In the hospital dream sequence, the black and white photography, like the impressionistic composition, draws Carmilla back in time toward the vampiress possessing her. In The Vampire Film, Silver and Ursini say of the black and white photography (and masque ball): "These events propel the film backwards figuratively into a dark age." That is, to Millarca's age.
Of course, black and white also heightens the dream's surrealism, and heightens its horrors. Bright red blood appears that much starker. Robbed of the warmth of colors, the nurses' mannequin-like movements appear coldly robotic, unnatural, as impersonal and antiseptic as death.
If I seem to spend overmuch time discussing the colors and composition and mise-en-scene, well, this is an art film. Blood and Roses is intended as a visual feast, rather than a suspenseful story. (An aural feast too; its classical soundtrack is passionate and romantic). It is a film meant to be accepted and savored for its sights and sounds and passions, rather than analyzed. In Dark Romance, David J. Hogan writes: "Vadim sacrificed logic and narrative at the altar of imagery.... Blood and Roses is a predominantly visual exodus through some very subtle psychological territory."
Blood and Roses won't convince you of its story if you have trouble suspending disbelief. You'll either accept the film on its own terms, or you won't.
It seems little-known among horror film buffs, yet avid fans of "vampire romances" will likely regard it as one of their favorites — should they ever stumble across it. I'm no fan of "vampire romances," not especially, yet Blood and Roses has long been one of my favorite horror films (say in the top 100).
Yes, Hardy is right. Blood and Roses was "clearly intended as an art-house horror movie." And as such, it's one of the best.
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