Following the practice established by European powers in the American colonies, U.S. presidents and their agents gave these medals to the chiefs of Native American tribes as tokens of friendship, sometimes accompanied by explanations of newly-established U.S. sovereignty. The best known examples were the medals carried by Lewis and Clark on their 1804-1806 expedition to explore the Louisiana Purchase. Those were made of silver, of various sizes, and the first to be struck as opposed to engraved. Prior to Jefferson's time, the obverse and reverse were separate silver sheets.
For many years, the reverse of an Indian Peace Medal depicted clasped hands and a crossed tomahawk and peace pipe. It also included the phrase Peace and Friendship. The left wrist was covered with the ornamented cuff of a military uniform; the right wrist was bare, except in the case of Jefferson's medal, which covered the wrist with a broad metallic bracelet with the image of an eagle on it. The Jefferson design is also the basis for the reverse design of some 2004 nickels.