In a turn-of-the-century Tokyo suburb, young doctor Yukio lives in a fine house that he shares with his wife, his parents, and the staff who tend to the living quarters and assist with surgery. Despite being located close to a large slum district where disease is rife and medical help is desperately needed, Yukio works exclusively for more wealthy patients. That he refuses to assist the poor even when begged is something his new wife Rin, whose past he knows little about, is unhappy about and admonishes him for. One night, Yukio's father dies in suspicious circumstances, and a short while later his mother falls victim to a heart attack after a nocturnal visit from the mysterious Sutekichi, a man who bears a striking resemblance to Yukio. It's not long before Sutekichi reappears and imprisons Yukio in a deep well in his own garden and assumes his identity. Rin, at first unaware what has happened, soon finds her past catching up with her.

Tsukamoto Shinya remains Japanese cinema's most boldly creative enfant terrible, a brilliant and twisted visionary whose punk sensibilities, electrifying visual and aural instincts and fascination with body horror places him alongside the likes of the two western Davids, Cronenberg and Lynch. That said, if his early films had a passing resemblance to the works of those directors in theme and tone, the energy and purposeful insanity of their execution put them very much in a class of their own. Almost all indie fans worth their salt have seen his extraordinary low budget debut Tetsuo: The Iron Man, and a good many of those have caught the more commercial (but in many ways equally bonkers) Tetsuo II: Body Hammer. But from then on the UK audience for his films dwindles, in part because the later works are so hard to track down here. Tokyo Fist – a dark, sometimes explosive sado-masochistic drama of failing relationships starring Tsukamoto himself as the film's beaten-down professional victim – did get a limited UK cinema and video release, but has nevertheless found a dismayingly small audience. It did at least fare better than his next film, the kinetic and similarly themed Bullet Ballet, which has yet to appear in the UK in any form.* His latest, A Snake of June, did make it to the UK and was released on DVD by Tartan, but once again failed to reach the viewership it really deserved. If you know Tuskamoto's work only through his first two films, then know that he did not calm down or dilute his style in the least in the works that followed, as the energetically twitchy camerawork, stark black-and-white visuals, pounding industrial score and sometimes frantic editing of Bullet Ballet testify, but he has since developed it in interesting new ways. There is a strong consistency of style to his work, and there are plenty of scenes in A Snake in June that are instantly recogniseable as the work of the man who made Tetsuo.

In many ways Soseiji (also titled Gemini for a foreign audience – both titles appear together on the film itself) stands out in Tsukamoto's filmography and represents a stark shift in style from the work that preceded it. The twitchy, long focus opening shots of rats feeding in wasteland and the thunderous rumble that accompanies it are almost a Tsukamoto calling card, but then we move into less familiar territory: pin-sharp 35mm colour photography, beautifully and sometimes symmetrically composed shots, a carefully stylised use of costume and make-up – this is almost as far from the director's usual aesthetics as you could imagine. But this is style with purpose, with the cool formality of these shots reflecting the studied composure and ritualistic behaviour of the occupants of the doctor's house, as well as the frostiness that exists between Rin and her new in-laws, who clearly regard her as being beneath her son's social standing. When composure slips into uncertainty, this formal style gives way to a more unsteady, hand-held approach, but things really shift gear in moments of crisis or conflict, first evident on the stormy night when the doctor refuses to help a plague-striken slum woman banging on his window, but drops everything to treat a local mayor who has been severely injured as a result of his own drunken tomfoolery. The camera itself suddenly feels charged with the emotion of the scene, animated and fidgety and deliberately refusing to settle on any one thing, as the doctor urgently attends to the mayor while his wife angrily berates him for shunning the slum woman. Later on the style shifts again, as Rin recalls her earlier days with her lover Sutekichi (Yukio's long lost twin), a time filled with joy and excitement given sometimes exuberant presentation, with energy fueled tracking shots and some soaringly uplifting chords from Chu Ishikawa's otherwise mesmerising, chant-driven score.

As the story of brothers separated at birth and re-united by their feelings for the same woman unfolds, a fascinating study of duality and split personalities emerges. What starts as a conflict between rich and poor develops into a more complex study of the extremes of human civilisation, as the ragged Sutekichi adopts the false trappings of so-called respectability and the imprisoned Yukio steadily regresses to a primitive state, eventually driven to scrabbling in the dirt for food like a wild animal. As Sutekichi slowly absorbs the identity of his brother, he also inherits his coldness to those around him, while Yukio learns both humility and raw hatred, and with it the propensity to violence and destruction. All of this reaches a dramatic peak with a physical confrontation between the two men whose aftermath only makes any real sense if read on a metaphorical or perhaps even supernatural level.

Tsukamoto encourages this reading through the film's consistently striking visual sensibilities and its haunting other-worldliness. It takes the project's own publicity to inform us of its locational and historical setting, but nothing in the film roots it in a particular place or time period – Tsukamoto teasingly plays games with costume, make-up and production design to create a world that appears anchored somewhere between an unspecified period in Japan's past and a more modern alternate reality. Shot with a vibrance, brightness and rich colour rarely associated with period dramas, Yukio's house, garden and equipment are rooted in tradition, as are the costumes of his family, while his own white work suit has a more contemporary feel, and the anti-contamination costumes used by the medical staff look almost like they were designed by Carol Spier for a Cronenberg film. The saucer-like hairstyles of the women and Rin's colourful costumes in the flashback sequences are purely design-driven, and in a strangely effective move that has nothing whatsoever to do with historical accuracy, none of the characters have eyebrows.

But it all works beautifully, the sometimes sublime unification of camerawork, editing, music and performance giving the film a unique look and feel, not just within Tsukamoto's own canon but modern Japanese cinema. Contained within are numerous moments of inexplicable perfection: Rin running joyously towards the slum to change clothes after catching sight of what she believes is her lost lover; her temporary relief from despair when passed by a band of roaming musicians, whom she herself is shown performing with (is this a memory, a dream, a flash-forward or just wish-fulfilment?); the furious wrestle between Yukio and Sutekichi for what appears to be their very existence; the moments when the slum itself seems to be generating a force so powerful it affects the stability of the image on screen.

Soseiji is in many ways an atypical Tsukamoto film, having little of the ferocity or extreme body horror and violence of Tetsuo, Body Hammer, Tokyo Fist or even Bullet Ballet. But don't let the initial surface calmness, carefully composed visuals and studied pace fool you, for this is Tsukamoto on magisterial form, and he has created in Soseiji a work that is captivating, beautiful, and yet also haunting and challenging. Rarely seen in the west at present, it seems likely that Soseiji will in future times be looked back on as one of the finest works of one of modern cinema's most exciting, individualistic and visionary talents.

The anamorphic 1.85:1 picture here is lovely, a pristine transfer from a perfect print, with excellent colour rendition, rock solid blacks and no visible compression artefacts. Sharpness is bang on with no signs of obvious edge enhancement. The print here has a sumptuously 'filmic' look that does the visuals proud.

Somewhat surprisingly, the only track included here is Dolby 2.0 surround, though it still shines in its clarity and breadth, and background sounds and music are very effectively distributed across the sound stage. Lower frequencies are reserved largely for the sonic rumbles that accompany the scenes of conflict, and these register well, especially if you are able to redirect them to your sub-woofer.

Two sets of subtitles are on offer, Japanese and English. Both are very clear, with the Japanese encoded on the right-hand side of the screen to be read top to bottom, right to left, as they should be (but often are not, even on Japanese releases). The English translations are, on the whole, very good, and contain virtually no spelling or grammatical peculiarities.

The included extras are in the 'Gallery' section on the main menu (the second option).

First up is Cast/Staff, which consists of brief biographies of key cast members, and more detailed coverage, plus 10 stills each, of the two leads. All text is in Japanese only.

Next up is a Shooting Diary, a reasonably detailed record of progress on the film's production, but being in Japanese only this will mean little to most western viewers.

Stills Collection features ten behind-the-scenes stills and seven examples of press artwork.

Trailers has two theatrical trailers (0:34 and 1:41) and a TV spot (0:15). All three are non-anamorphic 1.85:1.

A Special Features section is subdivided into three sub-sections (the fourth option plays the main feature).

The Making-of Featurette (17:47) is shot on 4:3 digital video and lacks any English subtitles, but still provides a very useful look at Tsukamoto at work and proves genuinely revealing at times, not least for the revelation that a memorable low-angle tracking shot of a housemaid polishing a floor was achieved by dragging the camera operator along the same floor on a blanket. Included are some intriguing sections involving the green screen process work and the large, purpose-built set for the interior of the well. A couple of brief, on-set interviews will need some understanding of Japanese to follow, but much of the rest speaks for itself.

Venice Film Festival (16:56) consists of diary footage of Tsukamoto and the film's stars at the 56th Venice Film Festival, at which the film was screened. It includes footage of the press conference and interviews conducted outside of the festival building, all of which are in Japanese with no subtitles, and the screening itself and its aftermath.

Make-up featurette (6:02) details the process of "removing" the eyebrows from the actors, set to music from the film with textual details provided in Japanese. Details of the exact products used and the step-by-step guide given give it the feel of an instructional video. The second half consists of an interview with make-up artist Isao Tsuge, intercut with on-set footage.

Soseiji is a beautifully realised and gripping study of duality and the very definitions of 'civilised' behaviour, and is one of the finest films yet by one of modern Japanese cinema's most talented and exciting directors, but one whose work too often goes unseen in the west. This Japanese disc is becoming increasingly hard to track down, as are similar editions from Korea and Holland, but believe me, the effort is worth it. Although five years old now, the film remains criminally unavailable in the UK, denying devotees of modern Japanese cinema access to one of its most arresting works. So hunt out the DVD, watch out for a late night screening on one of the satellite channels, or better still hassle Warner Brothers – the very international company responsible for this Japanese release – to put out a UK version.** But whatever you do, find a way to see it. As for me, I'm cueing the disk up for my eleventh viewing as soon as I finish this.

* The film has since been released on UK DVD by Arts Magic and on Blu-ray by Third Window Films.

** It has since been released on Blu-ray in the UK, again by Third Window Films