the opposite with the Church Giants. Their skin is distorted with pock marks. Their eyes deeply sunken to the point we almost can’t even make out their eyeballs. They seem ill.

I believe the Church Giants are meant to represent hulking versions of lepers. Leprosy is an old disease that can cause severe lesions on the skin, as well as the distortion of extremities and facial features. For thousands of years, societies responded to leprosy with fear and ostracism. In the Middle Ages, hospitals focused on housing and treating lepers emerged throughout Europe and may have helped set the stage for the development of modern hospitals in the 18th and 19th century. Despite the gradual improvement in care for people suffering from leprosy in the Middle Ages, exclusion and distrust were common. Lepers would be required to carry leper bells, signaling their presence to others. Based on the design of their skin, their facial deformities, their hats and their bells, I believe the Church Giants are being depicted as prisoner patients of Cathedral Ward.

Before we conclude, I wanted to take a brief look at Oedon Chapel, which technically is part of Cathedral Ward. In this episode and the previous video, we’ve focused on how From Software used Henley’s description of the Royal Infirmary as “half-workhouse, and half-jail” in creating Hemwick and Cathedral Ward. Oedon Chapel oddly enough seems to tie into this comparison as well. We have the option to send four individuals to the chapel, technically five if you include the Suspicious Beggar. Like the needy people who ended up in workhouses because they had no place to turn, our guests at Oedon Chapel ask us essentially the same thing:

“Do you know somewhere that might take me in?” (Adella) “Might you know of a safe place?” (Arianna) “Do you know of any safe places?” (Lonely Old Woman) “Would you know of any safe havens?” (Suspicious Beggar) “Tell me about your little safe place.” (Narrow-Minded Man)

Moreover, each person represents a class of people most likely to end up in a workhouse or prison in the 1800s. They include Arianna, a prostitute; the Suspicious Beggar, who is a beggar and a murderer; Adella, a mentally ill woman who, under the circumstances, is a murderer; the Narrow-Minded Man, a duplicitous layabout; and finally the Lonley Old Woman who is a…lonely old woman…but is also a drug addict. No, for real. She’s an angry old lady who carries the consumable called Sedative, which is undoubtedly a depiction of chloral hydrate. Chloral hydrate was the first major medical sedative to be produced, coming on the scene in the 1830s and slowly gaining popularity over the next half century. Chloral, as it was known, was employed by physicians to calm patients who experienced behavioral abnormalities associated with mental illness. Not surprisingly, it was used liberally within insane asylums before it became more widely prescribed for what we might now consider generalized anxiety disorder. According to the Sedative item description, it “calms the nerves” so that one doesn’t “fall…to madness.” Madness seems to be referring to mental illness, and thus the Sedative refers to chloral hydrate. By the late 1800s, chloral was a drug available to the masses in Europe, Great Britain and America. It’s a powerful, highly addictive drug. The Lonely Old Woman will give some of this drug to the player-character after she’s started to mellow out, implying she’s been sampling some of her Sedative as well. Drug abuse among the elderly wasn’t unheard of in the late 19th century, especially as access to opium-based drugs including laudanum and morphine became easier over the course of the century. So, yeah, party on, Lonely Old Woman.

In the next episode, we’ll take a look at the ways in which the city of Edinburgh and Victorian artwork appear to have shaped the features of Yharnam. The first thing we see when we set foot in Yharnam should have been a dead giveaway.

An Agony of Effort, Part X - The Valley Hamlet (The Real Yharnam) | Google Docs Link

Although Bloodborne’s opening scenes take place within the darkened halls of Iosefka’s Clinic, it seems as though the game doesn’t truly begin until we open the gates and step onto the streets of Central Yharnam. It’s here, amid the distinctive Georgian architecture, the brick streets and the medley of antique carriages and caskets that we grasp one of the most fundamental and important details of the early game: We’re wandering through a Gothic storyscape, as if we had emerged into an otherworldly version of a Great British metropolis of the Victorian age.

For years, players have made the default assumption that Yharnam is a horrific depiction of 1800s London. But as I’ve said and shown throughout this series, and as we’ll certainly see today, Yharnam is a distorted version of the Scottish capital Edinburgh. The clues are there; we just haven’t dug them up yet.

To see the influence of Edinburgh on the main city of Bloodborne, we have to examine Yharnam in its entirety. As we come to observe in the game, the various sections of Yharnam in a sense serve as snapshots in time, providing a sort of chronicling of the city’s history. To start this episode, we have to go back to the beginning: to the streets of Old Yharnam.

As I mentioned in Part III of this series when discussing the similarity of Ashen Blood and the real-life sickness cholera, Old Yharnam in the original Japanese is called “the Old Town district.” We can thank the lore hunter Last Protagonist again for his work on Japanese retranslations. This is a pivotal clue in connecting Yharnam and Edinburgh.

The oldest part of the city of Edinburgh is what is known as Old Town. This isn’t some little-known nickname. It’s the name of the biggest tourist hub in all of Edinburgh. The virtually identical naming between Edinburgh’s Old Town and Yharnam’s Old Town District help us to establish a possible association, but that’s just the start. Let’s dig deeper.

Although Edinburgh’s Old Town was likely first inhabited as early as the 7th century AD, the area didn’t really begin to grow into a thriving commercial and cultural center until the 15th century. As I noted in Part 3, conditions in Old Town in the 17 and 1800s were unhealthy at best. Thanks to the massive Flodden Wall that lined the city’s exterior, there was little room to expand housing as the city’s population swelled in the 18th and 19th centuries. It resulted in a densely packed urban space in which crime and disease were rampant. And just like we see in Old Yharnam in which plague and fire forced the abandonment of the old city, Edinburgh’s Old Town saw a similar exodus as the result of infernos and infectious disease. In the early 1800s, Edinburgh was beset by a series of epidemics, including outbreaks of cholera in 1832 and again in 1840. These cholera outbreaks came on the heels of decades of ravaging typhus and bubonic plague. It was the same time period, though—the early 1800s—that witnessed a rash of conflagrations including the Great Fire of Edinburgh, which devastated the city in 1824. The fire raged for five days, burning dozens of tenement buildings, several shops and businesses, and the steeple of the Tron Kirk principal parish church. More than 400 homes were destroyed.

Much like Old Yharnam was abandoned following the Ashen Blood sickness, the Scourge of Beasts and a district-wide fire, the combination of rampant disease and devastating fires forced Edinburgh’s leaders to embark upon a massive expansion of the city beyond its old Flodden Wall, leading to the formation of the district known as New Town, further to the north. Edinburgh’s Old Town was slowly abandoned by all but the poorest of Scots in favor of the new, more lavish enclaves of New Town, just like in Bloodborne when residents turned their backs on the diseased beasts of Old Yharnam and retreated to the more modern confines of Central Yharnam.

Whereas Central Yharnam and Cathedral Ward are home to a good many landmarks whose official titles or informal names appear in item descriptions, dialogue or lore notes, Old Yharnam to the best of my knowledge contains only one such structure: It’s the Church of the Good Chalice. The church is the final destination in Old Yharnam and serves as the arena for the boss fight with the Blood-Starved Beast. Gehrman tells us to go there to seek a holy chalice. In two pieces of dialogue, Gehrman specifies that the chalice can be found in the “valley” or “valley hamlet,” indicating that Old Yharnam lies at the foot of hills or a mountain. Keep this in mind, we’ll return to it momentarily. Because Gehrman tells us several times that we should venture to this church within Old Yharnam, we’re essentially being told that this location is one we’re supposed to prioritize and see as valuable. I don’t think this is a coincidence. While Edinburgh’s Old Town is home to numerous historic landmarks and tourist destinations, the most famous attraction of the area is the Holyrood Palace and its attached Holyrood Abbey Church, which trace their origins to the 1100s. When we place images side by side of the Church of the Good Chalice and the ruins of the Holyrood Abbey Church, it’s easy to see the astounding similarities. Both churches are missing their roofs. The outer walls of both abbeys contain intricate stonework designs that once served as window frames but are now missing their stained glass. But that’s not all. Just like the Church of the Good Chalice serves as a dead end at the bottom of Old Yharnam, Holyrood Abbey serves as the endpoint of Edinburgh’s Old Town where its main thoroughfare, the road known as Canongate, dead ends. Moreover, Edinburgh’s Old Town lies within a valley, just like Old Yharnam is the “valley hamlet” as Gerhman told us. Old Town is located along the edge of the Salisbury Crags, an ancient rocky outcropping that serves as the southern edge of the city of Edinburgh. The Church of the Good Chalice is our key architectural clue to help us see that Old Yharnam is a parallel for Old Town. These historical, architectural and geographical details are exceptionally persuasive.

With these clues from Old Yharnam in our portfolio, we can turn our attention to Central Yharnam. For this section, it’s important to take a bird’s eye view of the city. We can’t really apply cardinal directions to Bloodborne because the sun and moon are arbitrarily positioned and, as you might have seen other lore hunters point out, these astral bodies don’t adhere to any rules—they’re all over the sky. Nevertheless, for this exercise, let’s assume that Central Yharnam as we see here is arranged west to east as we look left to right on this map.

On its northern half, the Great Bridge stretches across a large, empty expanse before connecting to the other side of the city by the gate of Cathedral Ward. The Great Bridge’s southern portion, by contrast, is contained within the residential area of Central Yharnam. As we move southward, we see buildings immediately adjacent to the bridge on our right and left sides. This is exactly like what we see in Edinburgh. Although they’re named separately, Edinburgh’s North Bridge and South Bridge are the same roadway running north and south in the central part of the city. Much like Yharnam’s Great Bridge crosses over an expanse on its north side, the North Bridge of Edinburgh was built across a valley and former man-made lake known as Nor Loch, or the North Lake. As you move southward on the roadway and go beyond High Street, you find yourself on the South Bridge, which is lined on its sides with buildings. The arches of the bridge are almost entirely underneath the surface, having been closed off and built around over the span of nearly 200 years. But one archway remains above ground, which can be found along the road known as Cowgate. It’s situated within residential buildings on its sides. We observe a similar phenomenon in Central Yharnam. On the south side of the Great Bridge, a large archway can be found within the residential area of Central Yharnam where we find a large group of huntsmen by the burning corpse of a Scourge Beast. The archway contains a door, which helps to slightly mask the similarity of Yharnam’s Great Bridge and Edinburgh’s South Bridge.

One last note about architectural similarities. I would be remiss to not point out that Edinburgh, like Yharnam, contains an aqueduct. The Slateford Aqueduct on the southwest edge of Edinburgh carries water on its raised platform from the river called the Water of Leith to the Union Canal, a man-made waterway that runs into the heart of the city. Yharnam’s aqueduct funnels water to the sewers, as well as the canal that leads to the dry dock of Central Yharnam. I haven’t been able to observe any other major visual or historical connections involving the aqueduct, so I’ll just leave it at that.

The streets of Central Yharnam and the lowest parts of Cathedral Ward are littered with carriages, caskets and gravestones. The headstones are clustered in unusual places, such as brick walkways and outside of residential doors. While this strange feature is likely intended to make us question the reality of the game, as if this could only happen within a nightmare, I think they’re also meant to depict the overcrowding, disease and mass death of the Victorian city.

London, Edinburgh and other major metro areas of Great Britain in the Victorian age were overcrowded to an unimaginable degree. Authors and artists of the period described and illustrated the swarms of humanity flooding city streets and the ramshackle homes stacked on top of one another with one-room occupied by as many as 15 people. Gustave Doré, perhaps better than any other artist of the period, captured the claustrophobic density of human life.

Disease, mainly cholera, typhus and tuberculosis, were merciless killers. Cemeteries were quite literally overflowing with bodies in the major cities, forcing governments to establish state-run burial grounds. In London, city administrators closed all cemeteries within the city limits in the 1850s because there was no room for the seemingly never-ending arrival of corpses.

The carriages and horse-drawn carts that we find in Yharnam of course help us to assign a timestamp of sorts to Bloodborne. It’s an overt signal that the game is depicting the Victorian era. But these carts and wagons are also a reference to the Victorian period’s unimaginable loss of life. As the Bishop of London wrote to the home secretary of England in in 1855, “the corpses of children were frequently carried to the places of sepulture in cabs,” meaning horse-drawn carriages, “and that it was no uncommon sight to see a string of such vehicles, filled with dead bodies, waiting at the gate of an unconsecrated burial-ground, until they could be admitted.” The cabs we see in Central Yharnam, from the back alleys to the Great Bridge, seem to draw from this history.

If you recall from the second episode of this series, we observed how the work of English artist Richard Tennant Cooper and his painting “Chloroform” shaped the opening cutscene of the game. It appears that From Software may have drawn from several of his other pieces in designing several aspects of Yharnam. We see these parallels in his painting titled “Representing Cholera” In this image, we see piles of corpses, which are a common sight in Bloodborne, sometimes represented literally, other times represented by endless piles of headstones and caskets.

But we also see a dark disfigured man whose torso appears to be emerging from a black, oily pool on the ground, his arms outstretched. This seems reminiscent of the “rotted corpse” enemies we encounter in the sewers of Central Yharnam.

I think Cooper’s painting titled “Representing Bubonic Plague” also might have played a role in one other area, although it’s not within Central Yharnam. Cooper described this painting as “a giant hand roaming through the dark streets of London, people and rats trying to escape its grasp.” This giant unseen hand that emerges from the dark and inflicts harm upon the poor souls of the city seems somewhat similar to what the Amygdala enemy does to the player in Cathedral Ward, especially before we have enough insight to see the creature on the side of Oedon Chapel. A hand reaches down from out of nowhere and snatches the unsuspecting player. Cooper’s painting and the snatching move of the Amygdala might be completely unrelated, but because we know that Cooper’s work was used elsewhere, it seems plausible here.

In the next episode, we’ll take a look at Cainhurst Castle. Although this area remains a mystery in many ways, there are some lore discoveries here that will absolutely blow your mind.

An Agony of Effort, Part XI - Victo Dolore (Cainhurst Castle) | Google Docs Link

Cainhurst has always been one of the most beautiful and baffling areas within Bloodborne. Not surprisingly, the snow-covered castle that’s home to a blood-crazed queen has drawn appropriate comparisons to dracula and other popular works within the fantasy horror genre. But Cainhurst is also home to numerous clues that connect the forsaken castle to Bloodborne’s Victorian medical metaphor. With a little patience and some deductive reasoning, we can pierce through this fog.

Among other things, we’ll delve into four main topics in this episode:

1. Primarily, we’ll explain what Cainhurst is supposed to represent within the game’s Victorian medical metaphor.

2. We’ll take a look at the gargoyle enemies and discuss where they got their very unusual name. We’ll also examine why the Blood Licker enemies look like they do.

3. We’ll see what the Knight’s attire set is supposed to symbolize and why one gender-specific piece of the attire set has a unique coloration. And finally…

4. We’ll examine the symbolism of the various things we find within the Cainhurst throne room. There’s a very strange and unexpected correlation. I also cracked the mystery of the stained glass window in the throne room. The evidence related to this discovery is so overwhelming and convincing that it doesn’t just undergird what we’ll discuss in this episode; it solidifies the findings of this entire series. The review of the stained glass window comes late in the episode because a good deal of context is needed.

For everything to make sense, we have to review some universally accepted facts about Cainhurst, then we’ll need to quickly recap some of the important conclusions we’ve made in this series. First, let’s start with the basics.

As is well known, Cainhurst and its Vilebloods are the mortal enemies of the Healing Church. We learn about this blood feud from several sources. Queen Annalise, the ruler of the Vilebloods of Cainhurst, introduces herself and her now-deceased clan as the “sworn enemy of the church.” We learn from the Corruption rune that the Vilebloods are “heretics in the eyes of the Church.” Alfred also says that “the Vilebloods are fiendish creatures who threaten the purity of the Church's blood healing.” Annalise and Alfred together make clear that Logarius and his executioners wiped out the vilebloods, but the nuts and bolts of that aren’t particularly important for this discussion. The main thing to keep in mind is this: The Healing Church and the Vilebloods of Cainhurst are fiercely opposed factions that possess their own unique variant of the Old Blood, and they vehemently believe that their version of blood is superior to the other’s. That’s a bit of an oversimplification, I know, but we’re just laying down some basic building blocks at the moment.

Now, let’s recall one of the main conclusions of this series. As we established in Episode II, the Healing Church’s Healing Blood is without a doubt a metaphor for Victorian anesthesia. I showed in Episode II that the blood shares virtually every major characteristic of the anesthetic ether. Not only are we administered the Healing Blood in the opening cutscene while lying on an operating table, the blood causes us to drift into a dream-like state immediately after it’s administered, just like we would experience if we were undergoing surgery on an operating table while under the effects of anesthesia. Ether and the Healing Blood are exceptionally intoxicating, incredibly addictive, noted for their sweet smell, used in medical capacities and viewed as a sort of universal cure by the masses. With all that in mind, here’s the most important bit of deductive reasoning we have to make: If the Healing Church’s Healing Blood is indeed supposed to represent ether, the first successful surgical anesthetic, then the blood of Cainhurst, the archenemy of the Healing Church, should represent a competing anesthetic to ether. When we explore Cainhurst with this frame of mind, we find a collection of convincing evidence to support this very conclusion. Let’s review a bit of real-life medical history, then we can move on to these lore discoveries.

Ether rose to prominence in the early 1840s and was first employed as a surgical anesthetic in the United States. It wasn’t long before physicians in the United Kingdom and Europe adopted ether as a general anesthetic for surgical and dental procedures, where it proved remarkably successful. But shortly after ether’s emergence in the medical world, a Scottish physician would make a profound discovery that would significantly change Victorian medical practice. In 1847, a doctor named James Young Simpson experimented with chloroform from his home in Edinburgh, inhaling the vapor during incredibly risky late-night sessions that included two of his colleagues. Although chloroform shares ether’s sweet, chemical odor and its addictive properties, Simpson quickly discovered that chloroform’s effects were more powerful than ether’s, and the substance produced a longer period of unconsciousness without the invigorating effects of ether. Simpson was chair of midwifery at the University of Edinburgh Medical School at the time of his discovery of chloroform’s anesthetizing effects, and within a matter of days he began to incorporate the substance into his midwifery practices, most notably in the administration of chloroform to pregnant women to allow for pain-free childbirth. Over the course of his career, Simpson became a leading obstetrician of his era, developing new tools and techniques to safely deliver children and preserve the lives of mothers. But his discovery of chloroform’s unparalleled effects and its use in surgical and other medical applications was what led Simpson to become a global name.

This context leads us to the first of many revelations about Cainhurst. Let’s start with the vileblood itself. Just like chloroform, the vileblood burns, is described as sweet, is intoxicating and more powerful than the Healing Church’s ether-like blood. Let’s look at the evidence. If we decide to join the Vileblood Clan, Queen Annalise says, “Drink deep of Our blood, and feel the spreading corruption burn.” Chloroform vapor was notorious for burning the throat and lungs of patients, prompting a sensation of choking both before the patient lost consciousness and after coming to. We also learn from the Noble Dress that Arianna wears, and from the item Blood of Arianna, that Arianna is a descendant of Cainhurst whose forbidden blood still flows through her veins. Not surprisingly, the Blood of Arianna, like sweet-smelling chloroform, is described in both English and Japanese as “sweet.” It’s worth noting that neither the Blood of Adella nor the Blood of Adeline is described this way. The adjective “sweet” was intentionally applied to the Blood of Arianna to establish its metaphorical representation of chloroform. This is just the start. Let’s keep going.

As it applies to Bloodborne’s medical metaphor, it’s crucial to recognize that James Young Simpson didn’t just champion chloroform on its own merit. He was vociferous in advancing the use of chloroform to the detriment of ether. We see this explained in an 1897 biography of Simpson by H. Laing Gordon, who wrote:

“...Simpson magnified the superiority of chloroform over ether, and was led by that feeling to look on the history of ether as but a stage in the history of the greater chloroform. He regarded chloroform as the only anæsthetic…and offence was naturally taken by the introducers and advocates of ether.” (Sir James Young Simpson and Chloroform by H. Laing Gordon, 1897, pg. 113)

As we see here, Simpson shamelessly touted the superiority of chloroform over ether and railed against ether’s originators and its adherents in the medical community. French and English physicians argued passionately that chloroform was dangerous and was responsible for numerous sudden deaths of patients. The Anglican Church, meanwhile, denounced Simpson’s use of chloroform in childbirth, calling it sacrilegious. But Simpson was relentless in his defense of chloroform both in his speaking engagements and his many published articles in the medical journals of Great Britain. If you’ve been following this series, you might recall that I’ve said at times that the Healing Blood represents Victorian anesthetics, such as ether and chloroform. There are a few details that seemed to suggest it could be either one. But the more I look at the evidence, I think my initial conclusion from Part II of this series is accurate: The Healing Blood is meant to represent ether, while the blood of Cainhurst is supposed to represent chloroform. The real-life schism within the medical community over ether and chloroform is the inspiration for the conflict between the Healing Church and Cainhurst and their feud over which version of their anesthesia-like blood is superior.

We never encounter an NPC or enemy at Cainhurst who represents James Young Simpson, but instead we see subtle references to him in many places. Collectively, they’re rather compelling. Let’s start with the most persuasive evidence first and work our way through the supporting details.

Let’s recall a couple of key takeaways from this series. As I’ve repeatedly said, From Software used hunters as a metaphor for Victorian surgeons and anatomists. And while beasts can represent people who have lost their humanity to addiction to the anesthesia-like Healing Blood, beasts are also a metaphor for surgical patients and cadavers. Hunters carve up beasts, just like surgeons and anatomists carve up human bodies. We see this metaphor within the appropriately named Beast Patients, the Blood-Starved Beast and its dissected body, and within the nightmare corpse of Laurence which is a direct nod to the plaster cast of a dissected body titled From Nature. Within Yharnam, hunters are responsible for killing beasts. But at Cainhurst, as the Reiterpallasch description states, it was the knights who were tasked with slaying beasts. “The old nobles, long-time imbibers of blood, are no strangers to the sanguine plague, and the disposal of beasts was a discrete task left to their servants, or knights, as they were called for the sake of appearances.” From Software appears to be equating Cainhurst’s knights with the Healing Church’s hunters.

Why does that matter? During the Victorian period and in decades before and after, the most prominent physicians of Great Britain were either knighted or made baronets, a title of nobility that we’ll discuss in just a minute. A few major surgeons of the era to receive such honors were James Syme, James Young Simpson, Robert Liston and Joseph Lister, most of whom I’ve mentioned already in this series.

It makes sense that the knights are metaphors for decorated surgeons, just as the hunters of the Healing Church are described repeatedly as doctors and surgeons.

Let’s look at the most persuasive piece of evidence within this knight metaphor of Cainhurst. James Young Simpson’s use of chloroform as an aid in childbirth became much more widely adopted after a major historical figure endorsed the practice. In 1853, Queen Victoria instructed her doctors that she would be administered chloroform in the delivery of her eighth child, Prince Leopold. The childbirth proceeded smoothly and painlessly, and Victoria again requested chloroform in the delivery of her ninth child, Princess Beatrice, in 1857. Queen Victoria would go on to bestow one of the highest honors to James Young Simpson, naming him a baronet. A baronet is essentially the lowest class of hereditary titleage, beneath other statuses such as duke, earl and viscount. But there are two important features associated with the title. Baronets receive the honorific “Sir.” In this regard, they receive the same honorific as a knight. This is incredibly relevant. Cainhurst is known for its nobility and chivalry. In addition to its queen who sits in a lavishly decorated throne room, the castle was once home to nobles and knights. We see this history displayed in the gilded statues of knights on horseback lining the stairwell to the throne room, as well as in the Knight’s attire set, most of which we find within a chest in Cainhurst’s cavernous library. In addition to their honorific “Sir,” baronets were in essence deemed hereditary nobility. Their sons would be titled Second Baronet, their grandson Third Baronet, and so forth. As such, the baronet would receive a coat of arms with symbols to reflect their family’s house as well as the baronetcy honor. For baronets within most of Great Britain, this meant their coat of arms would include a special symbol associated with the baronetcy: The Red Hand of Ulster. Here, we see Sir James Young Simpson’s coat of arms, with argent crescents signifying the Simpson family, and the Red Hand of Ulster shown below a goshawk.

Baronets also would receive a badge or medal as a token of their title, which also displays the Red Hand of Ulster set within gold ornamentation. This is another clue linking Simpson with Cainhurst. The female version of the Knight’s Gloves is completely different from the male version and, with its red coloring, is one of the most distinctive pieces of attire in the game. Per the item description, the female Knight’s Gloves are a “regal piece graced with goldwork on red fabric.” Simpson, as a first baronet, would be titled “Sir James Young Simpson” just as a knight would, and the Red Hand of Ulster, just like the red gloves of the Cainhurst Knights, would be prominently displayed on his coat of arms and his baronet badge. This remains one of my favorite lore discoveries of the series.

The Knight’s Garb also gives us a revealing clue that reinforces the Victorian medical metaphor and the portrayal of knights as surgeons and anatomists. The set description states: “The Cainhurst way is a mix of nostalgia and bombast. They take great pride even in the blood-stained corpses of beasts that they leave behind, confident that they will stand as examples of decadent art.” While at first this description seems to portray Cainhurst’s nobles as psychotic taxidermists, we know that “beast” is a term we’re supposed to see as a metaphor for surgical patients and cadavers that have been dissected. When we think about it that way, the Knight’s attire description takes on a whole new meaning. The Knights of Cainhurst are a group of extravagant, regal figures who have constructed a monument to—or artistic display of—dead bodies. What would that look like in real life? It’s not far-fetched. It’s an anatomical museum, just like what we’d see within Edinburgh’s Royal College of Surgeons and its Surgeons’ Hall Museums. Not only does the old Surgeons’ Hall Museum house the piece titled From Nature which inspired Laurence’s Cleric Beast positioning in the Nightmare Cathedral, it contains hundreds of installations and artifacts of bygone surgical eras, including preserved body parts and skeletal remains. This is the “decadent art” of “blood-stained corpses of beasts” that the Knight’s attire is referring to.

It’s disappointing that we don’t see any sort of depiction of a museum or art gallery within Cainhurst that would display the “decadent art” mentioned in the Knight’s attire. Perhaps it’d be too on the nose and spoil the underlying metaphor. Instead, Cainhurst’s interior—or at least what we’re able to access—is essentially limited to four rooms. We have the grand entrance, which is a lofty hall of sorts. We have the dining room. And we have the throne room. But the overwhelming majority of the indoor square footage we can traverse within Cainhurst is in its massive library. The gargantuan size of the library, spanning multiple floors, is an indication to us that Cainhurst is a place of study and historical records. I think this is intentional. Let’s focus again on James Young Simpson. As a physician, Simpson was renowned for his pen. He was a prolific writer who published frequently within the medical journals of Great Britain, and it could be argued that he was the driving force behind medical publications becoming a major source of scholarship and exchange of knowledge in the 19th and 20th centuries. Simpson read voraciously, and in an era in which academic citations were rare if used at all, Simpson once published a journal article that cited 230 sources. His scholarly reputation would lead him to the position of president of the Royal College of Physicians of Edinburgh in 1850. We see a few design similarities between Cainhurst’s interior and the rooms of the Royal College of Physicians.

First, just like at Cainhurst, we have a multistory-story library with a long, rectangular layout. The space is regularly rented out for weddings and wedding receptions, hence the long table in the middle of the room, much like we see on the lower floor of Cainhurst’s library. Second, we have a gallery ballroom. Just as in Cainhurst’s entrance hall, we see marble columns lining the sides. But we also have statues built into the space of the vaulted ceiling, much like in Cainhurst, which displays statues set into the alcoves of the walls. These statues are not the same, and we’ll discuss the statues of Cainhurst when we examine the throne room.

James Young Simpson wasn’t just interested in medicine. As I mentioned before, he was a prolific reader and writer, and he was fascinated with ancient history. He wrote a series of essays that would be published after his death in a book titled Archaeological Essays, which explored artifacts, architecture and glyphs of prehistoric England, Ireland, Scotland and Egypt. Because of his reputation as an archaeological scholar, Simpson was asked to deliver the annual address to the Society of Antiquaries of Scotland in 1861. Simpson’s expertise in obstetrics, childbirth and the antiquities, I believe, are why the gargoyle enemies we find at Cainhurst are named Lost Children of Antiquity. A lost child can mean a child who died during pregnancy or childbirth, while antiquity is a term meaning ancient history and the relics, architecture and artwork of the distant past. These are topics synonymous with James Young Simpson. There’s a glut of other content out there speculating about the design of the gargoyle enemy and whether it’s Cainhurst’s version of Yharnam’s beasts. I don’t think we have very much to go on, so I’ll let others do that speculation.

Simpson’s reputation, of course, was the result of his work in obstetrics and his use of chloroform as an anesthetic for mothers during childbirth and other obstetric surgeries. This, I am convinced, is why the Blood Lickers look like they do. The enemy appears to have a more classically feminine albeit monstrous face, with long hair. And while of course the enemy’s tick- or flea-like appearance gives it a natural bloodsucking association and gives us a more superficial explanation for why certain Blood Lickers are engorged like an overfed tick, their protruding bellies I believe are supposed to represent the stomach of pregnant women who would be receiving the highly addictive chloroform. Just like in Yharnam, where patients receive the ether-like Healing Blood and become addicted to it, the Blood Lickers are addicted to the chloroform-like blood of Cainhurst. I will absolutely concede that the Blood Lickers do bear a very striking resemblance to the gaki or preta, a mythical being of South and East Asian religious folklore that is condemned to feed endlessly on filth, such as excrement, blood or dead bodies. While that very well could be the chief design influence for the Blood Lickers, and it seems like it is, I still think this feminine monster with a swollen belly lapping up blood is supposed to be a visual representation of pregnant women and chloroform.

This segues nicely into Annalise and the main idea of Cainhurst. Annalise at her core is fixated on one thing: her bloodline. She is desperate for an heir, specifically a “child of blood.” Just like James Young Simpson was known for his discovery of chloroform as an anesthetic and his subsequent use of the substance in childbirth, Annalise is fixated on her chloroform-like blood and her ability to somehow bear a child. She wants Blood Dregs to help her bear the child of blood, and as is well known, these Blood Dregs resemble sperm cells. Annalise’s fixation on gathering sperm-like dregs in order to bear a child is From Software’s way of getting us, the player, to associate Cainhurst with pregnancy and childbirth. From Software then layers onto this the vileblood, a version of the Old Blood that is seen as heretical to the Healing Church’s ether-like Healing Blood. We thus are able to see the vileblood as a parallel for chloroform and its relationship to pain-free childbirth.

With that said, I’m gonna make a somewhat speculative argument, which I really try to avoid doing. I just think this is interesting and slightly plausible. As many players have pointed out over the years, it’s strange that we find several named female NPCs in the game who have similar naming conventions. For example, the Healing Church’s two named Blood Saints are Adella and Adeline. Meanwhile, the female NPCs associated with Cainhurst are Annalise and Arianna. I think the use of “anna” in both of their names is a reference to anesthesia. I realize that sounds ridiculous, but hear me out. One of the most popular stories associated with James Young Simpson is one simply known as “Chloroform Baby.” On November 9, 1847, just days after his discovery of chloroform’s anesthetic effects, Simpson used the substance for the first time to assist in the delivery of a child. The mother had experienced a difficult three-day labor in the birth of her first child, and after three hours into this delivery process, she was suffering from extreme pain and anxiety. Simpson administered chloroform on the woman, who fell asleep and gave birth to the child within minutes. As the story goes, the mother was so astounded and grateful to Simpson that she named her child “Anaesthesia.” Although the story appears to have been completely contrived by Simpson’s daughter, Eve, who included it in a biography of her father, the myth persisted for nearly 40 years until a man confirmed that his mother was indeed the “Chloroform Baby” and her real name was Jane Carstairs. Still, I wonder if this myth of the child named “Anaesthesia” is what inspired the inclusion of “anna” into the names of Annalise and Arianna, two women whose blood is a metaphor for chloroform. It’s an entertaining idea.

Let’s turn our attention now to the hidden throne room. Across the grounds of Cainhurst, and especially within the throne room, we find the same statues again and again and again. One of these is of a woman holding an infant child. Without question, this statue is the Virgin of Paris, a work of art found in Notre Dame cathedral depicting the Virgin Mary holding the Christchild. I’m not the first person to point this out, and Last Protagonist has an interesting video on the art of Bloodborne that I’ll link in the description. Meanwhile, the kingly statue that we find throughout the castle as well as on the main doors of Cainhurst is an exact replica of the statue of Charlemagne found in the Galeries de l’Histoire at Versailles, just outside of Paris. Unfortunately, I haven’t been able to identify the other two statues that we find here, which include the queenly figure and the nude woman. But the two statues that we can identify, as well as two other details here in the throne room, are pointing in a single direction.

In terms of the king and queen statues, they certainly signify royalty, which makes sense within a castle ruled by a queen. And the Virgin of Paris statue obviously overlaps with the mythology of Annalise herself. She’s a woman with no male companion, yet she wants more than anything to give birth to a child of blood. There’s a sort of immaculate conception and virgin birth mythos around her, just as with Mary and the Christchild. But that’s not where these statues are leading us. We’ve got to keep investigating. Let’s examine Annalise. As JSF pointed out in the “Bloodborne Up Close” video that I mentioned before, Annalise is wearing a metal helmet and tells us “We are prisoner to this wretched mask.” This of course leads us to the obvious connection with the Man in the Iron Mask, a story by French author Alexandre Dumas that was inspired by the true history of an unnamed French prisoner in the early 1700s. This unidentified figure was incarcerated and died within the Bastille, the infamous place of confinement for political prisoners in Paris.

(26:15ish) We thus have a theme here at Cainhurst, but especially within the throne room. We have two statues that are exact replicas of statues found in and around Paris, while Annalise herself comes across as a metal-mask-wearing prisoner just like the Man in the Iron mask of Paris. I am convinced that these are clues intentionally dropped into Cainhurst, mainly the throne room, to get us to focus on France so that we can solve the castle’s final mystery: the stained glass window. It’s difficult to make heads or tails of many aspects of this window, but there are some elements that we can extract and illuminate. At the center of the window’s lower half, we find a collection of symbols, including three upward-facing crescents, which is the standard orientation of the crescent within heraldry. At first, I briefly wondered if this might be a loose reference to James Young Simpson. The Simpson baronet coat of arms, as we saw earlier, contains two upward-facing crescents, and the Simpson family coat of arms contains three upward-facing crescents. But those are silver or argent crescents, not gold. The royal blue color and white stripes also made me think this might be a reference to the Scottish flag. But after closer inspection, I realized that this is itself a coat of arms in the window, as we can see outlined here. The field of the coat of arms is royal blue—or in the heraldic nomenclature, azure—and contains several standard symbols of heraldry, including a white or argent chevron and three golden, upward-facing crescents. But it’s also covered by an inverted black triangle, which isn’t a traditional heraldic symbol and just seems to obstruct our view. I am baffled by this triangle, so I thought I’d investigate the items that I could identify. There are two coats of arms I could find that share the primary design. One belongs to Clan Durie, a Scottish family. And although much of Bloodborne is based upon Edinburgh, (28:16) this isn’t the correct coat of arms. Instead, it refers to the Blason de Dienne, the coat of arms of the family of Dienne, a small commune in south central France. As we saw before, everything in this room seems to point to France.

The commune of Dienne derives its name from Diana, the Roman goddess of the hunt and protector of hunters. Diana is frequently depicted in artwork as accompanied by one or more short-haired hunting dogs, such as greyhounds, which could also help explain why the coat of arms in the stained glass window is surrounded by what appear to be three short-haired dogs. I think I’ve seen a few players refer to these as decapitated animals, but I think the dogs just have collars on their necks, like we see in some of these examples. The animal at the top could be a stag rather than a dog, which also is very common in depictions of Diana and her Greek predecessor Artemis. Diana being goddess of the hunt is relevant symbolism for the game Bloodborne, I suppose, but that’s not what we’re supposed to take away from this. Diana is also the goddess of childbirth and guardian of women during labor. She’s generally viewed as the goddess of childbirth because her mother, Latona, painlessly gave birth to Diana but struggled for nine days and nights to give birth to Diana’s brother Apollo. Throughout this episode, we’ve seen how James Young Simpson became the father of pain-free childbirth thanks to his discovery and use of chloroform. The stained glass window is literally the final clue we can physically access in the castle, and it definitively punctuates our conclusion that Cainhurst is an area devoted to Simpson and chloroform.

A final thought. I think it’s fair to say that players have been absolutely bewildered by one aspect of Cainhurst more than any other. Oddly enough, it’s not even something found at Cainhurst. It’s the summons to Cainhurst. We find it within Iosefka’s Clinic, of all places, which just seems completely strange from a story or lore perspective. And even more perplexing, we have to travel to Cainhurst in a horse-drawn carriage—a mode of transportation that we don’t use anywhere else in the game. I have an idea why.

If you recall from the first video of this series, I pointed out the many similarities of William Ernest Henley’s arrival to the Royal Infirmary of Edinburgh and the player-character’s arrival to Iosefka’s Clinic. Looking for a miracle treatment, Henley traveled from London to Edinburgh, the home of blood transfusions in the late 1800s, where he received an antiseptic surgery at the hands of a man named Joseph. Similarly, the player-character travels from afar to Yharnam, the home of blood ministration, to seek a miracle cure at the clinic of Iosefka, a feminized version of Iosef, the Russian name for Joseph.

We don’t just find the Cainhurst summons lying on the floor in some random room of Iosefka’s Clinic. We find it on the same operating table upon which we were lying during the opening cutscene of the game. If our awakening in the second-floor sick room of Iosefka’s Clinic—and on this operating table in particular—are supposed to mirror Henley’s arrival to, and surgery within, the Royal Infirmary, then the placement of the summons on the table and our voyage to Cainhurst are symbolic of Henley’s departure from the infirmary.

Throughout this series, we’ve seen how Henley’s works from his book of poetry titled “In Hospital” appear to have shaped certain elements of Bloodborne. Henley spent two years at the Royal Infirmary of Edinburgh, and after a successful surgery and a long period of recovery, he finally was able to leave to a house in Edinburgh before eventually returning to London. In the final line of the final, triumphant poem of “In Hospital'' titled “Discharged,” Henley writes, “I sit, and the carriage rolls on with me into the wonderful world.”

Similarly, we, the player-character, take the summons from the operating table, ride off in a carriage to Cainhurst, and eventually proceed to a throne room containing dozens of knights on horseback that—just like Henley—are missing one lower leg. Coincidence? Maybe. But even if it is, I like it.

In the next episode, we’ll turn our attention to Bloodborne’s Great Ones. This episode, perhaps more than any other, will put the Victorian medical metaphor to the test.

An Agony of Effort, Part XII-A - Hunt the Great Ones | Google Docs Link

What are the Great Ones? It’s a question we’ve probably all asked ourselves at some point. Rightfully so—the Great Ones are one of the most mysterious, difficult-to-grasp parts of Bloodborne’s lore. In terms of the in-game lore, Great Ones are powerful, cosmic beings with their own unique physical manifestations. But Great Ones have a completely different meaning within the context of the extra-game lore and the Victorian medical metaphor that we’ve been following throughout this series. In this episode, we’ll approach the Great Ones from a completely new angle and in the process we’ll gain our own version of eyes on the inside.

In order to wrap our heads around the Great Ones, it helps to lay out as much basic evidence as possible. We need to first establish what we know, and second what we can logically infer. For the latter task, it’s crucial to find the common threads between these creatures. This video is the first in a two-part episode about the Great Ones. For this installment, I’ve chopped up the video into two main sections:

In Section 1, we’ll examine the text of the game—the item descriptions, lore notes and runes—that most clearly identify the Great Ones. This will serve as an essential foundation.

In Section 2, we’ll shift our focus to the visual or aesthetic characteristics that we can observe of the Great Ones. There’s a feature that we’ve just missed or downplayed that, I believe, is the single most important factor in understanding how the Great Ones fit into the game’s narrative and metaphor.

In the second installment of this two-part episode, which I’ll release in just a few days, we’ll do two things:

1. We’ll break down the concept of insight and how it works as both a game mechanic and a narrative mechanic that bridges the Great Ones and the medical metaphor.

2. We’ll combine all of these elements from both episodes, which will allow us to make several dramatic conclusions about the true nature of the Great Ones and their connection to the broader narrative of the game. This is where the in-game lore and extra-game lore converge.

Before we can confidently answer the question, “What is a Great One,” we need to start with a more basic question: Who is a Great One? This is a controversial topic, so we’re gonna do our best to avoid speculation and just rely on the facts.

There are surprisingly few creatures we encounter or learn about that we can say with absolute certainty are Great Ones. For this examination, we’re not gonna bother with things like Playstation trophy descriptions, old reddit threads or long-held beliefs. We’re just gonna look at the materials within the game. Let’s go through the list of confirmed Great Ones:

Amygdala We encounter the Amygdala creatures—primarily the lesser Amygdalae—in many places of Bloodborne, from the exterior of Oedon Chapel, to the gateway to Yahar’gul and the building walls of the Unseen Village. Then, of course, there’s the boss of the Nightmare Frontier, which we’re led to believe is a greater or major Amygdala. How do we know that the Amygdala is a Great One? Fortunately, we get confirmation from an item: the Amygdalan Arm. The weapon is described simply as “The arm of a small Amygdala Great One.” We don’t have to do any mental gymnastics to figure this out. The weapon tells us in no uncertain terms that the Amygdala is a Great One.

Brain of Mensis We find the Brain of Mensis, naturally, in the Nightmare of Mensis, where it inflicts frenzy on us until we can finally send it plunging into the darkness at the bottom of the nightmare fortress. If we kill the Brain of Mensis, we obtain the unique ritual material, the Living String. The text for the Living String is unequivocal: “The immense brain that Mensis retrieved from the Nightmare…was a legitimate Great One.” Same as with the Amygdala, an item description tells us in plain language that the Brain of Mensis is a Great One.

Oedon Oedon, in my belief, is the greatest mystery of the entire game. We never see or hear Oedon, at least that we know of, which seems to be From Software’s intent. But two rune descriptions give us indisputable proof that Oedon is a Great One. The Formless Oedon rune is most explicit, stating, “The Great One Oedon, lacking form, exists only in voice, and is symbolized by this rune.” Meanwhile, both the Formless Oedon rune and the Oedon Writhe rune include the statement, “Human or no, the oozing blood is a medium of the highest grade, and the essence of the formless Great One.” Oedon is a Great One, without question.

Ebrietas, Daughter of the Cosmos Within a cavern beneath the Grand Cathedral, we find Ebrietas, Daughter of the Cosmos. Although no item or rune description gives us a straightforward testament to the Great One status of Ebrietas, the combined text of two items allows us to easily make this assertion. The Augur of Ebrietas and the Choir set together overwhelmingly indicate she’s a Great One. The augur refers to her as “abandoned Ebrietas,” while the Choir set says “Together with the left behind Great One, [the Choir] look to the skies, in search of astral signs, that may lead them to the rediscovery of true greatness.” The description of the Great Isz Chalice states that the Isz Chalice was “the first Great Chalice brought back to the surface since the time of Byrgenwerth, and allowed the Choir to have audience with Ebrietas.” We can deduce that “abandoned Ebrietas” mentioned in the augur is the “left behind Great One” mentioned in the Choir set. The terms “left behind” and “abandoned” are virtually synonymous. But the linkage of the Choir and Ebrietas, who is mentioned by name in the Isz Chalice description, as well as the linkage of the Choir and the “left behind Great One” in the Choir set description, allows us to make the most minor of inferences that Ebrietas is a Great One. We are in no way making a major leap here.

Believe it or not, these four beings are the only ones for whom we receive explicit confirmation about their status as a Great One. If you’re an avid viewer of lore videos on YouTube or a reader of the thousands of reddit or other message board threads about Bloodborne, you know that most players assume that there are nine Great Ones. In addition to the four figures we’ve just discussed, the list would include the Moon Presence, Kos, the Orphan of Kos, Mergo and Mergo’s Wet Nurse. Further, there’s some dispute about whether Rom, the One Reborn, the Celestial Emissary and the Living Failures are Great Ones, although I think it’s fair to say the large majority of players don’t think that this latter group includes any Great Ones. But before we make up our minds, let’s establish a new paradigm for determining which creatures are Great Ones.

If we can’t rely on the game’s text to disclose every Great One, we need to look for other evidence. There should be some sort of commonality or criteria that’ll help us solve this mystery. Fortunately, the criterion exists and it’s one we can observe with our two eyes. Let’s look again at our confirmed Great Ones.

Brain of Mensis The Brain of Mensis is by far the most important figure for our understanding of the Great Ones. That’s because there’s no mystery about this creature. Its name tells us that it’s a brain. The creature drops the Living String, which tells us plainly that it’s “an immense brain.” And even if we didn’t have this information, we don’t need eyes on the inside to tell us so. We can simply look at it and determine that it’s obviously an immense brain. This isn’t a random design choice by From Software. The Brain of Mensis is a thing found within the body for a reason, as we’ll begin to see.

Amygdala Ever since we first learned the name of this creature in 2015, most players were quick to make the logical connection between the name of the Amygdala Great One and the amygdala, a part of the brain with the exact same spelling but different pronunciation. This is common knowledge by now, and dozens of threads on internet forums have detailed these connections. I won’t rehash those, other than to say that the amygdala is an almond-shaped feature of the brain that gets its name from the Latin word for almond. It’s involved in emotional memory and decision-making, and activation of the area can cause extreme emotional response, fear and paranoia. The monstrous head of the Amygdala Great One is also almond-shaped, and the identical naming allows us to conclude that this Great One, like the Brain of Mensis, is also directly inspired by something found within the body.

Ebrietas It’s widely understood that the name Ebrietas seems to be drawn from the word inebriation, or drunkenness. That makes sense in the game Bloodborne, in which blood drunkenness plays an important role. But Ebrietas also is the name of a genus of butterfly. This factoid proves exceptionally helpful in understanding the design of Ebrietas, whose body is modeled upon the trachea—or much of the bronchial tree—and whose head is based upon the thyroid. Why do I say that? The thyroid is commonly referred to as a butterfly-shaped gland in the back of the throat. This is where Ebrietas’ name as a genus of a butterfly clues us in. We can see that the bluish flaps on the side of Ebrietas’ head match the lobes of the thyroid gland. I understand if it’s hard to visualize Ebrietas as a massive trachea, and I think that’s by design. For most of the boss fight, Ebrietas leans forward. Her posture hides the fact that her face is actually the opening of the throat, or the larynx. When she performs her version of A Call Beyond, she stands straight up and we can see her true physiognomy, which is much like the trachea. If we examine the rest of her body, we can see that her tentacles appear to represent the larger bronchi leading to the lungs, while her wings are the tiny bronchioles that web their way through the lungs. Just as with the Brain of Mensis and the Amygdala, Ebrietas—who was designed as a monstrous depiction of the trachea and thyroid—is something found within the body.

So, of the four creatures that the in-game text confirms with absolute certainty are Great Ones, three are depicted as things found within the human body. The visual and naming clues are incontrovertible. The fourth Great One from our initial list, unfortunately, is a figure we can’t put to this same test. Oedon, as we saw from the runes bearing his name, is formless. We never see a physical manifestation of him, as he “exists only in voice.” This doesn’t mean our anatomy criterion is invalid, though; it just implies that Oedon is somehow unique. We’ll return to him later.

We can thus operate with a working and so far sound theory: The Great Ones from a design perspective should resemble oversized versions of things found within the human body. Let’s circle back to our list of possible Great Ones and see which of them seem to pass this test. Let’s begin with our least likely candidates and work our way through the list.

Living Failures The Living Failures, encountered at the top of the Research Hall in the Hunter’s Nightmare, aren’t referenced in any items or dialogue in the game. If we’re gonna consider them Great Ones, we need some other piece of evidence to help us make that call. With this enemy, we find none. The Living Failures’ appearance is almost a hybrid of the Celestial Minions and the Research Patients, which is important to note. We’ll return to this point later. Although the Living Failures have a humanoid appearance in their bodies and extremities, their heads are much like the amorphous sacs that serve as the heads of the Research Patients. There’s no distinctive feature of their heads that would grab our attention, and nothing I’ve been able to pin down that would serve as a representation of an organ or internal system of the body. There’s more to say about this judgment call, but I’ll wait and make a more summative conclusion at the end of this subsection.

The One Reborn Much like the Living Failures, The One Reborn isn’t mentioned by name or even hinted at in any of the game’s text. But does The One Reborn check our design box? No, it doesn’t. The One Reborn appears as a horrific fusion of bodies and body parts, mainly limbs, torsos and heads whose flesh has been peeled away. Yes, these are body parts, but they’re not things found within the body. That’s the key distinction. And as we discussed earlier, our confirmed Great Ones are designed primarily if not entirely as things found within the body. The One Reborn has no distinctive shape or feature that would lead us to conclude it’s a representation of some internal organ or system. If our design theory is correct, then The One Reborn doesn’t appear to be a Great One.

The Celestial Emissary The Celestial Emissary that we find in the Lumenflower Garden is essentially a gigantic version of the Celestial Minions we find in many places throughout Bloodborne. As with the Living Failures, the Emissary possesses a humanoid torso and limbs, but its head is its unique feature. And just like the head of the Living Failures, the head of the Celestial Emissary offers us nothing that would evoke an internal organ or system. It’s fairly nondescript. Again, if our design theory is correct, then the Celestial Emissary doesn’t appear to be a Great One.

Rom, the Vacuous Spider In my observation, Rom remains one of the most disputed figures in the Great One debate. People argue passionately that Rom is or is not a Great One. At a glance, Rom doesn’t appear to be much more than a blob with tiny legs. It’s not surprising that many players jokingly refer to Rom as a potato. Micolash suggests Rom might be a Great One in his line, “As you once did for the vacuous Rom, grant us eyes, grant us eyes. Plant eyes on our brains, to cleanse our beastly idiocy.” This indicates that Rom has elevated her thoughts to that of a Great One, but that’s a whole other line of analysis. Let’s just focus on our design theory for now. Does Rom meet our criteria? I don’t believe so. Although Rom is referred to as a spider, her form is much more like that of a butterfly or moth in its chrysalis stage. A hawk moth, for example, has a sort of hook or tail that it uses to hang from plants or thin branches when it’s in its pupa stage. Rom’s tail might represent this sort of hook. Based on what we know about Ebrietas and her butterfly or moth-like design influences, Rom as an undeveloped butterfly or moth might be From Software’s design intent. But otherwise, she doesn’t appear to meet our design criteria.

Moon Presence The Moon Presence beckoned by Laurence and his associates, otherwise known as Paleblood, as we know is the true final boss of the game. Although we never receive direct evidence in the game’s text that the Moon Presence is a Great One, it’s almost universally accepted that Paleblood is indeed a Great One. Some will argue that dream or nightmare realms are attached to a particular Great One, and Paleblood inhabits the Hunter’s Dream, therefore it must be a Great One. That makes sense, I suppose, but I’d argue there’s better evidence that Paleblood is a Great One if we simply examine this creature through the lens of our medical metaphor and the design criterion we’ve established. When we do that, we can say with virtual certainty that Paleblood is a Great One. The Moon Presence appears as a stylized depiction of the circulatory system, mainly the major venous pathways of the aorta. Its four long tentacles, for lack of a better term, are meant to depict the femoral arteries and the great saphenous veins of the legs. The part of Paleblood’s body that’s mystified players is its head, which appears to be completely alien and tilted sideways. If we’re able to view Paleblood from just the right angle, we can see that it isn't really a head at all; it’s more like a face that’s been created by way of a cross-sectional slice. Notice the incredibly straight edge here. To me, this indicates that Paleblood’s face is likely the bottom of the heart, or possibly where the aortic trunk would connect to the heart. It’s hard to say. We can see here that the tentacles coming off of what appear to be its head are actually coming out of the aortic trunk and could represent the carotid, vertebral and subclavian arteries. In any case, my best guess is that the face is meant to represent a transverse cross-section of the lower heart. And thanks to its appearance as the circulatory system, Paleblood appears to be both aptly named and a Great One.

Kos We find the corpse of Kos on the shore of the Fishing Hamlet. Her otherworldly appearance and unusually large size would lead us to think that Kos is a Great One, but those are more instinctual responses that aren’t firmly rooted in evidence. Stronger evidence comes from dialogue. The Baneful Chanters are unseen figures whose whispered mantra can be overheard within the Fishing Hamlet. The lengthy poem that they repeat serves as a historical record of the events of the hamlet. Their dialogue tells us “Kos we have beckoned.” This term “beckoned” is the same as we find on the lore note in the Lecture Building that states, “The [nameless] Moon Presence beckoned by Laurence and his associates: Paleblood.” This seems to line up with the text of the Moon Rune, which states, “The Great Ones that inhabit the nightmare are sympathetic in spirit, and often answer when called upon.” This is modest evidence that Kos was a Great One who was beckoned by the inhabitants of the Fishing Hamlet and then was killed by the scholars of Byrgenwerth whom the hamlet priest refers to as “blasphemous murderers.” In the base game, Micolash mentions Kos by name during the cutscenes preceding his boss fight, but we can’t really rely on this dialogue for much of anything. As Lance McDonald discovered in his mining of game data files, Ebrietas was originally named Kos, and the Moon Presence was originally named “Successor to Ebrietas.” This obviously undermines the integrity of what Micolash mutters in his famous line, “Ah Kos, or some say Kosm….Do you hear our prayers?” But what about Kos’s design? Does she meet our criterion? Even though it’s difficult to get a full grasp of Kos’s anatomy because we can only see her body from one side—and she’s a corpse so we never see her in motion—signs still point to yes that Kos meets our standard. As we can see from an overhead view of Kos’s corpse, her body is in the shape of the phantasms that we find throughout the game and especially within the caverns of the Fishing Hamlet. That’s no surprise. But it’s safe to say they got their design, just like the Kos Parasite, from Kos, not the other way around. And Kos’s design isn’t just supposed to look like a phantasm or parasite: She’s a massive representation of the womb. Credit to YouTuber BonfireVN, who has a neat video on the physiognomy of Kos that I’ve linked in the description. If we examine Kos from a bird’s eye perspective, we can see that her body and the flow of her spine down her back is the exact same as the curvature of a human spine when shown from a lateral view. Using this same perspective, we can see that the bulk of the womb from whence the orphan emerges is in the correct anatomical location as a womb would be relative to the spine in a human body. So yes, Mother Kos meets our standard. She, too, is designed primarily as a feature found within the human body.

The Orphan of Kos The Orphan, of course, has the proportions of a fully-formed man, but he wields his placenta as a weapon. We can see the placenta attached to the umbilical cord that wraps around the orphan’s arm, over his back and into his stomach at the belly button, just as it would be for a typical unborn child. While we could look to the placenta as our key piece of evidence and say, “Yes, the placenta is something found within the body, and this is our proof that the Orphan is a Great One,” I don’t think that’s exactly right. Up to this point, we’ve seen that the Great Ones are designed almost in total as things found within the body. It’s not just one small feature of their design; it’s the primary feature if not the entirety of their design. In this regard, the Orphan of Kos is no different. As a fetus or unborn child, the Orphan itself is the thing found within the body. Its placenta is just a signature part of the whole fetus. When we take that into consideration, then absolutely, the Orphan of Kos is almost certainly a Great One.

The remaining two beings on our list of potential Great Ones can’t be subjected to this visual test. Mergo and Mergo’s Wet Nurse aren’t exactly viewable. Mergo is never truly seen, and Mergo’s Wet Nurse is invisible. Only the outline of the draping shawl gives us any indication of the Wet Nurse’s size and shape. This might be an indication that these two entities aren’t Great Ones after all, but just like the formless Oedon, there could be something else going on with them. So let’s put them aside for now and return to them later.

The obvious question at this point, of course, is why? Why are the Great Ones designed as things found within the body? And why do I keep using this specific phrase, “found within the body”? If you’ve been following this series and seen how the Victorian medical metaphor has been used, then you probably have a good idea. We’ll answer both of these questions in the second part of this two-part episode.

Finally, a short housekeeping note: We’re nearing the end of this series. It’s likely that I’ll include a miscellaneous episode or two just covering many of the random observations and some of the interesting discoveries I’ve made that don’t really neatly fold into any episode of this series. But if there’s a topic we haven’t covered so far or something that you’d just like for me to discuss in one of these appendices or bonus episodes, feel free to reach out to me on reddit or drop a comment here. I really do appreciate everybody’s feedback and recommendations. And a huge thank you to everybody who has taken time to watch this very long series and especially to those people who’ve been kind enough to reach out to me either on reddit or in the comments or even sending emails. I appreciate the suggestions, the questions and the words of support. It’s all been great. I am looking forward, I know, to these final few episodes of the series and especially to hearing your ideas, so I will see you soon.

An Agony of Effort, Part XII-B - Hunt the Great Ones (Episode 2 of 2) | Google Docs Link

In their quest to understand the Great Ones, the major figures and institutions of Bloodborne recognized their shortcomings. They were “thinking on the basest of planes” and realized that they needed more advanced knowledge, or “eyes on the inside.” As their titles would imply, the scholars of Byrgenwerth, the doctors of the Healing Church, the students of the School of Mensis and the scholars of the Choir dedicated themselves to research and the advancement of knowledge, perhaps best documented by the description of an eye cord: “Provost Willem sought the Cord in order to elevate his being and thoughts to those of a Great One, by lining his brain with eyes. The only choice, he knew, if man were to ever match Their greatness.”

Although we’re led to believe that the Great Ones are enigmatic cosmic beings from a higher plane, we saw in the first installment of this two-part episode that the Great Ones share an unusual trait: They all appear to be designed as things found within the human body. In this concluding portion of the episode, we’ll see how the Great Ones serve as the keystone of the medical metaphor that buttresses the story of Bloodborne. Today, we plunge our hands into the viscera of the Great Ones and extract a hidden meaning of the game. This video will require a bit of patience, focus and a willingness to engage in abstraction. The journey admittedly will be daunting at times, but the destination should make it worthwhile. We’ll try to accomplish three main tasks along the way:

1. We’ll very quickly recap the topline takeaways of this series so far pertaining to the Victorian medical metaphor. (If you’re new to the series and you feel a little lost or maybe unconvinced about this video’s line of analysis, you might want to check out the other episodes for more detailed explanations.)

2. We’ll take a closer look at the concept of insight and how it works as both a game mechanic and a narrative mechanic. (It’s critical to our understanding of the Great Ones and the game’s hidden narrative. I’ll also reveal the real-life inspiration for the Mensis Cage and how this item helps us explain the true meaning of the Great Ones. That will segue nicely to the third section in which…)

3. We’ll answer the lingering question: Why are the Great Ones designed as things found within the human body? In this section, we’ll see how Ebrietas and the Great Isz Chalice draw from real-life medical history in what I think is a mind-blowing revelation.

I had hoped to use this video to circle back to some of the bosses that I deemed in the previous video were either inconclusive or don’t appear to be Great Ones. But this video was gonna end up being way too long if I included that here. So, instead, I’ll just split that off into a separate video which I’ll release next week.

A courtesy warning. This video will contain images of partially dissected bodies. Also, all references I make to the Japanese text are credited to Last Protagonist, whose channel and translations database are linked in the description. With that, let’s get started with a brief but essential recap.

The Medical Metaphor in Brief Throughout this series, we’ve seen how From Software used real-life Victorian medicine as a skeletal framework upon which the game’s narrative flesh is attached. For example, in Episode 2, I showed how the Healing Blood is a metaphor for ether, the first successful surgical anesthetic. In Episode XI on Cainhurst, we saw how the vile blood is a parallel for chloroform, a competing anesthetic to ether that rose to popularity thanks to its use in pain-free childbirth. In Episode 4, we examined the similarities between the College of Byrgenwerth and the University of Edinburgh Medical School in the late 1700s, with their architectural similarities, their shared focus on the central nervous system and their use of botanics and botanical gardens to study pharmaceuticals. In Episode 5, we saw how the School of Mensis serves as an analog for the prolific anatomists of Edinburgh in the early 1800s—the surgeons and medical students who carved up dead bodies for anatomical research. And in Episode 6, we made important aesthetic comparisons between the Healing Church and the Royal Infirmary of Edinburgh, while also showing how the evolution of the Church attire mirrors the evolution of real-life medical attire during the 1800s. Although we went into much greater depth in various episodes, these represent many of the topline takeaways of the series so far when it comes to the medical metaphor.

Eyes on the Inside While these medical references might initially seem irrelevant to our understanding of the Great Ones, this context is invaluable for our comprehension of insight, which serves as a sort of bridge between the medical metaphor and the Great Ones. As I noted earlier, we learn from a variety of items and bits of cinematic dialogue that the institutions of Bloodborne—meaning the College of Byrgenwerth, the Healing Church, the School of Mensis and the Choir—have a common desire or goal: They all want to gain insight. It’s not entirely clear what insight means—we get a bit of mixed messaging—but if nothing else we’re led to assume it means advanced knowledge or an epiphany that results from coming into contact with something that’s outside of our empirical understanding. The game’s main institutions in their own unique ways are striving to gain insight because they believe it’s required so that humanity can evolve or advance, as evidenced by the One Third Umbilical Cord description that we examined earlier, which details Provost Willem’s desire to elevate his thoughts to match the greatness of the Great Ones.

Within the game, we gain insight primarily in two ways: the discovery of new places and bosses, and through the use of items. But it’s not just any items: They’re items that are designed and labeled as body parts. These include Madman’s Knowledge, Great One’s Wisdom and the One Third Umbilical Cords. An umbilical cord, of course, would be found within the body. But with the Madman’s Knowledge and the Great One’s Wisdom, the artwork indicates to us that the insight we gain from these items is coming from within the skull of a dead body. Why would that be the case, and why is that relevant?

For hundreds of years, mainly the 1600s to the 1800s, medical knowledge was gained primarily by dissecting dead bodies, or cadavers. As we discussed in Episode 5, the School of Mensis and Yahar’gul almost certainly are dramatized depictions of this form of medical research, which became the calling card of Edinburgh, Scotland’s medical community in the early 1800s. Mensis and to some extent Byrgenwerth, with their student uniforms, lecture theaters and laboratories are meant to depict the Victorian medical schools of Great Britain. On behalf of the School of Mensis, the Kidnapper enemies kill people and transport their bodies to Yahar’gul—much like the real-life burkers and body snatchers of the Victorian era would either kill people and sell their bodies to medical schools and surgeons, or would dig up corpses from fresh graves and sell them to anatomists.

Anatomical dissection appears to be an important element within the game’s underlying metaphor. In addition to the allusions to anatomical dissection that we see with Mensis and Yahar’gul, we also saw in the first episode of the series that game director Hidetaka Miyazaki made a major reference to dissection during a 2015 interview with Future Press. When asked about the term “Paleblood,” Miyazaki said it was meant as a comparison to the night sky of Yahar’gul after we kill Rom. “The sky there is a very pale blue,” Miyazaki said, “like a body drained of blood.” A body drained of blood in real life is a cadaver, and Miyazaki’s specific reference to Yahar’gul, a realm overseen by the School of Mensis which depicts the dissection of bodies for medical study, is all meant to help us see the relevance of anatomical dissection to the game’s underlying meaning. It’s also why this is one of the most well recognized lines of dialogue in the entire game: “A corpse should be left well alone” (Lady Maria). We’ll return to this concept repeatedly in this video and the final episode of the series.

As we’ve also seen again and again in this series, From Software used hunters as a metaphor for surgeons and anatomists, while also treating beasts as a metaphor for surgical patients and, more commonly, cadavers.

With all of that critical context in mind, let’s take a closer look at the concept of insight, starting with the items that grant us insight. With both the Madman’s Knowledge and the Great One’s Wisdom, we can see a skull that’s been split open. If we just take the artwork casually or without any serious thought, we might just think, “Oh, it’s a spooky skull that was shattered by this powerful cosmic knowledge—this eldritch truth—that literally blew this person’s mind wide open.” But if we view it with the medical metaphor in mind, the artwork and descriptions for these items have a much more profound meaning. Knowing that Bloodborne is so deeply rooted in surgery and dissection, the skulls we see in the artwork for these items are supposed to depict a human skull that’s been broken apart by an anatomist who’s studying the brain of a dead man. There’s a ton of evidence to support this notion. We’ll build our way into the most compelling clues. One element of the Madman’s Knowledge artwork helps us make this cadaver connection: It’s the fangs. Even though blood drinking is a huge part of the game, Bloodborne doesn’t have vampires. The fangs are a reference to a beast. As I just said, Bloodborne treats beasts as a metaphor for cadavers and surgical patients, and the skull contains the sharp teeth of a beast, indicating that this skull belongs to a cadaver that has been dissected. The insight that the player-character gains in the game from consuming a Madman’s Knowledge is just like the medical insight an anatomist would gain from breaking open a skull and examining the brain. With this in mind, we can now turn to the item description.

There are two huge takeaways of the item description, especially if we examine the original Japanese text. The description in English states, “Skull of a madman touched by the wisdom of the Great Ones. Use to gain insight. Making contact with eldritch wisdom is a blessing, for even if it drives one mad, it allows one to serve a grander purpose, for posterity.” In Japanese, the latter portion of the item description is much more revealing. It says, “Even if they go mad, it is good fortune for those who come into contact with arcane wisdom, especially since it will become aid for future generations.” The description is telling us that the knowledge gained from whatever is inside this dead man’s skull will aid future generations, just like the medical knowledge gained from cutting open a dead body and examining it will help save lives in future generations. If you’re skeptical, I get it, but check this out. Although “insight” is the term used in the English version of the game, the term that From Software used in the original Japanese was “keimou” (KAY-moh), which means “enlightenment” or “instruction.” Last Protagonist suggested that keimou is better translated as “having knowledge of something and passing it on/teaching it to others.” This could not be a more appropriate conclusion on his part, based upon what we now understand. We can conclude from the Japanese text that by using the Madman’s Knowledge, we gain enlightenment or material for instruction that can be taught to others and thereby aid future generations. This, undoubtedly, is an allusion to the medical knowledge gained from dissecting corpses in an effort to teach and train doctors who can then save future generations from illness and disease. The term “eyes on the inside” now seems more appropriate than ever. It refers to a surgeon’s or anatomist’s ability to literally see within the human body during surgery or dissection. Their view of the internal organs of the body is what it means to have eyes on the inside.

Within Bloodborne, Willem wants to line his brain with eyes to somehow better comprehend the Great Ones. This makes sense mechanically speaking, because insight allows the player-character to see the world as it truly is. In fact, one of the best illustrations of this mechanic is within Cathedral Ward. Once we obtain 40 insight, we’re able to see the massive Amygdala clinging to the side of Oedon Chapel. In this regard, only by having enough insight or “eyes on the inside” can we see certain Great Ones. But as we gain insight, we ironically begin to see eyeballs on things in the game, from the lanterns of the Church Servants to the faces of the Maneater Boars. In a sense, as we gain insight, we start putting eyeballs on the details of the Bloodborne world. Although Micolash and Willem want to quite literally line their brains with eyes, which explains the jars filled with eyeballs within Byrgenwerth and the laboratories of the Lecture Building, this is just a literary and design choice by From Software to emphasize the horror elements of the game while keeping the subtext directly underfoot. Just like “eyes on the inside,” the concept of brains lined with eyes should be interpreted to mean a surgeon’s or anatomist’s eyes being able to literally view the brain, and thus the insight gained from this anatomical examination elevates their medical knowledge to a higher plane.

If you’re still skeptical and yet somehow still watching, this might help. Let’s look at another insight-granting item, the Great One’s Wisdom, and we’ll connect it with several other elements of the game. The description states, “Fragments of the lost wisdom of the Great Ones, beings that might be described as gods.” The description of Great Ones as gods is important. Gehrman refers to the labyrinth—or what players often refer to colloquially as the Chalice Dungeons—as the “tomb of the gods” that can be unlocked with a holy chalice. Alfred similarly tells us that the labyrinth carved out beneath Yharnam is known as the “tomb of the gods.” This seems to suggest that the Great Ones by and large are dead and are essentially buried in the ground. Referring to the labyrinth as the tomb of the gods is appropriate and enlightening in terms of our medical metaphor and how it relates to the College of Byrgenwerth and the Healing Church. As I noted in Episode 4, the word “byrgen” is an Old English word meaning burial place or grave. We can thus view the College of Byrgenwerth as the College of the Grave. Byrgenwerth, by name, therefore is associated with tombs, graves or burial places. We see this linkage of Byrgenwerth and graves in even greater detail in the item description of the Tomb Prospector set, which in Japanese reads: “Attire in the Healing Church, particularly for diving into and grave robbing the underground ruins. Byrgenwerth is the origin of the Healing Church, therefore they know just what the ruins are. They are not merely a hideaway of trinkets that strengthen hunters. They are a path of research…” The metaphor is punching us in the face: Byrgenwerth’s research was rooted in the exploration of graves. But they didn’t care about the hunter trinkets; they brought back something else from the grave: the remnants or knowledge of the Great Ones. This is just like the Victorian surgeons and anatomists who paid men to take bodies from fresh graves so that they could dissect and study them for medical research. The tombs are a path of research.

With all of this in mind, we can now easily answer the question, “Why are the Great Ones designed as things found within the human body?” It’s because they’re meant to represent the organs, systems and, yes, even the fetuses that surgeons and anatomists would have discovered and studied during the course of surgical operations and, much more commonly, during dissections of the Victorian era. Just like the Great Ones, these internal features of the body would have only been observable with “eyes on the inside” of the human body, and only through intense study could these features grant insight, meaning knowledge that could be taught to others to aid future generations.

Let’s take a look at a couple of the creatures that the game’s text confirms are Great Ones—and that we confirmed in the last video are designed as things found within the body—and see how they fit into this medical framework.

The Brain of Mensis As I said in the previous video, the Brain of Mensis is the most important creature for our understanding of the Great Ones. That’s because the Brain of Mensis looks like a brain, is called a brain and is described by an item as a brain. The brain’s name also immediately connects it with the School of Mensis. We find the brain in the Nightmare of Mensis, where we encounter Micolash, the Host of the Nightmare, who is wearing the student uniform associated with the School of Mensis. The brain drops the Living String, which indicates that the students of the School of Mensis somehow made contact with the Brain of Mensis, which is described as a Great One but specifically as a “rotten” brain. This implies the brain was decomposed. In Japanese, the term used to describe the brain is “eroded.” The implication is clear: The Brain of Mensis represents a decomposed, rotted or eroded brain of a corpse. The students of the School of Mensis, wearing the gowns of Victorian medical students, are being portrayed as figures who dissected a dead body and encountered this decomposed brain. They could have only encountered this brain by having literal eyes on the inside, meaning a view inside the human body. We learn from the item commonly called Mergo’s cord—the umbilical cord obtained after defeating Mergo’s Wet Nurse—that this cord “granted Mensis audience with Mergo, but resulted in the stillbirth of their brains.” The use of the term “stillbirth” seems to suggest that the Brain of Mensis wasn’t just any brain; it was the brain of an unborn child. We’ll discuss this idea in greater depth in the final episode. We’re told that the Mensis scholars used their iconic Mensis Cage headwear to make contact with the Great Ones. This item provides us with one of the most resounding pieces of evidence to support the medical metaphor. The Mensis Cage appears to be inspired by what’s known as a birdcage radiofrequency coil, a device used in MRIs for brain scans. In addition to their similar appearance and the use of the word “cage” in their names, the function of the birdcage RF coil and the Mensis Cage are extremely similar as well. As detailed in the medical textbook, “Magnetic Resonance Imaging of the Body” (Ronald Peshock, M.D., 1987), “The RF coils are basically radio antennas that are used to transmit and receive radio waves. The performance of the imager is critically dependent on how efficiently the antenna transfers energy to and from the body.” In essence, the RF coil acts as an antenna to amplify the radio signal coming out of the body and allows a computer to digitally display the signal, allowing doctors to gain eyes on the inside. They can see what’s happening in the brain via the MRI scan. Now, let’s look at the description of the Mensis Cage: “The cage is a device that restrains the will of the self, allowing one to see the profane world for what it is. It also serves as an antenna that facilitates contact with the Great Ones of the dream.” Just like the birdcage RF coil allows medical experts to make contact with the human brain, the Mensis Cage allowed the Mensis scholars to make contact with the Brain of Mensis, a Great One and thing found within the human body. Although the RF coil is modern and clashes with the Victorian portion of our Victorian medical metaphor, it firmly supports the overall medical metaphor without question.

Ebrietas I suggested in the last video that Ebrietas is designed as a monstrous version of the trachea. Her face is the opening of the throat, and the sides of her head are similar to the lobes of the butterfly-shaped thyroid gland, which is where Ebrietas derives her name, as it’s a genus of butterfly. I’m sure plenty of people think my argument is ridiculous, but I’m going to present a second batch of evidence that I think makes it exceptionally difficult to reject this idea. I think you’d have to go out of your way to deny it. There’s something unique about Ebrietas. Unlike the other confirmed Great Ones that we encounter, Ebrietas is found within the waking world. She’s in the cavern beneath the Grand Cathedral—the architectural centerpiece of the Healing Church, an organization dedicated to its ether-like Healing Blood. Ebrietas’s presence here is unusual, considering the other Great Ones are found within the dream or nightmare realms. The Moon Presence is in the Hunter’s Dream. Kos and the Orphan are found in the Hunter’s Nightmare. Mergo and Mergo’s Wet Nurse are found in the Nightmare of Mensis. And the Amygdala is found in the Nightmare Frontier. And even though there’s a ton of speculation that Oedon was responsible for impregnating Arianna and therefore must exist at least occasionally within the waking world, there’s no hard evidence of that. We have to go out on a limb to suggest it. But as far as Ebrietas is concerned, it is unique that she’s found in the waking world. The Mensis Cage and the Moon Rune tell us plainly that the Great Ones inhabit or exist within the dream. Because that’s the case, it makes sense that Ebrietas is referred to as “abandoned Ebrietas” or the “left behind Great One.” She’s supposed to exist in the nightmare or dream realm, but she’s seemingly stuck here in Yharnam. Why does any of that matter? To answer that question, we have to turn our attention to several important items. As we learn from the Great Isz Chalice, the Choir found the chalice within the labyrinth and “brought [it] back to the surface,” which allowed them to have audience with Ebrietas. I believe these are elegant visual and verbal clues to help bolster the medical metaphor. Let me explain. Take a look at the Isz Chalice. It doesn’t look like any of the other chalices we use to access lands within the labyrinth. It’s not a traditional goblet or cup like the other chalices. It looks organic, not man made. I believe the Isz Chalice was designed to resemble a rotten tooth, specifically a molar. Why? The first medical procedure in which general anesthesia was employed took place in 1846, when American dentist and chemist William T.G. Morton first used ether to successfully and painlessly extract a patient’s rotted tooth, bringing it back to the surface, so to speak. The successful use of ether as a general anesthetic, essentially knocking the patient unconscious during the dental procedure, paved the way for ether to become the world’s first successful surgical anesthetic and led to the development of other anesthetics and techniques that allowed physicians for the first time to observe internal organs and systems while the patient was still alive. Nearly 50 years after Morton’s seminal tooth removal, physicians used cocaine as an anesthetic along with a device known as an autoscope, allowing them to directly view the larynx for the first time in a living body. The larynx is known as the voice box. It contains the vocal cords. This is why Ebrietas is designed as a gigantic trachea, with her head shown as the opening of the throat, or larynx, which contains the vocal cords. She represents one of the first internal systems that physicians were ever able to observe in a living patient, thanks to the use of anesthesia. Moreover, the organization within Bloodborne that made contact and is closely associated with Ebrietas is the Choir. Just like real-life physicians laid eyes on the vocal cords thanks to anesthesia, the Choir was granted “audience” with the Great One known as Ebrietas, which is a cosmic horror depiction of a trachea, home to the voice box. And while I can’t say for certain, this might be what the Moon Rune is supposed to depict: the view of the larynx. The rune description states, “The Great Ones that inhabit the nightmare are sympathetic in spirit, and often answer when called upon.” But in Japanese, it’s even clearer, stating that “there are many cases of [the Great Ones] responding to the voices of those calling out.” The Moon Rune, when turned 90 degrees, appears to depict the vocal cords as seen within the body using a laryngoscope. This would naturally be the source of a voice that’s calling out. We’ve seen other examples in which the Caryll Runes represent concepts or features of medicine or medical science. The Clawmark Rune depicts a surgical incision that’s been stitched up. The Hunter Rune, when turned upside down, matches the incision pattern used during dissections and autopsies. And as I posted on the Bloodborne subreddit a couple of months ago, the Heir Rune is a crude depiction of the double helix of DNA, which makes sense given the item description: “Perhaps the ‘Heir’ is a hunter bearing the echoing wills of those before him.” Shout-out to reddit user AmINotMonstrous, who smartly pointed out in response to my post that the artwork for the Heir Rune even displays the alternating major and minor grooves of the DNA strand. The Moon Rune depicting the larynx certainly seems plausible. There’s more to the idea that Ebrietas represents the trachea and vocal cords seen for the first time in a living patient. We know with virtual certainty that Micolash’s physical body is dead in the waking world and presumably has been that way for a long time, but his consciousness persists in the Nightmare of Mensis, a transcendental realm that, because he’s dead, serves in a sense as an afterlife. We’re also led to believe that the same can be said for Gehrman, Maria, Laurence and Ludwig—figures who have been dead in the waking world for many, many years but whose consciousnesses somehow persist in these dream realms that, by default, are their afterworlds. I’m certainly aware of the commonly held belief that the Great Ones are transcendental beings that can move between dimensions or planes of existence, but I’ve wondered if there’s another way to interpret this. If the dream worlds essentially act as a purgatory, hell or some other underworld for the human figures in the game, might it be similar for the Great Ones? After all, the Great Ones are referred to as gods throughout the game, and yet the only place we know they’ve existed other than the dream worlds is in the “tomb of the gods,” implying they’re somehow dead. The Pthumeru Ihyll Chalice description in Japanese seems to suggest they’ve not just asleep or “slumbering”—they’re divine creatures that have gone on to the next life. If this is true, then Ebrietas being a living Great One within the waking world helps support my previous assertion that Ebrietas’ design as the trachea was inspired by doctors’ first direct view of the vocal cords within a living patient in the late 1800s. It also seems to suggest one possibility: The Great Ones that we find in the dream realms, just like the human figures, are all dead. They might be more like spirits who represent organs and other things that were found in the human body during dissection of a corpse. The presence of the lesser Amygdalae in the waking world certainly undercuts this idea, so this particular theory might be misguided. I think it’s interesting and plausible nonetheless.

In the next video, we’ll turn our attention to the group of creatures that I said in the previous video were either inconclusive, not likely to be Great Ones or are Great Ones but can’t be subjected to our visual test. Afterward, in the final part of this series, we’ll stitch everything together in a summarized explanation of Bloodborne’s underlying story.

An Agony of Effort, Part XII-C - Addendum to “Hunt the Great Ones” | Google Docs Link

So, this is just a short addendum that I wasn’t originally planning to make, but there was a very helpful comment on Episode XII-A from ZuluKasuki that brought something new to my attention. Then I realized that this might actually be an important link that would help sort of sync up the episodes on the Great Ones and the final episode of the series. So, after doing a bit of thinking, I felt like I had to put together this short video.

Zulu noted that other lore hunters had pointed out that the face of the Moon Presence bears a striking resemblance to a cross section of an umbilical cord, albeit one that’s slightly compressed and distorted. After taking a closer look, I think this is absolutely correct, and my previous assumption that the Moon Presence’s face might be a cross section of the lower heart is incorrect. This idea appears to have originated with reddit user dximenez, an account that appears to have been deleted. Redgrave went on to mention this observation in a video with JSF and Aegon of Astora, which Zulu was kind enough to track down and I’ve linked in the description. As Redgrave described in this 2016 video, in both endings that involve the Moon Presence, the creature presses its face to the player-character, almost as if to drain us of our essence, or our blood echoes or something along those lines. It’s as if it’s trying to feed off of us, just like a fetus would draw sustenance from the mother via the umbilical cord. I think this is a fantastic observation and it’s one that I completely agree with. But it is strange that the rest of the Moon Presence’s body doesn’t look at all like an umbilical cord; it looks like the circulatory system, just as I had mentioned before.

At risk of sounding like I’m grasping at straws, I think it might be both, and here’s why I say that. I’ve argued that there are only a handful of entities we can say with very high confidence are Great Ones, the Moon Presence being one of them. I wonder if my original theory is correct, that the Great Ones indeed were designed to look like things found within the human body, but the theory was just incomplete. They also appear to contain some sort of design aspect that is associated with pregnancy or childbirth. I think there might be something here, and we have five examples to work with.

In addition to the Moon Presence, which looks like a massive circulatory system with the head of an umbilical cord, we have:

The Orphan of Kos, which carries a hulking placenta and is a man-sized version of a fetus. It checks both boxes. It’s something found within the human body but also associated with pregnancy or childbirth.

We have Mother Kos, who I contend is a huge representation of the womb. Again, something found within the human body but also has an association with pregnancy or childbirth.

We have Ebrietas, who I’ve argued is a gigantic representation of the trachea and thyroid. But I have to confess that like many players, including several of whom commented on Episode XII-A and on my reddit post this year about Ebrietas, for a long time I thought Ebrietas was a depiction of the female reproductive system. Ebrietas will rarely showcase one move; it’s not an attack, it’s literally her just moving. She’ll vault into the air and slide to one side. When she does this rare animation, her body takes on the shape of the reproductive system, with her two “tails” kind of coming together below her to resemble the cervix and vagina, while her wings and tentacles spread out to resemble the fallopian tubes and at least hint at the ovaries. I cannot for the life of me find a video showing this move. If anyone can track it down and post it in the comments, that’d be great. Or feel free to message it to me, I’ll add it to the description. Anyway, maybe this idea about Ebrietas is an overreach on my part, but I’ve just seen so many players over the years remark about this resemblance. So, as with the other three examples of Great Ones we just discussed, maybe it’s the same deal with Ebrietas. Maybe she is both a monstrous depiction of the trachea and thyroid while occasionally taking the form of the female reproductive system, something associated with pregnancy and childbirth.

We also have the Brain of Mensis. There was a commenter on Episode XII-A who said that the brain looks like the placenta, which I hadn’t considered before. I’m not ruling it out, but it wasn’t something that’s ever crossed my mind and I’m not quite sold on that, at least not yet. Instead, something that’s always jumped out to me are the eyes on the brain. In case you hadn’t noticed, they look like breasts. The dark iris is much like the areola, but the feature that most strongly mimics the appearance of a breast is the pupil, which is slightly raised and pointed like a nipple. Enlarged breasts certainly are associated with pregnancy and childbirth, and obviously with breastfeeding a newborn. And as you might have noticed or seen other players point out, the Brain of Mensis also appears to be composed of hundreds and hundreds of Messengers. As I’ll discuss in the final episode, the Messengers also appear to be related to childbirth.

Finally, there’s Oedon. I might as well take this opportunity to share my thoughts on Oedon here, since I separated them out from the original video on the Great Ones. As many viewers correctly pointed out, Oedon is described as a thing found within the body: blood. The descriptions for both Oedon runes specifically state, “Human or no, the oozing blood is a medium of the highest grade and the essence of the formless Great One, Oedon.” This pretty clearly states that Oedon can be considered “oozing blood.” There are a few things that have given me pause when it comes to Oedon, though, and I’ve been incredibly reluctant to say that Oedon is just simply blood, either within the context of the medical metaphor or within the in-game lore. I’ve seen all sorts of suggestions about what Oedon might be. I’ve seen people contend that Oedon is the player-character, or that he’s actually the Moon Presence, or that he’s the source or father of all Great Ones. We, as a lore community, are far from reaching a consensus when it comes to Oedon. I’m not really in position to substantiate or refute any of those ideas. I can only add a few thoughts that admittedly complicate the matter but still might be interesting. As I mentioned in Part XII-B, there’s a common assumption that Oedon was responsible for impregnating Arianna. As I said before, there isn’t a ton of hard evidence to support that, but that’s not to say that it’s completely baseless. It’s not. After all, Arianna mysteriously becomes pregnant within a chapel bearing Oedon’s name. It also doesn’t seem coincidental that the first thing that we can observe once we set foot into Oedon Chapel are the building’s massive windows, which are an enormous phallic symbol. It also might be noteworthy that the Formless Oedon and Oedon Writhe runes refer to this oozing blood in both English and Japanese as the “essence” of Oedon, a term that in English can be seen as a synonym for semen. Last Protagonist’s re-translations of the Oedon runes also indicate that the term “medium of the highest grade” is probably better interpreted as “a catalyst,” suggesting that the blood is the trigger of some sort of process or reaction. Hang on to this idea for a minute because we’ll come right back to it. It’s also worth noting that one of the two runes associated with Oedon is the Oedon Writhe rune. The Japanese text is evidently closer to the term “wriggle.” These terms are often used interchangeably, and I realize I’m probably splitting hairs, but I’ve usually associated the word “wriggle” with worms or other invertebrate insects that rapidly squirm or flail around. Again, hang on to this idea for a minute. The same exact verbiage can be found within the dialogue of the Imposter Iosefka if we encounter her after defeating Rom. On a table in the clinic, the imposter doctor is experiencing some sort of strange transformation while positioned on all fours. She tells us, “Don’t you see? How they writhe, writhe inside my head. It’s rather rapturous.” In Japanese, as with the Oedon Writhe rune, Imposter Iosefka’s dialogue is re-translated as “Wriggling on the inside of my head.” So, when it comes to Oedon, we have a woman impregnated mysteriously within Oedon Chapel, which is a stone structure containing a colossal phallic symbol in its windows. The runes associated with Oedon describe him as blood, using the terms “essence” and “wriggle.” As we start to connect some dots with Oedon and see these inferences to impregnation, the term writhe or wriggle gets me thinking about wriggling sperm cells. Let me be clear: I am not suggesting at all that Oedon is semen; I’m simply pointing out that Oedon isn’t just being described as blood. From Software seems to be going out of its way to insinuate that Oedon is associated with pregnancy and childbirth—and likely is responsible for impregnation—just like the other Great Ones we previously discussed are associated somehow with pregnancy or childbirth.

The exception seems to be the Amygdala. As we’ve already covered, this creature could represent the amygdala within the brain, or as French viewer Katemine points out, the word “amygdale” is the French word for the tonsil, which helps explain why the Tonsil Stone and the head of the Amygdala Great Ones are so similar in appearance. But I don’t see anything that would be associated with pregnancy or childbirth. Babies are born without tonsils, and I’m not aware of anything unique about the amygdala within the fetus, although I’ve glanced at some research that a mother’s stress levels and cortisol output during pregnancy can adversely impact the fetal amygdala. I don’t really see anything there, but I haven’t researched it very much yet, so who knows?

At any rate, I’m starting to wonder if there’s a theme here with the Great Ones that I had totally missed before. Because some of the main conclusions that I’ll make in the final episode are so closely associated with pregnancy, childbirth and fetuses, I think this is intentional; I think it’s important. So, the more information I can get I think will just help to solidify some of the conclusions that I’ll make there.

An Agony of Effort, Part XIII - Attempts at Greatness | Google Docs Link

Attempting to rise to the level of the Great Ones, the leading figures and institutions of Bloodborne appear to have been met with nothing but failure and ruin. A few creatures serve as living monuments to these disastrous efforts to achieve cosmic greatness. In this episode, we examine these strange beings and attempt to explain what they symbolize within the game’s medical metaphor. Today, we join the experiment.

I argued in Episode XII-B that the Great Ones resemble features found within the human body because they’re supposed to represent the organs and systems that medical researchers—specifically surgeons and anatomists—would have only been able to see by gaining eyes on the inside, meaning a literal view into the human body. Rising to the level of the Great Ones, or elevating one’s thoughts to those of a Great One, within the game’s medical metaphor, means gaining medical knowledge so that scholars and practitioners can understand the mysterious inner workings of the human body and master its physiology. If this interpretation is correct, then it seems to help us comprehend the other creatures that are commonly referred to in the lore community as either failed or manufactured Great Ones, or as they’re sometimes called, Kin of the Cosmos, although there’s much disagreement about what exactly constitutes kin and which creatures fall into this category. For that reason, and because of what we’ll discuss today, I’m gonna use another term throughout this video when referring to these bosses that don’t seem to meet our established criteria for Great Ones. I’ll refer to them as attempted Great Ones. In this episode, we’ll try to answer two main questions which are inextricably linked: What are these attempted Great Ones within the in-game lore, and how do they fit into the medical metaphor that we’ve followed throughout this series?

To answer these questions, I think it’s most helpful to start with the Living Failures. In order to adequately investigate these creatures, we need to first inspect the facility in which they were created.

Just like we observed in episode XII-B when we noted that the so-called Tomb of the Gods was a “path of research” for Byrgenwerth’s scholars and its tomb prospectors, the hospital facility overseen by Lady Maria was also a path of research, hence its name: the Research Hall. The implication is that this was a place of experimentation and study. We learn from the disturbing dialogue of the Research Patients, and from the Balcony Key item description, that Lady Maria was the primary caretaker of these “people.” We know from Maria’s Hunter Attire that she was one of the first hunters and a student of the first hunter Gehrman, which leads us to believe that she and Gehrman were alive and active during the days of Byrgenwerth prior to the establishment of the Healing Church. But there’s a feature of the Research Hall that suggests that Maria was around long enough to become a leading figure in the Healing Church after Laurence departed from Byrgenwerth to establish the Church in the city of Yharnam. The signage throughout the Research Hall tells us the floor number and room names of several facilities within the hall. They all display the Communion Rune, which is virtually identical to the emblem of the Healing Church that we find on the Hunter Chief Emblem and on the main gate of Cathedral Ward. This suggests that the Research Hall belonged to the Healing Church. Because the building is physically connected to the Grand Cathedral, which is the heart of the Healing Church, it makes it all the more likely that the Research Hall was the Church’s early testing ground. Much of what we can extract from the Research Hall comes from one NPC: the Blood Saint Adeline. Depicted as an overgrown brain in a bag and strapped securely in a restraining chair, Adeline has by far the most extensive dialogue of anyone in the Research Hall and sends us on a quest to retrieve a substance upon which she places great value: Brain Fluid.

The description for one of the three Brain Fluid quest items helps us to see that the Healing Church, in its early days within the Research Hall, was trying to gain insight, or eyes on the inside, through the use of substances. The description states, “In the early days of the Healing Church, the Great Ones were linked to the ocean, and so the cerebral patients would imbibe water, and listen for the howl of the sea. Brain fluid writhed inside the head, the initial makings of internal eyes.” If “internal eyes” or “eyes on the inside” means a literal view into the human body as we discussed in Part XII-B, then we can interpret this to mean that the Brain Fluid—which was the initial makings of internal eyes—is supposed to represent a substance given to patients that had intense neurological effects, and the doctors of the Research Hall were observing these effects on the patients to gain an understanding of brain function or the effect of certain substances on the brain.

Adeline is clearly experiencing the painful symptoms of withdrawal and asks the player to bring her Brain Fluid, for which she will reward us. Based on the hypodermic syringe sticking out of her arm, the auditory hallucinations she’s experiencing and the intense feelings of euphoria she associates with brain fluid, it seems likely that Adeline and other research patients are being depicted as real-life patients who are incredibly high on psychoactive drugs, quite possibly heroin. Heroin was discovered in the mid 1800s, but it wasn’t until the 1890s that the German pharmaceutical company, Bayer, commercially manufactured heroin. Bayer gave the drug heroin its name in honor of its heroically powerful pain-killing properties. The presence of bottles throughout the Research Hall labeled HCL, or hydrochloric acid, makes this heroin assumption slightly more plausible. Hydrochloride salts, derived from hydrochloric acid and an organic base, were used in the 1800s to synthesize morphine, and tetracetyl morphine diluted in hydrochloric acid is what produced heroin. But there’s stronger evidence, I believe, that Adeline and the non-hostile research patients represent medical patients hooked on heroin. As Last Protagonist notes in his Japanese retranslations, when Adeline asks for brain fluid, the original Japanese includes a descriptive statement that’s closer to “darkly melted brain fluid.” This description is very reminiscent of what is known as black tar heroin, a crude, coal-like version of the drug that’s known for its dark brown or black color. And in almost all of her dialogue with the player, Adeline refers to the “sticky” sound of Brain Fluid, which matches the most distinctive physical feature of black tar heroin—its sticky, tar-like consistency. Heroin and morphine, both derived from opium, were prescribed in Europe and Great Britain in the late 1800s as pain relievers and, in the case of heroin, as a cough suppressant. These routine treatments were eventually banned in Europe and America because the substances were incredibly addictive, as we well understand today.

What does this all mean for our understanding of the attempted or manufactured Great Ones? As we see in the Research Hall in the early years of the Healing Church and as we observe with the other major institutions of Bloodborne, each organization wants to find a way to make contact with or to simply comprehend the Great Ones. To do so, they need eyes on the inside. Although that was a shared aim of all the institutions of Bloodborne, their approaches weren’t always the same.

The early work of the Healing Church within the Research Hall meant giving patients this highly addictive, mind-altering substance. Brain Fluid transformed patients from normal human beings into these bag-headed monstrosities who lost their grip on reality. They babble and wander aimlessly. They scream and thrash around. They speak of noises of water and talk about becoming an egg. Their dialogue and the description of Brain Fluid imply that the Research Hall was giving brain fluid to these patients to help them evolve or advance. But it didn’t work, at least not as planned. As the exasperated Research Patient confesses to an absent Lady Maria just before we exit the Research Hall, “I have failed…” The Research Patients didn’t evolve to become Great Ones. The patients that underwent the most radical transformation as a result of their exposure to Brain Fluid became merely Living Failures—or failed attempts to evolve into Great Ones.

This is what the bosses associated with each major institution in the game represent: attempts to use their own method of research to evolve or advance humanity to the status of Great Ones. Whereas the Living Failures were brought about by exposure to this strange Brain Fluid substance, which was administered in a medical capacity in a hospital-like Research Hall, Rom was Byrgenwerth’s attempt to do so—I believe by using pharmaceutical substances in the form of botanics. This is why, I’ve argued, Byrgenwerth appears so tightly bound with the nervous system and why we see visual depictions of mushrooms and flowers on Master Willem. We also know from the Choir set that the Choir, the highest echelon of the Healing Church, continued the work that began at Byrgenwerth. The Choir’s realm is Upper Cathedral Ward, and its version of an attempted Great One is the Celestial Emissary, which can be found within the Lumenflower Garden, another reference to botanics and the pharmaceuticals derived from them. It’s no mistake that the Living Failures of the Research Hall look like a hybrid of the Research Patients and the Celestial Minions we find throughout the game. The Failures were the most transformed of the Research Hall patients and contain their bag-like heads, but their bodies resemble those of the Celestial Minions and Celestial Emissary, which were a much later and presumably much more refined or advanced attempt at using experimental medicinal substances to force humanity to evolve. Thanks to our discovery of the Celestial Minions on the operating tables in the back of Iosefka’s Clinic, including one that’s only partially transformed and still displays a human hand, we know that these creatures are humans who have been transformed by exposure to substances that were administered in a medical capacity.

Unlike the Living Failures, the Celestial Emissary and Rom—all of whom appear to have been transformed by the use of brain-altering substances—The One Reborn is the School of Mensis’s attempt at a Great One, which takes the form a fusion of bodies and body parts whose rotten flesh has been peeled away. As I discussed in Episodes V and XII-B, Mensis is an organization depicting the anatomists of the early 1800s who carved up dead bodies for medical research. With all of this in mind, I think we can draw some conclusions: Each institution in the game represents a snapshot in time of medical science, and when viewed chronologically in the game, they represent the evolution of medical science from the late 1700s to the late 1800s. Each institution has its own method of trying to gain insight or eyes on the inside. And we’re led to believe that each organization attempted to create a Great One using their unique method. For the Healing Church, Byrgenwerth and the Choir, it meant using powerful and addictive substances, be they psychotropic botanics or the heroin-like Brain Fluid. These methods of gaining insight and attempting to create a Great One reflect the real-life medical research practices of the pre-Victorian and Victorian era—mainly, the development and administration of new medications, anesthetics and narcotics—and in the case of Mensis, the widespread practice of anatomical dissection. It seems reasonable that a group depicting the anatomists of the early 1800s would use this method of medical research in their attempt to manufacture a Great One—The One Reborn—which is a nightmarish amalgamation of body parts, mainly the sinewy, skinless limbs of cadavers.

In my interpretation, the real Great Ones are the creatures that resemble internal features of the human body, representing the internal organs and systems that surgeons and anatomists would have discovered during surgery and dissection. By contrast, From Software appears to have used the failed or attempted Great Ones as a means of representing humanity’s real-life desire to gain mastery over the human body using many methods of medical research. But no such method could ever truly bring humanity’s knowledge of the human body up to a level at which we would have such mastery. Pharmaceuticals and anatomical dissection only grant so much medical insight. Alone, or maybe even together, they’re not enough to deliver humanity to a higher plane of knowledge. But the hubris, pretentiousness and naivety of the game’s leading figures has them convinced that they can indeed match the greatness of the Great Ones, so the effort continues generation after generation, failure after failure.

In the next and final episode, we conclude the series and I’ll put forth an argument about the origin of the medical metaphor. Although it’s rooted in real-life Victorian medicine, this element is far more nightmarish and disturbing than anything we’ve discussed so far. It seems all too appropriate for what we observe in the game.

An Agony of Effort, Part XIV - The Price of Progress (The Hunters Dissected) | Google Docs Link

The original sin of the hunters, their great misdeed driven by arrogance and curiosity, set in motion the events we observe and read about in the Bloodborne’s infamously cryptic story. In the remote Fishing Hamlet, the scholars of Byrgenwerth—the first of countless hunters—committed atrocities that would forever haunt the members of this bloodstained profession.

Although these events fundamentally shape Bloodborne’s in-game narrative, the atrocities of the Fishing Hamlet—along with those committed later by the Mensis scholars—are the most significant elements of the game in terms of our ability to decipher Bloodborne’s hidden meaning. In this concluding episode of the series, we’ll make our final foray into Bloodborne’s medical metaphor and attempt to explain its origins. If game director Hidetaka Miyazaki did in fact set out to tell a horror story inspired by real-life early medicine, there was no shortage of historical material to work with. He could have easily drawn upon the horrific nature of disease, gross experimentation and gruesome, blood-soaked early surgery. I believe wholeheartedly that that’s exactly what inspired Miyazaki in crafting this game. But there’s a compelling argument that the medical metaphor—and its relationship to several of the game’s most important characters—was drawn directly from two medical figures of the 1700s whose tale is both supremely noble and unfathomably nightmarish. By digging through this history, we take arguably the biggest step so far in demystifying Bloodborne’s story and unearthing its hidden meaning. In this episode, we make our final incisive dive into this medical mystery.

Across 15 installments of this series, we’ve discussed the many ways that Bloodborne reflects the evolution of medical science in 17 and 1800s Great Britain. I’ve argued that the game’s leading figures represent the medical scholars, surgeons and anatomists of the period, whereas the Great Ones symbolize the internal organs and systems of the body that could only be encountered and understood by gaining eyes on the inside—a clever double entendre meaning insight and a literal view inside the human body. But what was the impetus for telling this kind of story? In this episode, we’ll try to accomplish two main goals:

First, we’ll examine the shared attributes and histories of two essential female figures of Bloodborne. Their adjacency to the game’s most pivotal plot points appears to stand as a testament to these characters’ relevance to Bloodborne’s in-game story and lore—and to the game’s underlying meaning.

Building upon this overview, I’ll then put forth my argument for the origin of Bloodborne’s medical metaphor and quite possibly of the entire game. If I’m correct, we’ll see that Bloodborne’s main concepts, its leading factions and at least four of its most prominent characters or entities were derived from a single historical source. I think the evidence is extremely powerful and persuasive.

It’s no secret that pregnancy and childbirth are prominent themes in Bloodborne that are presented oftentimes with no subtlety whatsoever. Arianna, for example, becomes pregnant and eventually gives birth to a Celestial Child, presumably an infant Great One. Annalise, queen of the Vilebloods, tasks her followers with collecting Blood Dregs so that one day she may give birth to a child of blood. But pregnancy is the central feature of the game’s two most important female figures, neither of whom utters a single word of dialogue: Queen Yharnam and the Great One, Kos. These two voiceless characters possess virtually identical stories, and by examining their relationship to the hunters, we can reveal the game’s historical origins.

We can begin this exploration in the Hunter’s Nightmare, which is a living record of the dreadful exploits of Bloodborne’s oldest institutions, specifically Byrgenwerth, the Healing Church and their old hunters. Almost every major NPC we encounter in this area speaks of a dark secret—a heinous act committed by the scholars of Byrgenwerth. Most detailed of these accounts is that of Simon the Harrowed, who tells us that the nightmare “sprouted from their very misdeeds.” When we finally encounter Lady Maria at the top of the astral clocktower, she grabs our arm, pulls us in close and whispers, “A corpse should be left well alone.” Maria, we come to discover, did not honor these words. Several pieces of information lead us to believe that Maria and Gehrman came to the Fishing Hamlet long ago where they murdered the inhabitants of the hamlet and examined their brains [Accursed Brew]. We see a peg-legged figure walking into the hamlet in the DLC teaser video, and we find Maria’s beloved weapon, the Rakuyo, in the hamlet’s well, which she presumably discarded in disgust because it served as a constant reminder of the barbaric acts she committed there.

But their greater sin, we come to learn, was their defilement of the body of the Great One, Kos, whose carcasse washed upon the shore [Kos Parasite text]. Whether Kos died a natural death or was killed at sea is unclear, but we know for certain that her body contained an unborn Great One, the Orphan of Kos, which the hunters removed. The whispers of the Baneful Chanters, unseen figures of the Fishing Hamlet, chronicle the atrocities committed here:

Mother is dead, her baby taken Scales are suffering the grief of Kos … Kos we have beckoned, and Kos is dead Forgive us, and curses upon the fiends A call to the bloodless, wherever they be

A unique piece of dialogue from the Doll seems to confirm that Gehrman was primarily responsible for the hamlet atrocities. After we slay the Orphan of Kos and end the nightmare, the Doll tells us: "Oh, good hunter. I can hear Gehrman sleeping. On any other night, he'd be restless. But on this night, he sounds so very calm. ...perhaps something has eased his suffering.” This naturally implies that Gehrman was haunted by his actions in the hamlet, which included the defilement of her body and that of her unborn child.

As a hunter, the player-character is said to be just like our forefathers. Curious. Looking for secrets. Consumed by a lust for knowledge. It’s what compelled the first hunters to murder the villagers of the Fishing Hamlet and probe their internal organs in the name of research. It’s what drove them to cut open the carcasse of Kos and remove her unborn child. But it haunted them forever, and it’s why Brador, Simon and Maria tell us that some knowledge isn’t worth the price. Maria’s memorable warning that “A corpse should be left well alone” is even more striking in the original Japanese, which Last Protagonist retranslates to “Rummaging through corpses isn’t very admirable. But I understand…the secret is too sweet.” The hunters’ desire for knowledge, gained by dissecting Mother Kos’s body and removing her unborn child, superseded any sense of morality and decency they might have possessed.

Although the evidence is far less direct, there are numerous pieces of information indicating that the circumstances surrounding Kos are virtually identical to those of Queen Yharnam. We encounter Yharnam in the base game in two locations and at two critical junctures of the storyline. When we defeat Rom, we see the spectral presence of Queen Yharnam appear on the glassy bed of the Moonside Lake. She’s looking down, possibly staring at her bloodied abdomen. She raises her head and directs her gaze toward the gigantic blood moon that looms over the lake. The cries of an infant suddenly can be heard. We later come across Yharnam at the base of the Lunarium in the Nightmare of Mensis. Just as before, Yharnam stands with her gaze upward toward the moon and the Lunarium where we fight Mergo’s Wet Nurse. It’s here that we find an empty carriage that would have belonged to Yharnam’s child, Mergo, had Mergo been born. But the evidence overwhelmingly indicates that Mergo didn’t make it to term. Within the deepest reaches of the chalice dungeons, we find Queen Yharnam and engage her in battle. Here, she displays two forms—one in which she’s in the late stages of pregnancy, and another in which her abdomen isn’t swollen and instead is badly bloodied. Concept art also shows Yharnam in the latter months of pregnancy. This is the most explicit evidence that Yharnam doesn’t represent just a woman or queen; she was a pregnant woman whose abdomen was cut open. While it’s possible that this act might have been a failed Caesarian section, I don’t believe that’s what we’re supposed to surmise from Yharnam and the loss of her unborn child. Two questions naturally emerge: What exactly happened to Queen Yharnam, and who was responsible?

There are precious few references to Queen Yharnam in the game outside of the encounters we’ve already discussed. Importantly, though, the Pthumeru Chalices tell us that the Pthumerians carved out the labyrinth. Similarly, Alfred tells us of the “tomb of the gods, carved out below Yharnam,” implying that what lies beneath the city is essentially a burial place or grave. This term “tomb of the gods” could apply only to the Great Ones who are referred to elsewhere as gods, but it could generally indicate that the labyrinth is also a tomb of this long-gone Pthumerian civilization.

We know that Byrgenwerth’s scholars delved into the labyrinth. Alfred indicates as much, as does the Tomb Prospector set. But something that I don’t think we’ve collectively paid enough attention to is the linkage between Byrgenwerth and Queen Yharnam. The last barrier we have to overcome to access the College of Byrgenwerth is the boss of the Forbidden Woods, the Shadow of Yharnam. The name of this boss isn’t a reference to the city of Yharnam. It’s a reference to the queen. It’s why we later encounter these Shadow figures on the same level of Mergo’s Loft on which we find Queen Yharnam. Presumably, the Shadows are the servants of the Queen who are mentioned in the Blood Rapture Rune, which is dropped by the Shadow of Yharnam boss. Why does that matter? The boss fight arena for the Shadow of Yharnam is immediately adjacent to the grounds of the College of Byrgenwerth. This lamp location is called the “Forbidden Grave.” And as we’ve repeatedly discussed in this series, the word “byrgen” is an Old English word meaning burial place or grave, indicating that the College of Byrgenwerth essentially is the College of the Grave. When we piece all of this together, I believe we’re supposed to see that the Byrgenwerth scholars—who are described as “tomb prospectors”—created their own dig site on the edge of the college grounds, in essence digging through and prospecting within this Forbidden Grave. It was here that they accessed the Tomb of the Gods and dug up the dead, pregnant body of Queen Yharnam and dissected it. I realize that many people will reject this idea, but let’s run with it.

Yharnam, and the Pthumerians, are representations of the undead if not just the dead. The “Pthumerian Look,” as it’s sometimes called, is intentional. They’re designed to look like dead bodies. Their skin is ghostly pale. Their eyes are recessed with dark rings around them. Their cheeks are sunken. The skin around their lips is wrinkled from dehydration, just as it would be in a body in the days after death. It’s quite possible that their name is even a reference to the fact that they’re dead. The term “umeru” in Japanese, as I understand it, means buried in the ground, although I’d like to receive better confirmation from a native speaker.

While yes, we encounter Yharnam in a physical form of sorts, we do so at the bottom of a place called a tomb. In our other encounters, she’s a spirit figure with no physical presence. This further reinforces the idea that Yharnam is dead. I’m not certain whether we’re supposed to interpret that Yharnam was found and killed by the scholars of Byrgenwerth so that they could extract her unborn child, Mergo, or if they simply came across the body of the dead, pregnant queen and dissected her for research. But in either case, we’re led to believe that the scholars of Byrgenwerth, or their successors in the School of Mensis, were involved in this process. We know that Rom is hiding the Ritual of Mensis, blocking our access to the hidden village of Yahar’gul. When we kill Rom, a veil is lifted, Mergo’s cries begin and we see Yharnam appear on the lake. We thus can conclude that the Ritual of Mensis that Rom was hiding involved Mergo, or even Yharnam and Mergo. When we access the Nightmare of Mensis by touching the dead body of Micolash near Advent Plaza, we’re able to yet again encounter Yharnam, hear the cries of Mergo, defeat Micolash, who was behind the Mensis ritual, and eventually slay Mergo’s Wet Nurse, which brings an end to the nightmare.

I’ve argued that the Ritual of Mensis is a metaphor for anatomical dissection. But I stopped short of saying exactly what it entailed. In my reading of the evidence, the Ritual of Mensis was the dissection of Queen Yharnam and her unborn child, which created the Nightmare of Mensis. Yharnam’s consciousness or spirit cannot rest, nor can the cries of Mergo be silenced, until this horrific act is avenged and the Wet Nurse—a knife-wielding dissector—is slain in atonement. If you’re open to this idea but still not convinced, the latter half of this episode might change your mind. But first, let’s look at one more thing associated with Queen Yharnam. If we navigate the chalice dungeons and eventually defeat Queen Yharnam, she drops a strange item called the Yharnam Stone. Many players have suggested this item refers to an ectopic pregnancy or lithopedion, a fetus that dies and calcifies outside of the womb and is commonly called a stone baby. This trinket absolutely confounded the lore community for years. For all the effort it takes to reach, let alone defeat Yharnam, we’re rewarded with this token that has no application as a currency, has no impact on the player’s stats and has no ability to unlock new areas. It appears to have just one use, although it was cut from the final release version of the game. Lance McDonald revealed in a 2019 video that if the player carries the Yharnam Stone and ventures to the Fishing Hamlet, there is a dialogue option in which the player may give the stone to the Hamlet Priest. If we do, the priest says, “Kos! Fair child of Kos. Time is not, and the sea rumbles afar. And yet, a mother’s pungent devotion can still be felt. Ahh, thank you messenger. I exude gratitude for one such as you. Kos, bless this messenger, this visitor from beyond.” Although there’s likely no in-game connection whatsoever between Queen Yharnam and Mother Kos, the Yharnam Stone item and this unused bit of content reinforce the idea that the stories are essentially one and the same with these two mother figures whose unborn children were taken from their dissected bodies.

Fine, you might think. The hunters carved up the pregnant bodies of Kos and Yharnam. What does this have to do with Bloodborne’s medial metaphor? Far more than you might fathom. In the mid-1700s, within the heart of the Georgian Era of British history, the world of medical research would be permanently altered by the groundbreaking and equally horrifying work of two men. These men, just like Maria and Gehrman, would become forever known for dissecting the bodies of pregnant women and their unborn children in the pursuit of higher knowledge.

These men were the Hunters. And I believe their story was the primary inspiration for Bloodborne’s hunters and its medical metaphor—if not the entire game itself.

It’s not an embellishment to say that there are no larger names in the history of anatomical dissection in Great Britain than William and John Hunter, brothers who were born in 1718 and 1728 in the countryside south of Glasgow Scotland. The elder brother, William, abandoned his plans to join the clergy in favor of medicine, earning his medical degree from Glasgow University before accepting an apprenticeship with Scottish physician William Cullen. Cullen would go on to become professor of chemistry and pathology at the University of Edinburgh and a leading medical scholar of the central nervous system. As I argued in Part IV of this series, I believe William Cullen was a key inspiration for Provost Willem. William Hunter briefly studied at the University of Edinburgh before relocating to London in the 1740s to assist two fellow Scottish physicians in their midwifery practice. Because he was able to ingratiate himself with the intellectuals and high society of London rather quickly, William chose to break an agreement with his former master, William Cullen, to become a junior partner in his practice in Scotland. He instead remained in the English capital to continue his work in midwifery. It was a wise and lucrative decision. By his mid-40s, as described by researcher Peter M. Dunn, William Hunter had become “the leading physician-man midwife of his day.” But William’s passion and the source of his fame was his zeal for anatomical dissection as a tool for teaching and research.

In 1746, William opened his own anatomy school in London that was unique in all of England. Unlike the medical schools at Oxford and Cambridge, or even other private anatomy schools of Great Britain, William’s anatomy school guaranteed that every student would receive his own cadaver to dissect at every session of the four-month-long course. Other schools obtained at most two corpses that the head master would dissect over a period of weeks during colder months of winter while the students merely observed. The steady stream of fresh bodies to William’s anatomy school was unheard of at the time. In the 1740s, there was no legally sanctioned method for private anatomy schools to obtain bodies for dissection. The Murder Act of 1752, which allowed executed criminals to be dissected, was still years from passage when William founded his anatomy school. Because William enrolled as many as a hundred students per term, the demand for bodies was staggering. To satisfy demand, the only recourse was body snatching—the digging up of coffins from fresh graves, dragging the body out with a length of rope, shoving it into a sack and transporting the corpse under the cover of night to the basement of the anatomy school. The task of obtaining bodies fell to William’s brother, John, who had come to London to train under William who was 10 years his senior. Within a few years, John would become a full partner in the operation of the Hunter school. While William would lecture and present practical information from his perspective as a physician, John would demonstrate dissection and surgical applications on the cutting table. In the school’s early years, to satisfy their cadaver demand, it’s believed that John dug up bodies himself. This lasted for only a short time before he expanded his grave robbing operation to include anatomy students and, eventually, a hired band of professional body snatchers. These men were otherwise known as “Resurrectionists.” But colloquially among the commoner class, they were known as “Sack ‘em up men'' because they delivered bodies in cloth or burlap bags fresh from the graveyard to the anatomy school door. These figures were the inspiration for Bloodborne’s Kidnapper enemies, commonly called “Bag Men,” as we discussed in Part V of this series. The Kidnappers kill the player-character and deliver the body in a bag to the underground keep below Yahar’gul.

John Hunter would soon surpass the dissecting prowess of his older brother, thanks to his extraordinary knife skills and his penchant for experimentation. In his 12 years at the Hunters’ anatomy school—first as an apprentice and later as a researcher and lecturer—John dissected more than 2,000 bodies, making him the most prolific anatomist of the Georgian Era. This work not only produced a multitude of anatomical and physiological breakthroughs; the Hunters brothers’ preservation of diseased tissues and physical abnormalities helped ensure that the thousands of aspiring surgeons they trained were able to successfully identify illness and disease in both the living and the dead. This is why, I am convinced, the ritual materials within Bloodborne—the items most prized by hunters who delved into the Tomb of the Gods—are virtually all body parts and preserved tissues. The items Sage’s Hair, Sage’s Wrist and Yellow Backbone are all specifically referred to in their item descriptions as “body parts.” The cadaver element is right there in their item descriptions. We also have Bloodshot Eyeballs that are “removed quickly after death, or even before,” just as in a postmortem dissection. The Sage’s Hair and Wrist, specifically, are said to have been used by the Healing Church in its search for truth, or knowledge, yet again strongly implying their use in medical scholarship. And most explicit of all ritual materials is the item called Inflicted Organ, or as it’s more accurately described in the original Japanese, “Disease-riddled Organ.” All of these ritual materials are body parts and diseased tissues that anatomists would have removed and preserved to aid in anatomical instruction. Because Bloodborne treats these materials as “ritual” materials, it suggests that the game’s rituals might represent anatomical dissection. The most notable of these, of course, would be the Mensis Ritual, which I argued in Episode 5 is a reference to dissection.

But here’s where the story of William and John Hunter mirrors what we observe in Bloodborne. William was trained as a man-midwife, serving as a physician to London’s wealthy women during their pregnancy. He would go on to deliver all 15 children of King George III and Queen Charlotte. Compelled by his fascination with human anatomy and obstetrics, and quite likely by his insatiable hunger for wealth and fame, William set out to accomplish the unthinkable: He would dedicate the latter half of his life to studying—and, more importantly, to visually capturing—the development of the fetus at every stage of pregnancy. In the mid-1700s, little was known about fetal development. Not surprising, considering there were social, religious and logistical barriers to fetal study. Not only was it considered morally reprehensible to dissect the corpse of a pregnant woman, a fetus or a stillborn child, there were few opportunities to do so even if the anatomist was unbound by social mores. Although women weren’t spared from capital punishment in 18th century Great Britain, it was unheard of that a pregnant woman would be sent to the gallows and thereby render her corpse fair game for the dissecting table. With few pregnant corpses to study, the anatomists of the 16 and 1700s had made few breakthroughs in studying the fetus and the mother’s physiology. William Hunter was intent to change that. To do so, he would rely on the impeccable dissection abilities of his brother, John, and the illustration skills of Dutch artist Jan Van Rymsdyk, who would capture the Hunter brothers’ dissections with lifelike precision. And while John’s steady knife-wielding hand would be critical to this venture, it was his familiarity with the seedy underworld of body snatching that proved even more valuable.

As historian Wendy Moore chronicled in her 2005 biography of John Hunter titled “The Knife Man,” the Hunter brothers secured the corpses of at least five pregnant women, paying their team of body snatchers to exhume the bodies often within hours of burial. Through John’s meticulous handiwork, the Hunters and the artist van Rymsdyk created 34 engravings that would constitute William Hunter’s magnum opus, “Anatomy of the Human Gravid Uterus,” which he published in 1774. The book, which was printed as an elephant folio of unusually large proportions to ensure the visibility of van Rymsdyk’s striking sketches, showed the fetus in its various development phases, including in its final state just days before birth.

Medical scholars acknowledge that the Hunters could have exhumed and dissected as many as 20 pregnant women in the completion of the “Anatomy of the Human Gravid Uterus.” But I suspect that the story of the Hunter brothers might have come to the attention of Hidetaka Miyazaki in or around 2010 following the publication of a shocking and highly contentious article by sociologist Don Shelton. In his piece published in the Journal of the Royal Society of Medicine, Shelton cites hospital data of the period to conclude that there simply weren’t enough dead pregnant women in London to have accounted for the known dissections of William and John Hunter. Pregnant women by nature tend to be young and healthy, and deaths during pregnancy were much less frequent than they were among infants, children and the elderly—or even among women shortly after they gave birth and died from blood loss or infection. Instead, Shelton argues, the Hunter brothers didn’t just dig up the corpses of pregnant women—they paid men to kill and deliver the bodies of expectant mothers to the doorstep of the Hunters’ anatomy theater. William Hunter, much like Gehrman, might have been driven by such a powerful, manic curiosity that it would compel him to engage in this murder-for-hire scheme to obtain these anatomical treasures.

Although Shelton’s article received coverage in the mainstream press, leading to television pieces and news stories in the British news source The Guardian, historians and medical scholars almost universally denounced Shelton’s conclusion, insisting that he had ignored the fact that William Hunter was a physician at a lying-in hospital and would have known when pregnant women at the hospital would have died. The Hunters, therefore, could have easily targeted the graves of these women rather than digging up graves at random in hopes of finding a dead expectant mother, or hiring men to kill and deliver these prized specimens. Still, Shelton’s study garnered enough interest in international media five years before the release of Bloodborne that it seems plausible to have been the source that brought the Hunters to Miyazaki’s attention. It was 2012, after all, when the game began development under the name “Project Beast,” meaning Miyazaki would have had a year or two to develop a conceptual framework for the game between the release of Shelton’s article and the beginning of Bloodborne’s development. Bloodborne’s inescapable medical metaphor and its central themes of pregnancy and childbirth would make perfect sense in a game inspired by William and John Hunter and their dissection of pregnant women in the name of medical science. Bloodborne builds upon this primary historical source, expanding the game to subtly reflect the evolution of medical science and practice in the 17 and 1800s, rooting its Gothic horror aesthetic in the real-life history of Edinburgh, the center of medical study of the Victorian period.

I’ve argued in several episodes of this series that the Great Ones of Bloodborne were designed to resemble things found within the human body—organs, systems and even fetuses—because that’s what anatomical researchers would have discovered during the course of dissection, the main form of medical research in the 17 and 1800s. But as I noted in Part XII-C, the Great Ones also have a subtle element to them that connects us back to William and John Hunter. The Great Ones seem to possess some aspect that is associated with pregnancy and childbirth. Based on what we now know, this doesn’t seem at all coincidental. The Great Ones aren’t just based on things found within any cadaver’s body—they represent the organs and systems that would have been found within the dead bodies of pregnant women and their unborn children. It’s why Kos—the central figure of the Hunter’s Nightmare and source of the Curse of Kos—is designed as a massive womb and her unborn child, the Orphan of Kos, is a fetus. It’s also why the Brain of Mensis is described as a rotten, eroded brain. It’s the brain of a dead fetus that has begun to decompose. And that’s why, when the Mensis scholars encountered this Great One, their brains were “stillborn.” We’re supposed to associate the Brain of Mensis with a dead fetus or stillborn child whose rotting brain would have been discovered during an anatomical dissection of a pregnant woman and the child she was carrying. Finally, it’s why the Moon Presence’s face is a cross-section of an umbilical cord while its body is designed as the circulatory system. John Hunter’s most important medical discovery that resulted from the dissection of pregnant women was that the fetus’s blood circulation was separate from that of the mother. That the final boss of the game is a giant circulatory system seems very relevant.

Queen Yharnam and Mother Kos are our connections to the real-life history of William and John Hunter, and Maria and Gehrman—presumably the first two in a long lineage of hunters—seem to be the direct analogs to the Hunter brothers. Much like the younger John served first as an apprentice to his older brother, so too did Maria serve as a student to Gehrman, the first hunter. Together, they raided the Fishing Hamlet and committed the original sin of the game—the defilement of Mother Kos’ corpse and the removal of her dead, unborn child—just as the Hunter brothers gained medical fame and infamy for their dissection of pregnant women. Why would Kos be designed as an oceanic creature that would have washed up on the shore of the Fishing Hamlet like a whale, only to be dissected? There are several theories that From Software drew from Japanese history and manga set in fishing or whaling villages beset by mysterious illness. But I think there’s a strong possibility Kos is depicted as a large sea creature because one of the most famous anecdotes about John Hunter was his dissection of a piked whale, whose 17-foot-long carcasse was delivered from the banks of Thames river where it washed ashore to the doorstep of the dissecting room in the rear of John’s London home. He wrote an entire book on it, titled “Observations on the Structure and Oeconomy of Whales.” Dissecting expectant mothers and all manner of exotic animals contributed greatly to John’s reputation as an eccentric and morbid figure. As an interesting aside, medical and literary scholars have noted that John Hunter and his home on Leicester Square were almost certainly the inspiration for Dr. Henry Jekyll and his elaborate mansion in Robert Louis Stevenson’s “The Strange Case of Dr. Jekyll and Mr. Hyde,” which we’ve acknowledged repeatedly was a major influence on Bloodborne.

The successors to Bloodborne’s early hunters, the students of the School of Mensis and their leader, Micolash, appear to have committed the same sin as Gehrman and Maria, only at a later time in the game’s history. Mensis somehow encountered Queen Yharnam deep in the Tomb of the Gods and then removed her unborn child, Mergo. This appears to have created the Nightmare of Mensis, a realm where Mergo’s consciousness, and that of Micolash, is trapped. Micolash, as he dies in the nightmare, screams, “I’m waking up. Now I’ll forget everything.” The knowledge he gained from dissecting Yharnam’s body and that of her fetal child Mergo was lost.

The Hunter’s Workshop, which we observe in the waking world and in the Hunter’s Dream, is our constant reminder of fetal dissection. The workshop seems to be a small anatomical study space, complete with the dissecting tools, jars and chemical solutions that are reminiscent of real-life dissecting rooms of the 1700s. It’s also why we find one of the four umbilical cords there in the waking world version of the Abandoned Old Workshop. We find it atop a small table that’s covered in bloody cloth, as if a dissection of a small body had taken place there. It would make sense that some waking-world version of the Orphan of Kos—one of infant size as opposed to the man-sized version we encounter in the Hunter’s Nightmare—was brought to the Hunter’s Workshop and dissected so that its umbilical cord could be removed.

We also see the Surgery Altar in the Hunter’s Nightmare isn’t a place of surgery at all, or even an homage to surgery. It’s a monument to dissection. All the figures in the display are carved in stone, even the body lying on the operating table. But unlike the three living figures standing around the altar, the subject on the table is a desiccated corpse with its head cut open. This is an altar to the art of dissection, which was the source of the Hunter’s Nightmare realm—the dissection of Kos and her unborn child. Laurence, seemingly racked with guilt, is posed in the Nightmare Cathedral in the exact same position as From Nature, the cast of a dissected corpse, to further reinforce that the original sin of the hunters and of the scholars originating at Byrgenwerth, was dissection.

Dissection of pregnant women and their unborn children is certainly nightmarish, and I’m convinced this is the origin of the “Nightmare Slain” text we receive three times in the game. Unlike the usual “Prey Slaughtered” text that’s displayed after defeating most bosses, we see “Nightmare Slain” when we defeat Mergo’s Wet Nurse, the Orphan of Kos and the Moon Presence. By freeing the consciousness of the dead, dissected Mergo from its captor, the nightmare is ended and Yharnam bows to us in gratitude. By slaying the Orphan of Kos, whose pregnant mother was defiled by the hunters, we return its restless spirit to the sea. And by killing the Moon Presence, presumably we are ending the endless cycle of the hunt. In my interpretation, the hunt isn’t just the slaying of beasts. It’s everything that Bloodborne entails—an endless search for knowledge in the hope of advancing humanity. It’s a grand metaphor for medical research. And only by consuming three umbilical cords—body parts that would have been only obtainable by dissecting fetuses—can we obtain the necessary knowledge, the medical understanding, to end the hunt.

Bloodborne has always been a medical story at its core, one inspired by the surgical history of Great Britain. Within the game’s steelbook case, early concept art shows the gate to Cathedral Ward with the inscription, “Faithful hath been your warfare,” a quote from John Milton’s epic poem, Paradise Lost. But the quote’s connection to Milton’s biblically inspired work is irrelevant; it’s the quote’s application in real-life architecture that’s important. It appears on the signage at the entrance to the British Medical Association, a union for surgeons and physicians in London. As I said months ago when we first began, “Bloodborne is meant to depict the nightmarish experience of Victorian-era illness and disease and the dehumanizing nature of medical research, surgery and addiction.” I hope that over the course of this series, I’ve been able to argue this point and give you something new to think about. My dissection of Bloodborne, at least for now, is complete. Thanks for watching.