The syringe with the injection that being used to make Eldian people titans. Modeled with Fusion360
The origin of Titan injections and their usage is unknown, but it is probable that this was the method of creating new Titan monarchs within the Reiss family since the time of Karl Fritz.
Around 60 years before the fall of Wall Maria, Ymir and her cult of Ymir-worshipers were caught by the Public Security Authorities. They were sent to Paradis Island and were turned into Pure Titans.