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This is another nice medical piece being offered, it is a cased tortoiseshell bloodletting tool. The papier Mache case measures approximately 2 3/4“ and the steel blade is marked “EVANS” with pivoting tortoiseshell blade protector.
This surgeon’s pocket instrument was manufactured by John Evans & Company of London, England and exported to the US. It is the type commonly carried by the surgeon due to its convenient size. One of the more established makers of surgical instruments in England, John Evans & Co. was in business from 1676 through 1874, and these fleams (lancets) could very well have been used by a regimental surgeon during the Mexican and Civil Wars.
There is an exact example in "Pictorial Encyclopedia of Civil War Medical Instruments and Equipment", by Gordon Dammann (see pictures). This medical piece is in genuinely nice condition. There are examples in the National Civil War Museum in Harrisburg, PA and in the Civil War Medical Museum in Frederick, MD (see pictures). It comes in the glass top display case pictured.