Jump to: Spoilers (5)
Director Tom Six showed a drawing of the human centipede to all the actresses who showed up to the casting sessions. Many actresses walked out in disgust after discovering what the role actually entailed.
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When approaching investors prior to filming, the filmmakers told them they wanted to make an international horror film that involved stitching people together but did not mention how exactly they would be stitched, fearing the mouth-to-anus aspect would put off the investors.
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When the Toronto Underground Cinema showed this film, there was a "centipede deal" where if two tickets were purchased, the third one would be free.
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The paintings of conjoined twins displayed throughout Heiter's villa were painted by director Tom Six, which he felt contributed to the atmosphere in the house.
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The concept of the film arose from a joke director Tom Six made with friends about punishing a child molester by stitching his "mouth to the ass of a very fat truck driver."
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Director Tom Six contacted a real surgeon for the human centipede design. This is why the film has the tagline "100% medically accurate," which is not true.
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Roger Ebert refused to assign this film a star rating for his review (not to be confused with giving it a zero star rating, which he hands out to the very worst films that he sees), saying it does not really matter whether the film is perceived as good or bad. He closed the review by writing, "[The film] is what it is and occupies a world where the stars don't shine."
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The actors playing the centipede were given massages at the end of every day's filming due to being on their hands and knees all day long.
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Some scenes of the movie are so controversial, some people walked out during test screenings.
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Although the film is set in Germany, it was shot in the Netherlands due to the countries' similar landscapes. Heiter's home, where most of the film takes place, was a villa in the Netherlands found by the production team. The property was in a residential area and not surrounded by woodland as it appears in the film, but by other houses, so the filmmakers had some difficulty ensuring the other houses did not appear in shot. Real hospital beds and intravenous drips were rented from a local hospital.
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In the scene where Lindsay falls into the swimming pool, Ashley C. Williams's shivers were real as the heating was not working, so the water was really cold.
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Dieter Laser came up with the ideas to both smell the pus and lick the blood on the stairs.
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Josef Heiter's first name references Josef Mengele, a Nazi doctor who carried out torture experiments on prisoners in Auschwitz concentration camp. The surname Heiter, literally meaning "cheerful" in German, is a reference to lesser-known Nazi war criminals, doctors Fetter and Richter.
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The opening scene, which only featured Dieter Laser and Rene de Wit, was shot on the last day of filming. Laser wore director Tom Six's mirror sunglasses for the scene.
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Feces is simply what remains of food after most, if not all the nutrients have been absorbed from it by the body, although it usually retains some water. Because of this, the only person who could hypothetically survive living as part of a human centipede for more than a few weeks would be the person in front. The other members of the centipede would eventually die from lack of water, unless they receive intravenous fluids; they would most likely die due to nutritional deficiencies in that case. In the unlikely case that that doesn't kill them, ingesting fecal bacteria causing severe lung and stomach infections would.
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The defecation in the mouth scene was done in a single take.
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The two female leads were cast in New York City. Akihiro Kitamura auditioned via Skype.
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Dieter Laser was director Tom Six's first choice to play the mad doctor Heiter. Laser supplied most of Heiter's wardrobe and stayed in character throughout the filming, deliberately keeping himself away from the other actors and crew as much as possible.
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The cage the human centipede was kept in was a real dog cage.
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Since Human Centipede (2009) was marketed as "100% medically accurate," the doctors on Hi Everybody! A Bad Medicine Podcast (2019) use this film as their baseline for rating the medical accuracy of other films and TV shows. For example, they determined that SAW 2 (2005) was "500% medically accurate," meaning it was five times more medically accurate than The Human Centipede (First Sequence).
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Akihiro Kitamura wrote the monologue he says before his character commits suicide.
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Body Count: 6
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In the scene where Heiter roughly grabs and injects Lindsay, Dieter Laser actually hurt Ashley C. Williams, which caused a pause in filming.
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This is the only Human Centipede film where the villain dies at the end of the film.
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Some copies of the film leave the German and Japanese dialogue without subtitles, making some sections of the film somewhat difficult to interpret. The German man in his car in the beginning remarks that he seems to recognize one of the girls from a 'tape' he has at home, before he starts to make sexual comments. The two detectives are visiting Dr. Heiter because they responded to a call from someone who claimed to hear a girl yelling with an American accent. Heiter offers them a drink, saying that he only serves water. When one of the officers refuses the drugged drink and the glass breaks, Heiter apologizes, saying that he is overworked. The detectives inquire about Heiter's basement; Heiter reacts defensively, telling them it can be either a lab, a work room or a torture chamber. The detectives insist on a tour, but Heiter wants to see a search warrant first, which they claim they can get within 20 minutes. At the end, Katsuro's long Japanese monologue reads: "God. Are you God? I'm just a puny insect. I cast out my parents, left my child, dismissed their love and led a selfish life. Just like an insect. No, my existence is even lower than insects, but... but dear God... that's how I've lived, and this is my punishment. I want to believe that I'm still a human being... Hey girls! Hey mister! What an insane world we live in" before he commits suicide.
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