Spirit-Repelling Items

New to Silent Hill 4 are several different items to fight back against the spirits (mostly Ghosts), both inside Room 302 and in the outside world. These enemies cannot ever be killed but usage of these items will help you either suppress them or put them "out of service", while inside your apartment they can exorcise hauntings in the latter half of the game.

Refer to the chart below for an overview and more specifics below.

Spirit Chart Saint Medallion Holy Candle Silver Bullets Sword of Obedience
Availability 3 5 1 2
Usage 4 3 1 2
Power 3 2 5* 5*

1 - Scarce / 2 - Semi-Rare / 3 - Moderate / 4 - Common / 5 - Very Common

1 - Very Low / 2 - Low / 3 - Okay / 4 - High / 5 - Very High

* - Special

Saint Medallion

Wine Bottle

Description: "Can be equipped along with a weapon. Anti-spirit effects while held, but will eventually break."

When equipped, these medallions prevent the harming effect of a Ghost's nearby presence while also dramatically slowing their speed and attacks. You can see the medallion pulsing from your inventory at the bottom of the screen whenever it is working. However it will slowly degrade as it does its job and eventually break and disappear from your inventory. They're not completely necessary but will help an awful lot so go ahead and use them, and if they break, so what.

You'll find a handful of them on your journey so put them to good use. Also note that medallions can be used to exorcise hauntings in your apartment, but they are somewhat wasted that way since there are enough Holy Candles to handle 302 while Saint Medallions are better spent in the outside world to repel Ghosts (and also Wheelchairs).


  1. Water Prison World: At the north of the interior staircase between floors B1 and B2.
  2. Hospital World: On a nightstand in a 2F hospital room.
  3. Subway World 2nd time: Lynch Street Line southwest subway train, B3 (must cross over from southeast train).
  4. Forest World 2nd time: Beside the strange rocks in northeast passage.
  5. Water Prison 2nd time: On a bench in the B1 dining hall.
  6. Building World 2nd time: Beside the boxes in the south rooftop of B12.
  7. Outside Room 302: In a circular cage in room 301's hall, 3F.

Holy Candle

Wine Bottle

Description: "Special candle with anti-spirit effects. Begins working shortly after being lit and placed down."

Holy Candles are primarily meant to be used to exorcise hauntings in your apartment in the latter half of the game. When a haunting is located by your screen flashing, place a candle on the floor or a chair/counter near it to let it burn and take the haunting away with it. One candle will always be enough to exorcise a haunting in full, even with a bit of candle remaining that can no longer be used.

Holy Candles can also be used to repel Ghosts in the outside world within a small radius, and can even take them down on their own (1-2 candles) to be stabbed with a Sword of Obedience. Holy Candles can also be used to temporarily boost Eileen's status by removing her blood flow, but understand that she'll briefly return to her old status. In all my testing any benefit of this never extended over to the final fight.


  1. Hospital World: Behind the vase in a random 2F hospital room.
  2. Subway World 2nd time: On the shelf just before re-entering the first hall of the subway, B1.
  3. Subway World 2nd time: Southeast Lynch Street maintenance room, B3.
  4. Subway World 2nd time: In the northeast Lynch Street subway car, B3 (cross over from northwest car).
  5. Forest World 2nd time: Near the wheelchair doll among the Wish House remains.
  6. Forest World 2nd time: By the west gate in the second part of the northeast passage away from Wish House.
  7. Forest World 2nd time: At the end of the final northeast path.
  8. Water Prison World 2nd time: In the 2 o'clock cell on 3F.
  9. Water Prison World 2nd time: In the 11 o'clock cell on 2F.
  10. Water Prison World 2nd time: In the 10 o'clock cell on 1F.
  11. Building World 2nd time: In the southeast corner through the south elevator doors on B12.
  12. Building World 2nd time: At the top end (B13) of the staircase that leads down to Bar Southfield.
  13. Building World 2nd time: On the floor beside the shelf in Albert's Sporting Goods storage room, B5.
  14. Building World 2nd time: By the water tank near the car on B1.
  15. Outside Room 302: Between bunk beds in the bedroom of room 206, 2F.
  16. Outside Room 302: On the kitchen counter in room 106, 1F.

Silver Bullets

Wine Bottle

Description: "Special bullets effective against ghosts. Small diameter. Best used with 'Pistol.'"

Silver Bullets are an extremely rare type of ammo used in the Pistol to down Ghosts in one hit. The effect is only temporary and they are meant to work in tandem with Swords of Obedience, allowing you to stab one into a Ghost while they're briefly out of commission. Despite each one being called "Silver Bullets", the pack only contains one bullet and there are only two found normally in the game, however a third pack can be obtained via some heavy late-game backtracking that is frankly not worth it.

One Silver Bullet will also kill regular enemies (just as the Revolver does), but it's totally wasted this way. Instead they are best used against the two most annoying Ghosts you'll encounter. You will be required to fight Victim 18 in the Water Prison World, making him an ideal candidate. Otherwise, perhaps Victim 16 in the Subway or Victim 19 in the Building World are most ideal.


  1. Subway World 2nd time: Southeast stairs past the turnstiles, B1.
  2. Forest World 2nd time: By the roots in the tree lot, southeast passage.
  3. Hospital World: Appears in Eileen's 2F hospital room after finding but before using the Keys of Liberation before Outside Room 302 (requires heavy backtracking with Eileen to reach).

Sword of Obedience

Wine Bottle

Description: "Extremely rare sword. When used against downed ghosts, it stops them in place. When pulled out, the ghost is revived."

These special swords are very effective tools for putting Ghosts out of commission for the rest of the game or until pulled out. It is the only tool available that will actually stop and prevent a Ghost from coming after you. To use one, a Ghost must first be downed multiple times by normal weapons before they'll stay down long enough for you to stab one in.

Silver Bullets make this process a lot easier by immediately downing them, but a Holy Candle or two can sometimes do the same trick if you can keep the Ghost around it for long enough.

Approach a downed Ghost and use a Sword of Obedience to stab it in and pin them down, which will be required on one occasion in the Water Prison World 2nd time. There are five available in the game so don't hesitate to use them if certain Ghosts are really bothering you.


  1. Building World: Stabbed into a Ghost in the birthday cake room on B3.
  2. Building World: At the end of the hallway through the northeast elevator doors on B8.
  3. Subway World 2nd time: Beside the exit door right after moving the subway train on the King Street platform, B4.
  4. Water Prison World 2nd time: Under the bed in the 7 o'clock 2F cell.
  5. Outside Room 302: In the bedroom of room 202, 2F.


As you progress through the game you'll find a variety of supplies to keep you going, although health items are on the rarer side in the first half since your apartment restores your health. Be sure to grab and save them for when you need them later in the game, although you'll begin to find a lot more in the second half.

Refer to the charts for a quick overview of supply availability and effectiveness.

Health Chart Nutrition Drink Portable Medical Kit Ampoule
Availability 5 2 1
Health Restored 25% 50% 100%
Ammo Chart Pistol Bullets Revolver Bullets
Availability 4 1
Power 3 4

1 - Scarce / 2 - Semi-Rare / 3 - Moderate / 4 - Common / 5 - Very Common

Health Restored:

1 - Very Low / 2 - Low / 3 - Okay / 4 - High / 5 - Very High

Nutrition Drink

Wine Bottle

Description: "Heals your body with supplemental nutrition."

This small bottle is filled with a nutritious red liquid that refills Henry's health. Although its name has been changed, it is no different than the Health Drink from Silent Hill 1-3 and recharges about a quarter of your health, or less/more based on your difficulty. Save them in the first half and return to Room 302 to fill your health if you can make it back. Use them in the second half to heal small wounds, or turn to the other supplies for bigger wounds.

Portable Medical Kit

Wine Bottle

Description: "Heals your body by repairing wounds."

A medical kit that offers a boost of about half your health (or less/more based on difficulty), known as a First-Aid Kit in previous games. Save them in the first half of the game for when Room 302 no longer charges your health. Otherwise, use them for large wounds or combine them with Nutrition Drinks.


Wine Bottle

Description: "Restores a fairly large amount of health. Continues to restore health for a time."

Ampoules are extremely rare health items that will give you a strong boost of health and then continue to charge your health over a short period (until completely full if staying out of trouble). The only drawback is that there's only two of them found in the game, so save them for when they're most needed and your health is absolutely critical.

Pistol Bullets

Wine Bottle

Description: "Small-diameter bullets for use in the 'Pistol.' Not very powerful."

An ammo pack for the Pistol, loaded with an amount of bullets that depends on your difficulty level. Each box contains 12 bullets on Easy, 10 on Normal and 8 on Hard. Ammo is less available than previous games and each pack takes up an inventory slot, making firearms less practical than before. While ammo conservation was key in the past, it's not really a factor here so use it as you choose. But I do suggest using the Pistol as a secondary weapon when facing multiple enemies. That way you can carry a clip or two without wasting too much space.

Revolver Bullets

Wine Bottle

Description: "Large-diameter bullets for use in 'Richard's Revolver.' Reasonably powerful."

Ammo for Richard's Revolver, which is obtained around halfway through the game. The Revolver is a very powerful weapon that can kill the tougher enemies fairly quickly, so consider saving it for these cases, especially when facing groups. Just like the Pistol though, it's not exactly needed at any point so don't hesitate to use it when you feel it'll help you. Not much ammo is found for it though.