pacifist run
I did a full pacifist run after getting a shield scale from Matthew. Eventually you run into snakes that never attack, just poison, and so don't take damage from spikes.
Maybe it's possible to replay until you get lucky and don't encounter snakes? Maybe there's another pacifist-ish way to kill them?
teddy bear sword but its very very very very very very very very very very very very very very very very very inefficient in endless even with 12 duct tapes