[Illustration: FIGURE 30.--Flint lancets used by native doctors in Alaska, 1880s. (Anthropology Catalog 127758; SI photo 73-4208).] [Illustration: FIGURE 31.--Instruments and technique of phlebotomy: Fig. 1 shows an arm about to be bled. A ligature has been applied to make the veins swell. The common veins bled--cephalic, basilic, and median--are illustrated. Fig. 2 shows several types of incisions. Fig. 3 is a fleam, Fig. 4 a spring lancet, and Fig. 5 a "French lancet." (From Laurence Heister, _A General System of Surgery_, London, 1759. Photo courtesy of NLM.)] [Illustration: FIGURE 32.--Replica of a barber-surgeon's signboard dated 1623. Top left corner shows a phlebotomy being performed. (NMHT 215690 [M-7343]; SI photo 44681.)] [Illustration: FIGURE 33.--Instruments for bleeding from the arm, 1708: A, a serviette to cover the patient's clothing; B, a cloth ligature to place around the arm; C, a lancet case; D, a lancet; E and F, candles to give light for the operation; G, a baton or staff for the patient to hold; H, I, and K, basins for collecting blood; L and M, compresses; N, a bandage to be placed over the compress; P, _eau de la Reine d'Hongrie_ that can be used instead of vinegar to revive the patient if he faints; Q, a glass of urine and water for the patient to drink when he revives; R, S, T, implements for washing the hands and the lancets after the operation. (From Pierre Dionis, _Cours d'operations de chirurgie demontrees au Jardin Royal_, Paris, 1708. Photo courtesy of NLM.)] [Illustration: FIGURE 34.--Two 18th century trade cards advertising lancets. (Photo courtesy of Wellcome Institute, London.)] [Illustration: FIGURE 35.--Lithograph, London, 1804, showing a phlebotomy. (On loan from Armed Forces Institute of Pathology; SI photo 42579.)] [Illustration: FIGURE 36.--18th-century cutler's illustrations for making lancets. Note the variations in the shape of the lancet blades. (From Jean Jacques Perret, _L'Art du Coutelier_, Paris, 1772. Photo courtesy of NLM.)] [Illustration: FIGURE 37.--Thumb lancet, 16th century. (From Leonardo Botallo, _De Curatione per Sanguinis Missionem_, Antwerp, 1583. Photo courtesy of NLM.)] [Illustration: FIGURE 38.--Typical 19th-century thumb lancets, engraved "S. Maw, London." (NMHT 139980 [M-4151]; SI photo 73-4230.)] [Illustration: FIGURE 39.--Typical 19th-century brass spring lancet and case. The case is stamped "Traunichtessticht," which translates, "Watch out, it stabs." (NMHT 308730.10; SI photo 74-4088.)] [Illustration: FIGURE 40.--Spring lancets, dated 1775. (Held by Rhode Island Medical Society; SI photo 73-5762.)] [Illustration: FIGURE 41.--Fleam, 16th century. (From Leonardo Botallo, _De Curatione per Sanguinis Missionem_, Antwerp, 1583. Photo courtesy of NLM.)] [Illustration: FIGURE 42.--Hand-forged fleam with hand-carved wooden case, 17th and 18th century, Swiss or Tyrolean. (NMHT 233570 [M-9666]; SI photo 59139-E.)]