Is it just me or does the medium difficulty of Hurt Me Plenty seem like hard or very hard mode from a game like Doom or Duke 3D? I mean, the enemies seem to do about 30hp per hit and you can get killed in a split second lol. Maybe this game is known for its difficulty and I'm missing something?

This is a very difficult game indeed, running headlong into battle generally won't get you anywhere. Most of the fun comes from learning enemy tactics and finding the appropriate weapon for each situation. (Use the alternative fire mode of explosives for softening the enemies lurking beyond corners, alt-fire of the flare gun for some crowd control etc.). The best part of Blood - for me, at least - is the fact that EVERY weapon has its use, even the pitchfork comes handy many times.

thanks and actually I completely forgot about alt-fire....most games usually don't take advantage of it really, so I'm gonna mess around with that and see how much that helps.

It is quite hard but it gets easier as you progress.
Main problem with starting missions is that they lack a lot of weapons and you often have to save ammo and use more dangerous aproach, while in later levels, you have more weapons so you also have more ammo and can choose the correct one weapon for each situation.
You will also learn some tricks how to handle enemies (like not to charge head on), so yeah, it will get easier.

I'm not one to charge head on in these types of games, but like you said; this game really did get a lot easier after level 1 because of the better weapons and more ammo and now its a ton of fun.

The game is hard, exactly what you would expect from classic FPS. I've bought the game yesterday to refresh my childhood memory and i gotta say i had the same problems as you, especially on the first level ( medium difficulty). At the moment I'm few levels further and its easier - ammo wise, but the fact that you can get killed in instant remains. Nevertheless game is amazing and I'm having awesome time with it despite it's age and i think it shows how great this game is :)

Yes its a tough game indeed. I started a run a few months ago on Extra Crispy uploading it on youtube, but stopped. I'm going to start over in high quality.

Anyhow. Its a lot of work. A lot more than it looks like. On higher difficulty settings, the game pretty much has you planning ahead and using everything you have at your disposal to make it through. Not knowing where a cultist can be enough to be a death sentence. I like it that way, its a real challenge that one can overcome with strategy, foresight and knowledge, more than pure FPS skills (although that comes in handy).

And the first episode... is the hardest. Period. Its just cruel. Cultists can hardly be attacked head on, otherwise you lose. Bullet weapons are innacurate and need you to be close, making a lot of situations trickier. You end up having to use heavy stuff (flare secondary, dynamites) very often because cultists is all those levels seems to have, and all those shotguns and tommy gun can go to waste really quickly when dealing with simple groups of cultists. Oh yeah, you can supress a cultist from long distance with the tommy gun. Just make sure you have a hundred bullets handy. Shotgun is the same -> it can supress them, but actually taking them out needs you to either be really, really close, or to waste 4, 6 shells.

Once you get farther in, the game throws you more weapons that can finely deal with cultists and more dynamites as well, making things quite a bit easier.

Thats not to say there aren't other threats, though. But still. Yeah, its a tough game. Love it for that, and in the end, there's difficulty settings for everyone, which is great.

In the firsts levels the game looks harder, but the fact is that after the firsts levels Blood starts following his build engine nature and becomes a very explosive run and blast everything experience.
So yes, game becomes easier

Blood 1 is very, very hard on the top difficulty, as is Blood 2. It doesn't help that there's more enemies and that they take more damage to die.

This is truly a game from those times when hard mode meant more than just the enemies doing more damage.