ible to fully
duplicate the patina of ancient bronze.[44] Seventeenth-century and later
bloodletting instruments usually have not been copied.[45]

From the earliest examples of the fleam, such as the specimen found at
Pompeii, this instrument has been associated with the veterinarian. Since
early practitioners, particularly the Roman physician, performed the
duties of the surgeon as well as those of the veterinarian, it is possible
that they used the same instrument to open blood vessels in humans and
animals.[46]

In the seventeenth and eighteenth centuries a type of fleam (German
_fliete_, French _flamette_), which had a pointed edge at right angles to
the handle, was in use in Germany, Holland, and Vienna, Austria.[47] Since
the specimens found in museums vary in size, it is likely that this type
of fleam was used on both animals and humans.

In about the fifteenth century the thumb lancet, also called a
_gladiolus_, _sagitella_, _lanceola_, _lancetta_, or _olivaris_, was
introduced.[48] It soon became the preferred instrument for opening a vein
in any part of the body. The double-edged iron or steel blade was placed
between two larger covers, usually made of horn or shell, and all three
pieces were united at the base with a riveted screw. The blade could be
placed at various angles of inclination when in use. The shape of the
blade, whether broad or narrow, determined the ease with which the skin
and vein could be penetrated. A long slender blade was essential to pierce
a vein located below many layers of fatty tissue.[49] These tiny and
delicate thumb lancets were often carried in small flat cases of silver,
tortoise shell, shagreen, or leather with hinged tops and separate
compartments for each lancet. (Figure 5.)

A surgeon was advised to carry lancets of various sizes and shapes in
order to be prepared to open veins of differing sizes and in different
locations. Even Hippocrates had cautioned bloodletters not to use the
different size lancets indiscriminately, "for there are certain parts of
the body which have a swift current of blood which it is not easy to
stop."[50] For vessels that bled easily, it was essential to make narrow
openings; otherwise it would be difficult, if not impossible, to stop the
flow of the blood. For other vessels, lancets that made larger openings
were required or the blood would not flow satisfactorily.

The blood as it spurted from the vein would be collected in a container
and