This is an Ex-Voto. The VFCA stands for Votum Fecit Gratiam Accepit, which is Latin for a vow made, blessing received. These were purchased in Naples and believed to be Italian from between 1800-1900. They could be silver-plated copper or silver leaf. The ex-votos were offered for a grace received, but also to implore intercession for recovery from an illness or for surgery. The blessed Guiseppe Moscati chapel is an interesting combination of medicine & religion. In the Church of Gesu Nuovo in Naples, there is a chapel dedicated to the doctor Beato Guiseppe Moscati (1880-1927) whose walls are literally covered with ex-votos for the most part, of anatomical subjects. The faithful who turn to him for healing exploits his dual therapeutic power, as a doctor and as a saint. Measures 3 1/8 inches by 3 3/4 inches.