From the RuneScape Wiki, the wiki for all things RuneScape
The Blood talisman is an item that allows players to enter the blood altar located beneath Meiyerditch. It can be combined with a tiara to make a blood tiara for 52.5 experience at the blood altar by using the tiara on the altar. This will make the talisman disappear, but the tiara can be used in just the same way and can be worn. Both the tiara and the talisman allow players to use the Runecrafting skill.
The altar is located a long distance from any bank. The only efficient way to craft blood runes would be through the Abyss. The best alternative is to continue past the altar down the tunnel, which leads back to the pub under Canifis. The bank there may be used to run through the shortcut to create a reasonably short run. However, level 65 Agility is required to pass the spiked wall along the path.
The blood talisman, and thus Blood rune crafting, was released on 22 April 2008 as a reward from the Legacy of Seergaze quest. If you lose the talisman it is possible to receive another one from the wall lockers within the Columbarium.
- Before the official release of the Legacy of Seergaze Quest, image of the blood talisman was discovered on the Jagex website before its release via URL manipulation, leading many at the time to believe blood runecrafting would be made available quickly. Jagex responded to the discovery by removing the blood talisman image from the website.
- The Blood Talisman was referenced long before the release by the dwarf Thorgel from the Mournings End Part 2 quest. In the quest you take a list of items to him in exchange for a Death Talisman, but if you ask why he wants the items, if one of them is Jail Key he will say "Pretty please with a Blood Talisman on top?" at which point you exclaim "A Blood Talisman!?" and he replies "Oops! I meant 'Death Talisman'! with a very shifty look on his face.