Item: 8 Inch Nails

Spawns a beggar familiar which floats around the room and picks up any nearby coins, leveling up after collecting several coins. At level 2, Bumbo gains a body. At level 3, it begins to fire tears. At level 4, Bumbo chases enemies slowly, dealing contact damage.

Increases damage by 1, range by 5.25, and tear height by 0.5.

Grants a familiar that transforms into another random familiar every 10 seconds.

A demonic familiar that follows Isaac and shoots tears identical to Isaac's in terms of damage, range, fire rate, and effects.

Adds a chance to shoot slowing tears, reducing speed of enemy movement and any projectile fired by them.

Continuously firing tears for several seconds causes Isaac to drop a Butt Bomb. Butt Bombs explode for 50 damage like normal bombs, but also deal 10 damage to all enemies in the room and daze them for a short period of time.

Adds a chance to shoot petrifying tears, which stop enemies in place and prevent them from moving or attacking. Range up.

Increases speed and reduces character size. Also gives a random pill.

Increases damage and speed. Upon entering a room adjacent to a secret room, a howl sound effect will play.

Increases Damage by 1.

Spawns several coins around Isaac.

A familiar that follows Isaac around shooting blood tears.

Automatically negates first taken damage in every room.

Gives Isaac's tears a boomerang effect, and increases range and shot speed.

A white orbiting fly which deals 3 contact damage per tick to enemies. This familiar orbits Isaac at a middle length distance somewhere between Distant Admiration and Forever Alone.

Spawns a familiar that will follow Isaac's movements on a 2.5 second delay. Tears that pass through the baby will be doubled and increase in speed.

Grants Isaac piercing tears that travel through enemies (but not obstacles) instead of breaking on impact with them.

Gives +5 bombs and makes all bombs Butt Bombs that fill the room with gas, damaging and confusing all enemies.

One of two parts necessary to create Mom's Shovel.

Gives Isaac 99 coins. Can be found multiple times in a single playthrough.