Is Bloodborne’s Depiction of Victorian Medicine Historically Accurate?

Number 16 Bus Shelter
9 min readOct 7, 2021

The modern are privileged, for they know what lies beneath the skin.

Trolls in the papacy, agoraphobic physicians and priests who administer poison in every self-serving sip of communion.

From the quaint conurbation of Old and Central Yharnam, these curious authorities welcome you.

And, when I say “trolls”, I mean the fellows of folklore who drink their milk thrice a day, inhaling whey powder as if it were dispersed through the atmosphere like the air was on steroids.

Not to mention the most important practice of preaching where reliance on nature is boasted as the organic solution to skincare.

The Victorian Era was a less-than-picturesque framing for religion and medicine. When the mere mention of ‘Victorian’ evokes an image of England over America, it should be expected.

Perennial climes of weeping clouds and pale skies. Breathtaking attire and a suffocating second skin.

Many customs of auld lang syne were queer and questioning.

The unfortunate byproduct of an age where technology was unavailable, limiting humans to their organic instruments.

The five senses, notably attuned to sight, touch and smell.

During a time when the eyes were the only feasible tools for visual observation, barring the magnifying glass and early usage of X-rays, the latter of which, even if promising, was dangerous experimentation.

Especially for the flourishing population of physicians and patients alike who had little choice but to contend with nescience as the prime animus.

Medical practitioners of the 19th-century primarily relied on bodily fluids for visual stimuli. Easy access to the workings of human anatomy sans significant harm or fatality to the patient.

If not conducting autopsy over biopsy, gaining entry to the interior of a body was grounds for accusation as Jack The Ripper.

Examining the internal organs with blind hands and sharp objects is not as easy as programming machines with a list of commands, equipped with superior insight.

Human vision is unable to peer beneath the surface. Victorian physicians had to take a chance when attempting to determine and diagnose illness and injury. Heart, lungs and brain were simple enough to identify and locate through a blind study.

However, it was the stomach and its neighbours that were hard to stomach. A complex arrangement of organic housing for components that were pressed against each other in a compact area of storage.

Regardless of frame, the range of scope remains the same.

Any error was not in the surgeon’s best interest to make. It was not a basic operation to make tentative incisions into the skin, to make slightly deeper impressions, drawing blood and penetrating muscle fibres, finalising the descent with gradual increase in pressure.

Much like FromSoftware’s signature framework for mechanics, medical praxis for Victorian practitioners was an exercise in punishment.

Beneath the beastly flesh of Bloodborne’s underlying message for knowledge being both a boon and bane is the necessity of players fostering patience and perseverance in the face of repetition.

Players who are new to FromSoftware may find the need for bloodletting after only a few minutes of gameplay. Not even a few seconds after being released from hospice, you are dressed, if not addressed, as a “Hunter”.

Technically, you awake, still wearing the attire custom to your native residence. A striped, wine red vest, plain white dress shirt, pleated trousers and a hooded cloak.

In the aftermath of repatriation, released from the claws and gaping maw of an incubus, you casually slip down from the operating table.

One side of the room is pitched in darkness.

The other, lit by a glim, beckoning entry.

Or rather, exit.

Quite an exit to greet you, whilst strolling down the stairs to another light, brighter than the last.

The celestial glow of a lantern, leading to an ethereal place.

From the beginning of a delirious nightmare to projected dream, named after yourself and the new career you’ve now been assigned to.

Most likely to be interpreted as a metaphor for “seeing the light” before death, as ‘The Hunter’s Dream’ is a location beyond the earthly realm, rising to something spiritual.

The relevance of it all, in relation to medical practice, traces back to where the game starts. Having little to no foreknowledge of the narrative, you are just as disoriented as the displaced character.

“Hospice”, in this context, is not referring to the home of one who is receiving care in the final stages of terminal illness.

In archaic terms, the word defines a place of lodging for travelers. Namely, one that is ruled under the order of religion.

Although, we don’t know for certain if our anonymous caretaker is of the religious order.

The building appears vacant upon waking. The door that’s shrouded in shadow is locked. A mystery that remains to be unveiled at a later date in this fevered journey. A queer reveal with mystifying design for the entrance.

Descending the stairs and passing this lamp is the only moment of respite received before encountering the first trials on your first day at the job.

A traveler who, for a day, becomes a Yharnamite, unable to repatriate to their homeland, diseased and searching for a cure. Making your first encounter of the evening.

Symbolism is stark with the next room’s striking plunge into tenebrous deluge.

FromSoftware is also reputed for their craft in ambience.

Reflexively, you halt your character’s light trot to an almost glitching rigidity.

Rigour mortis besets the limbs, transferred to the thumb’s twitching placement atop the joystick. Before you’ve even stepped one foot beyond the threshold, the sound design quality is terrifyingly accurate.

The traces of massacre it leaves behind is pronounced by the subject. A fellow diseased patient, engaging in their own heuristic session of bloodletting.

It’s hirsute.

It’s ravenous.

It’s the abomination of man’s best friend.

The sounds produced from it are blood-curdling, but the blood it spills has since lost animation to cause chemical reactions.

The reality of bloodletting involves the process of extracting blood. Letting blood flow from venous injection. A measured modicum of lifeforce released from the body as a means of therapy.

A few paltry ounces of blood would be collected, the patient would be patched up and, perhaps, feeling a little lighter upon departure.

This would often be in direct relation to the four humours, a category of bodily fluids condensed to blood, bile and phlegm.

These humours, the most optimal substitute to the missing tools needed for visceral examination, were identified as sanguine, choleric, melancholic and phlegmatic.

Sanguine Humour = blood.

Choleric Humour = yellow bile.

Melancholic Humour = black bile.

Phlegmatic Humour = phlegm.

These humours applied not only to physical substance, but psychological. Addressed as temperaments when identifying common traits of individual personality.

Sayings like “bad blood” may be attributed to a person who expresses poor circulation, infection, poison or other common conditions associated with negative effects on the blood.

Subsequently, regardless of if the person is afflicted with physical illness, the symptoms allude to an impression of the psyche where they are inclined towards sadness over happiness.

Healthy levels of sanguine humour indicate a cheerful disposition. If one was observed as sullen or in a depressed state, they would likely be described in poor humour via sanguinary disruption.

Namely, in the heart.

Choleric and melancholic humours, located in the liver and spleen, respectively, may have indicated a person’s mood to be either irritable or in low spirits.

Sanguine humour may have been considered a precursor to melancholy when the cheerful disposition of normal sanguine has been compromised.

Phlegmatic, not to be confused with melancholic, accounts for the sinuses, where mucus deposits assume the highest precedence. Otherwise, it takes the shape of plasma. A viscosity of which could be interpreted as congestion of good humour.

In contrast, good humour may be characterised by clear sinuses. No buildup of mucus to obstruct respiration.

In essence, phlegmatic humour is evinced by a stolid disposition. A phlegmatic fellow prescribes to the philosophy of stoicism. The school of thought that discourages submission to emotion, instead channeling energy to the endurance of pain without complaint.

In any case, the physician, unlike the alienist, is unconcerned with the emotional or psychological state of their test subject.

The physician is only attuned to flesh, bone, blood and muscle. Every dissection is an orchestrated gorefest for personal viewing. There is no nervous tick to attend their snips through the nervous system.

What matters most to the anatomist in their contorting arrangement is that the humours remain in balance.

Dominance is a major factor of negativity that must be tamed. No fluid is permitted to gain increase in volume without causing disturbance to overall function of the mind and body.

In Bloodborne’s case, namely, Yharnam, the dominant factor is concentrated in the prefix.

The title, itself, is defined by disease, where the blood is a transport vehicle.

A fitting example being the transmission of malaria. A mosquito, who is also infected, injects the parasite’s genetic material, which travels through the bloodstream.

Is this the primary reason as to why patients receive bloodletting treatment?

The solution (of elixir) is half-and-half.

London, England, regardless of era, is rather bereft of mosquitoes.

Again, bloodletting was simply considered the most optimal approach to balancing those four humours.

The treatment was specifically reserved for when blood overpowered bile and phlegm. For modern and antiquated humans alike, we see it most notably when experiencing adrenaline or being beset by an impassioned state of anger or general excitement.

Heart rate increases and a frenzy possesses the blood.

Of course, it should be considered that relieving a modicum from the system would restore the body.

The religious order, in question, is the Healing Church. A secular body of heathens who prey upon the lost to continue their tradition of hunting.

But, the hunt is anything but ordinary.

The targets are not limited to animals.

Humans, by vice of indulgence, have become beastly.

Through psyche and physicality, they have regressed to a former state, born again to something savage and insentient.

In essence, their humours are out of balance. Driven mad by an insatiable bloodlust.

The Healing Church signifies the worship of blood as currency for eternal life.

Such obsession and praise was a corruption of Christian communion.

Drops of poison through the blood of Jesus.

Resistance to the sickness.

Bloodletting is The Healing Church’s prayer and direct cry of piety.

Because of the illness spreading throughout Yharnam, beastly and bloodborne, the need for release is as piercing in plea as the chilling chime of Little Ben upon ascension of Jacob’s Ladder.

The tortured screech of a wounded animal as an unsound sibling in the near distance, striking terror in the familiar and unfamiliar alike.

A greeting that warms the heart upon sight. Blood churning in its restless chamber of throbbing muscle. Toughened threads that unravel interminably slow, yet no less determinedly.

Forget what you’ve heard.

Erase the hearty tales of your homeland from memory.

Here, weak is welcome.

Here, the weak are willed.

Yharnam is pleased to welcome the faint of heart.

Its physic is based solely on the principle of opposition.

Yet, be not mistaken.

The Healing Church, and its papacy, do not address evil by the Devil. Nor is title announced to the cleansing personification of Light.

Inordinate worship of knowledge is not the only root of sin that Bloodborne edifies unto its players.

A carnal appetite for blood. Physical taste, conversing with intellectual, is the reason for Being, yet also the most deadliest of sins.

Ofttimes, worship of flesh is synonymous to worship of the Devil. However, to denounce either entity, redefining the concept of up and down, Heaven or Hell, left to resolve conflict between right and wrong, is to instill faith in something near and familiar.

A Kill Care Club that is not only exclusive to humans, but all earthly forms of life.

Anything, animate or exanimate, subsisting on the perpetual recycling of blood, was deified.

Animals, humans, insects.

Creatures yet, if ever, to be named as they are the peerless winners of hide-and-seek, cloaked beneath layers of sightless water.

Absorbed through the bark and leaves.

In summary, the answer is yes.

The Healing Church’s practices with blood and preachings of blood healing are historically accurate.

In a time where humour was a measure of one’s health, the evolution of its term to comedy is emphasised by the technique of release.

Whether morbid or lively, the nostrils flare from splitting sides.

A pain that blurs to pleasure.

A coppery scent filling the air.

Transformation predicts the weather.

The gut-wrenching humour of healing blood with a bloodborne disease.