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Another turn of the wheel and blood began to flow, thick and glossy crimson.

The blood in question belonged to a duck, seared and flambeed until its skin reached a rich golden brown, but rarer than rare within. Relieved of its breasts and legs, the bird was now being crushed inside several pounds of Christofle silver in a contraption that would be decried medieval if it weren’t so elegant.

And so, after a few strained revolutions, a swift flow of claret.

Confronted with this atavistic sight, customers become unpredictable says Otto Tepasse, the London restauranteur and maitre d’ responsible for this meal of canard a la presse.

The time two psychoanalyst guests began drinking blood straight from the saucepan springs to mind.

Arriving in a chauffeur-driven Rolls Royce, this glamorous couple, well into their twilight years, commandeered the press and were soon supping with glee. “It was literally Jungian,” Tepasse recalls, laughing. “I was absolutely flabbergasted. Even I wouldn’t do that.”

He finds a photo of a female customer, bare-chested and, for want of a better euphemism, communing with the contents of the press. “This is what happens when the blood comes out,” he offers as explanation. “It’s quite amazing.”

The height of French haute cuisine certainly has some curious followers. Now I was becoming one of them.

Bird is the word

Bavarian-born but with French cooking in his veins, Tepasse has been crushing animals for the best part of half a century. He estimates he’s prepared canard a la presse, arguably his signature dish, roughly 25,000 times. Curiously, he says he’s never once eaten the whole three-course feast he makes of each bird.

Duck breast at Otto's, the centerpiece of any meal of canard a la presse.

The menu and the setting are traditional, and yet in some ways on-trend. While the culinary world has come back around to the idea of nose-to-tail cooking, Tepasse never left.

First up is the duck’s liver, cooked in the liquor for the blood sauce and spread across brioche – richness incarnate.

The main event, the reason people travel from all over the world to this quiet corner of central London, is thinly sliced breast doused in Otto’s sauce – a reduction of duck stock, cognac, red wine, port, orange peel and sugar – finished off with the blood.

Lastly the leg, express-confited, served with truffle and a mercifully light salad frissee.

Needless to say, it’s all delicious, Tepasse putting his own spin on a recipe codified by his previous employer La Tour d’Argent. A Parisian institution and the spiritual home of canard a la presse, it claims to have served over one million ducks.

Both bastions of table-side service, that restaurant and Otto’s source their birds from the same supplier in Challans, France, bred for their blood content and asphyxiated at eight months old to make sure none of it escapes.

The blood is key to the sauce, argues Tepasse. “It’s like a rocket, it gives it a boost.” To borrow a geopolitical metaphor, “it’s the difference between North Korea and America.”

But this rocket is temperamental, and as unstable as a radioactive isotope. “You really have to respect [the blood],” he explains. “If you don’t know how to use it it will just curdle.”

Canard a la presse, prepared at  the Tour d'Argent in Paris. The restaurant claims to have served over one million ducks.

Few maintain the tradition of pressing animals today. Tepasse is one, Daniel Boulud in New York another; Le Tour D’Argent, of course.

Part of the problem is the rarity of the presses and their prohibitive cost. Tepasse’s duck press dates from 1927; his lobster press is even older and a complete one-off. It’s probably too vulgar a question to ask how much they’re worth.

Another obstacle is the gumption required to front up to guests and cook three courses before their eyes. For the chef, there is nowhere to hide.

“If you can’t do it well, don’t do it,” Tepasse says matter-of-factly.

Why blood matters

“I call it existential,” he says of canard a la presse. “It really goes back to the beginning of time.”

Tepasse is aware that he’s tapping into a foodstuff that connects us all. Blood is truly a common denominator in world cuisine. Vegetables, fruit and herb varieties may be highly localized, but ever since livestock was first reared, we’ve been consuming their blood.

It was the plutocratic Medici family of Renaissance Italy who first brought elegance to blood cuisine in Europe, says the chef, pioneering the use of presses. Today Europeans are more likely to consume it in blood sausages: black pudding in the British Isles, blutwurst in Germany and sanguinaccio in Italy are just a few varieties.

MORE: Inside Europe’s strangest sausages

A world away in China and Southeast Asia, blood from pigs, ducks and yaks is a mainstay in soups and stocks, like Filipino dish dinuguan, or congealed into cubes in Bun Bo Hue from Vietnam. Snake blood is infused into rice wine in the same region, and consumed for its purported aphrodisiac qualities.

Consumers of raw blood, the Maasai of Kenya and Tanzania, and the Bodi tribe of Ethiopia’s Omo Valley, tap the jugular of their cattle, extract a few pints and mix it with milk for a nutrient-packed “shake.”

Like all foods, blood is something to be consumed in moderation. It’s rich in protein and iron, but high doses of the latter can be toxic. Overall, it’s a vastly underutilized foodstuff. Studies have found around only 30% of slaughterhouse blood is used by the food industry. When you factor in that up to 4% of an animal’s total body weight is blood, that’s a lot not being eaten.

So why the low use? There’s a perception issue at hand – perhaps an extension of the aversion many of us have to offal. There are other factors too. Religious stipulations mean that blood is drained from all kosher and halal meat and never consumed.

However, the biggest problem is that blood doesn’t keep well. As supply chains become longer, this becomes an issue. Perhaps as a consequence, in most Western slaughterhouses a larger percentage of blood is turned into blood meal used as animal feed and fertilizer.

Of the portion reserved for human consumption, much is powdered, preserving it but significantly impacting taste and quality. In a world of convenience and increased food miles this doesn’t bode well for blood cuisine’s popularity.

All this makes a dinner with Otto – in which blood is celebrated, not sidelined – all the more special.

For him there’s nothing perverse in indulging in this primeval delight. Prepared correctly, and with a little finesse and theater, blood can become not just sustenance but a culinary experience.