Shagreen lancet cases
These lancet cases are Shagreen covered with silver fittings.  These types of cases are some of the older forms of decorative lancets cases.  The piece on the L holds 6 Tortoise shell lancets.  The one on the right contains 4.  When looking to buy these types of items it is important to find items with all of the original covering in place.
Decorative pivot stays on the lancets with London silver marks on the handles.  Research in progress on the makers identification.