The earliest bloodletters probably used sharpened pieces of wood and stone to “breath a vein.” There are many steel lancets with flat ebony or ivory handles that exist today (figure 1). There is some controversy surrounding these items. Firstly, though they are called lancets, they are thought by some to be ink erasers. Indeed, many have the signatures of stationers or cutlers that did not make surgical instruments. Some are unsigned. There are those who think that they were used for both purposes. Some feel that as bloodletting went out of favor in the late 19th and early 20th century the many leftover lancets were sold as “leftover stock” to stationary stores and sold as ink erasers. While I’m not sure of the truth, I feel that the commonly seen ebony-handled steel pointed instruments with clover leaf shaped blades were not used for phlebotomy. I just haven’t seen much evidence for their use in bloodletting
The fleam is perhaps easiest-to-find bloodletting antique. These devices have one or more blades at right angles to the handle. The most common form is a brass case containing 2 or 3 steel blades, often stamped with a makers name (figure 8). The blades were usually of various sizes to offer a selection to the phlebotomist. Many of these fleams were likely used on animals but the ones with small blades no doubt were used at times on humans as well. Imagine the farming family that used their fleam for both purposes! Figure 9 shows several fleams in horn casing. Some of these came with a removable thumb lancet inserted into the horn case.
THE SPRING LANCET
A much more elegant bloodletting method was used for humans. While fleams were sometimes used it was more common to use a spring loaded device in the 18th and 19th centuries. This is when the spring lancet was developed (though its origins go back earlier than this). Figure 13 shows a spring lancet in its simplest form. The case is brass and the blade is steel. The blade was cocked by the hook at end and released with the button on the side. Note the small size of the blade (for human use). Single blade spring lancets came in many sizes and shapes (figures 14-17). Most were brass and steel but some were made of iron or silver. Devices with larger blades were probably for veterinary use. Note the one with the depth adjuster. Figure 18 shows an unusual American hand-forged spring lancet that is signed “P.I.V. 1775.” One wonders if the bleeder was anxious over the politics of the time as he bled his patients, whether human or animal!