Of the many and varied ways of extracting blood from one’s patient, the most common and the simplest was venesection with a thumb lancet or knife.
Sharp steel blades were protected on either side with hinged covers which when the blade was exposed also served as a handle. The covers were usually made from tortoise shell but came in a number of other precious materials.
Jenner used thumb lancets for vaccination. Later vaccination lancets designed for the specific purpose were made with arrow shaped points.
The containers used for thumb lancets were small enough to be carried in the pocket of a physician on his rounds. They varied from simple leather boxes to beautiful finely crafted cases made from silver, gold, sharkskin, tortoise shell, mother of pearl, horn and wood.
They would have been a reflection of the standing of the physician and some of the example used by doctors in high society were “objets de vertu”. If not intended to impress their patients in the first instance, they might at least have made them sympathetic to the ensuing fee.