Granted, the Japanese had a stranglehold on the intense horror/gore in the past. Guinea Pig, Naked Blood, Ichi the Killer, etc were all the top dogs of their day. But Guinea Pig is pretty tame compared to some stuff that is out now. The previously mentioned L'Interieur (Inside) is far more disturbing than any of the Guinea Pig installments. Martyrs (the French are really going for it in the gore/disturbing department) is another one that utterly trumps Guinea Pig. The main thing that Guinea Pig had going for it was the snuff mystique. But since it's obviously been outed as fake and the fact that the effects are pretty dated, it just doesn't have the same impact. Plus I think there's a disconnect with Guinea Pig because it's just mindless torture. There's no reason other than simple human sympathy to feel anything for the victim. There's no storyline, no character development, just torture and death. That's where the French seem to be taking over. They combine the intense gore of the Japanese with actual storylines. There are characters that you can actually empathize with. It makes for a far more horrific movie.
But for over the top gore and gut wrenching disturbing, I have to go with August Underground's Mordum. I have no problems watching any kind of horror/gore you can think of. L'Interieur, Martyrs, Guinea Pig etc were intense, but I could easily watch them again. Mordum? I'm not so sure I'd watch it again. It's just that intense and insane. If you ever wanted to have a glimpse into a serial killer's life Mordum will give you just that. It's the only movie to actually make me feel nauseous while watching it and it had nothing to do with the shaky cam.
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