“The hierarchy of hell is tremendously important,” a woman remarks casually in the second installment of Lars von Trier's medical burlesque, The Kingdom, “rather like it is here.” The character, a dotty spiritualist named Drusse, is talking about the fictitious Copenhagen hospital that gives this bravura, self-consciously recondite epic its name, but she could just as easily be talking about von Trier's own brain – an enigma every bit as twisted and cryptic as his acclaimed series. Best known here for his award-winning miracle movie, Breaking the Waves, von Trier is the most celebrated filmmaker to emerge from Denmark since Carl Dreyer (1889-1968), a genius whose metaphysical work – his most famous films are The Passion of Joan of Arc, Vampire and the sublime Ordet – has proved a great influence on von Trier.

The Kingdom (Riget in Danish) is a hospital in which the living, when not conspiring against one another, are communing with the dead. A colossal slab of waffled concrete, steel and glass, the building rests uneasily on filled-in marshlands that were once used as bleaching ponds. Apparently, the bleach fumes have lingered long enough to pickle the gray matter of various patients and the self-important personnel, including that of Dr. Stig Helmer (the wonderful Ernst-Hugo Jaregard), a corrosive Swedish surgeon whose operating-room botch-up has left one of his patients, a girl named Mona, a drooling cretin.

Helmer, whose previous misadventures led him to consort with voodoo fanciers in Haiti, has returned to the Kingdom, as too has everyone else from the series, including Helmer's chief nemesis, Krogen, the crafty rake who lives in the hospital basement, and Krogen's girlfriend, Judith, whose mysterious pregnancy has resulted in a monstrous birth: a greasy, putty-colored infant with the head of Udo Kier. The baby, whose high-pitched whine at times sounds suspiciously like Emily Watson's voice in Breaking the Waves, isn't just verbally precocious; he's got a size problem to rival that of Alice in Wonderland: He can't stop growing.

The Kingdom itself is something of a Wonderland, a phantasmagoria in which walls ooze, spirits roam and a demon sprouts horns under a blinking fluorescent light. Just as fantastical, if often ridiculous, are the offenses perpetrated by the doctors, orderlies and patients who wander the hospital. A doctor swoons into a voodoo trance, an intern faints during an autopsy as organs are squishily pulled from a cadaver. Another intern, afraid of being thought dull, races an ambulance against traffic while his co-workers place bets on his survival. One surgeon lovingly nurtures a cancerous tumor, both in his body, then out; yet another scrutinizes his turds like tea leaves, searching for signs of sickness as the camera stares up from the bottom of the bowl. Meanwhile, Drusse and her hulking son Bulder roam the halls searching for salvation and stumble across some Satanists.

On the face of it, we are a long way from Dreyer; von Trier and his ostentatious camera, his technological preoccupations, seem worlds apart from Dreyer's pared-down aesthetic and transcendental sense of space. But as with Dreyer, who made films in which the human was inexorably wedded to the spiritual, von Trier seems preoccupied with forces that exist outside human explanation. In Zentropa, von Trier's technically brilliant, emotionally vacant treatise on post-World War II Europe, it was history that lay beyond human explanation, though really it was the film itself, a muddle about innocence, corruption and desire, that defied understanding. Breaking the Waves is, of course, about a miracle, and as such explainable only on a formalist level. And The Kingdom? It's hard to say. The surest bet would be to note that medicine, like cinema, is a fusion of science and art in which quackery is, at times, the best tonic for what ails us.

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