Although the game's story diverges in several places and features a completely different protagonist, several levels mirror passages from Lovecraft's novella The Shadow over Innsmouth.
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The game is based on the works of H. P. Lovecraft, author of "The Call of Cthulhu" and progenitor of the Cthulhu Mythos, and in particular the game is a reimagining of Lovecraft's 1936 novella The Shadow over Innsmouth.
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A major sub-plot of the game is inspired by Lovecraft's novella The Shadow Out of Time.
The Pnakotic Manuscripts appear in both "The Collect Call of Cathulhu" (an episode from The Real Ghostbusters), and in the computer game Call of Cthulhu: Dark Corners of the Earth as the Pnakotica.
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"The Call of Cthulhu", the original 1928 short story by H. P. Lovecraft
The Agency: This "investigator" faction comprises the Blackwood Detective Agency, law enforcement agencies, and others involved in criminal justice.
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In 2008, InQuest Gamer magazine voted the Call of Cthulhu CCG the number 57 ranking Game of All Time saying that it "broke new ground with domain-based resource mechanics and great integration of the requisite horror and madness themes."
It bases some of its narrative around Lovecraft's novella Herbert West–Reanimator, also containing elements from the Call of Cthulhu role-playing game.
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The cult, headed by a mysterious figure called Docktor Kaul is using the stolen technology of Herbert West (the re-animator) combined with arcane mythos magic to build an undead army from the victims of the Great War as part of a larger plot to eliminate humanity from earth to clear it for a new hybrid species of part human, part Star Spawn of Cthulhu.
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He joins a British Army officer, Captain Hill in tracking down a secret cult while the war rages about them.
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The development of the game was influenced heavily by both Lovecraft's original writings and the Call of Cthulhu RPG.
Examples of games with prolific solitaire lines were Dungeons & Dragons, GURPS, Das Schwarze Auge, DC Heroes, and Call of Cthulhu.
In the Call of Cthulhu role-playing game Vorvadoss is classified as an Elder God.
Due to these ascribed effects and the appearance of the sign on doors and doorways in Lovecraft's original works later uses by other authors, such as in the Call of Cthulhu role playing game, have connected it with doors and their sealing.
While at Chaosium he also created Stormbringer, Worlds of Wonder, Elfquest, and Superworld, and contributed to Thieves' World and Call of Cthulhu.
In the Call of Cthulhu role-playing game system, the raid on Innsmouth by government agents eventually leads to the creation of Delta Green and its mission to combat the Old Ones whenever possible.