Quoting the Gamespot review:

"The biggest problem is that the game is just too damn hard. You've never seen enemies deliver so much damage as quickly as in Blood - even the mice will start draining your life meter at an amazing rate. Put simply: when an average player has to play on wimp mode to avoid being killed every 30 seconds, there needs to be some serious adjustment made in the difficulty levels."

It's a tough game, and I'm actually playing it at the 2nd. difficulty level because of that, but at least the difficulty can be changed (See most NES games -_-). Also, it's absolutely amazing.

Yeah Blood isn't the easiest game.
Also, keep in mind:

The Games today almost ALWAYS are build to suit even the most casual player. You have almost always unlimited health (okay you can die but you regenerate health and mostly extremly fast) and others.

The old games however like Duke, Shadow Warrior (when the fuck does it arrive here, goddammit), Blood, Doom are a different kind. You have very limited health and thus you feel like being overwhelmed. You can sometimes be killed in 1-2 hits, so those games need you really to walk away, take cover and try to outrun your enemies.

You can even do a lot of levels with no or absolutely minimum killing.

But I am "weakened" by the actual games too.
Where I once beat Blood on the hardest difficulty after a few days of ultra quicksaving and quickloading every few meters, I do have my problems on the lowest difficulty.

Same goes to every kind of game.
They get easier and easier...

I agree, Blood is a damn hard game.

I honestly can't say it much harder than Duke Nukem 3D or Shadow Warrior. Enemies are extremely stupid and you should exploit it.

I think the reason some people find second difficulty hard is that in this game and in modern games the basic strategy is different. When your health regenerate your goal is to manage your ammo and survive the fight. But in games like Blood your health is your top priority, hence things like life essence.

Finding Medikits makes the Game more realistic, something which is sadly lacking in Games today.

Well, games are meant to be fun, not realistic. You saw what happens to a cultist when you shoot him with a flare? It's not realistic, but it's damn fun. It's more about the way you prioritize resources. In most modern games you'd rather sacrifice some health since it regenerating to conserve ammo for example. In Blood it's different - you should rather sacrifice good ammo to preserve your health.
Actually, second difficulty is not hard at all. Enemies are dumb, ammo is plentiful and gargoyles just can't hit you at all if you're running. Once you're comfortable with controls it becomes much less difficult. Shadow Warrior for example is much more difficult than Blood. Those damn invisible fire-launching ninjas. So, where the hell is Shadow Warrior?
Seriously, where? They have a deal for Duke Nukem 3D, why won't they add Shadow Warrior to catalogue as well?

It's also a real shame that there is no source ports for Blood. Atari is sitting on the source code, it seems. For Shadow Warrior there's an awesome source port, which allows high resolutions and 16x anti-aliasing, so you actually get rid of those pixelated edges.

I agree, we need Shadow warrior on here. If they have Blood, Duke3d and Redneck Rampage on here why cant they have sw?

The normal difficulty can already be overwhelming at times

I dread to think what the hardest difficulty can be like

Well, it's not as bad as Duke Nukem 3D - enemies don't resurrect in Blood. It's just you get ridiculous number of them on hardest difficulty. To the point that it contradicts with game's plot. For example, in the end of first episode you're supposed to fight 1 gray gargoyle, the boss that kidnapped and killed Ofelia - see cutscenes. But on hardest difficulty you get 2 gray gargoyles and a whole pack of small brown ones. No plot reason, 1 gargoyle in cutscene. Still, crouch - and you'll be fine.

pretty much what I was thinking

thanks for the tip

That Gargoyle reappears in later episodes as well.

Of course. Just like spider queen and Cerberus bosses. Heck, they all are back in Cryptic Passage as well. Those other Gargoyles however are irrelevant to plot/cutscenes. I've just illustrated how enemies are ridiculously increased in number on hardest difficulty. I think if somebody is playing Blood for the very first time 2nd difficulty is the best choice.

The manual actually states that the highest difficulty is meant for cooperative play. That's why there are two Gargoyles at the end of Episode 1.

I would hate to see how hard cooperative play is XD

I hear that TNT is messy without coordination. :P