A Dissertation upon the Cancer of the Eye-Lids, Nose, Great Angle of the Eye, and Its Neighbouring Parts, Commonly Called the Noli-Me-Tangere, Deemed Hitherto Incureable by Both Antients and Moderns, but Now Shewn to be as Curable as Other Distempers. Addressed to the Royal Society of London by Mons. Daviel, Consulting Surgeon in Ordinary, and Oculist to the King; Master of Arts, and of Surgery at Marseilles; Royal Professor and Demonstrator of Anatomy of the Same City; Member of the Academy of Sciences of Toulose, Bologne, and That of Surgery of Paris; And Translated from the French by James Parsons, M. D. and F. R. S.

children, joined together by the bellies, in No 489. page 527. of the Philosophical Transactions, where, in my remarks upon them, I have attempted explaining the phenomena of all these preternatural appearances in animal bodies, as well as in those of vegetables. XXX. A Dissertation upon the Cancer of the Eye-lids, Nose, great Angle of the Eye, and its neighbouring Parts, commonly called the Noli-me-tangere, deemed hitherto incurable by both Antients and Moderns, but now shewn to be as curable as other Distempers. Addressed to the Royal Society of London by Mons. Daviel, consulting Surgeon in ordinary, and Oculist to the King; Master of Arts, and of Surgery at Marseilles; Royal Professor and Demonstrator of Anatomy of the same City; Member of the Academy of Sciences of Toulosoe, Bologne, and that of Surgery of Paris; and translated from the French by James Parsons, M.D. and F.R.S. Paris, April 20, 1754. Of all the diseases which seize the eye-lids, nose, angle of the eye, and its neighbouring parts, none appears so formidable as as the cancer, in the opinion even of the most able oculists, who have written upon this subject, such as Antoine Maitre Jean, St. Yves, and others. They have constantly declared it to be incurable in these parts, and have even forbidden meddling with it: Antoine Maitre Jean says, "The operation is so doubtful, that it is rejected by the best practitioners, not only for cancers of the lids, but also for all those of the face, &c." And St. Yves is of the same sentiment, where he says, "That when the edges of the ulcer are accompanied with callousness, there is nothing to be done but by palliatives." The patients would have reason to complain, if we were willing to have regard to what these authors have advanced, as well as others, upon the same subject, who were of the same opinion. The most able oculists have indeed met so many difficulties in this case, that they entered into an opinion, that they were impossible to be cured; and therefore never dared to undertake them. Some are content to treat them with palliatives, such as frog-spawn-water, and other such ingredients, as serve only to amuse the patient; whilst others, more bold, touch them with liquid caustics, or the lapis infernalis, from which they have had no better success than from the application of the water; because the best managed caustics only serve to irritate these kinds of tumors, as experience has too often shewed. But why therefore should these parts be incurable? Is it that they differ from the other parts of the human body? Certainly no. Why should these therefore be thought more desperate than the breasts, lips, and many other parts, which often yield to the knife, when directed by a skilful hand: I will venture to say, it is indolence, little or no experience, and an ill-grounded fear, in oculists, both ancient and modern, that made them believe these kinds of diseases ought to be treated differently from all others. A bad prejudice! which yet seduces a great part of our most able practitioners: but it must be averred, that they are deceived, if, in order to put it upon the footing of an ill-grounded fear, we must say, it has often hindered them from helping a number of patients, who have perished in a miserable manner, by not properly attempting their cure. I am willing to free myself from so hard a law; I reprimand both antients and moderns, and the opportunities I have had of operating upon cancers of the lids and face, easily shew'd me, that they were very curable, and that the cure ought not to be given up to an uncertain issue. The examinations I made in these kinds of tumors have informed me, that cancers of the lids, nose, and adjacent parts, have all their seat in the Periosteum, and Perichondrium; and that we cannot hope for a thorough cure, without taking them entirely off: in a word, the vessels that go from the cancerous tumor are strongly connected with the Periosteum and Perichondrium, that they seem but one body, which becomes at length so greatly swelled, that the very bone is often affected. When a wen or wart (which is often the beginning of a cancer), begins to appear, and they endeavour to pull them off, they become irritated, and spread to that degree, that the edges are reversed, and become callous and livid, accompanied with a pain, pain, and every other symptom which characterise the cancer. These kinds of wens, warts, and tubercles, which are situated in the great angle of the eye, upon the lids, or the nose, very often shoot out their roots upon the cartilages, that is, upon the very membranes which cover them, and the roots sink in sometimes to the substance of the cartilage itself, which they swell and tear in the end. The more cancers are touched with caustics, the more they are irritated; therefore there is but one method, but it is a sure one, of curing them, and hindering their progress; which is, to take them off with a cutting instrument, destroying the Periosteum and Perichondrium, or even the lids, if the cancer has penetrated them in their substance, with their cartilages: which the following observations will prove. Observation I. upon a cancerous upper-lid. August the 11th, 1736, I was called to Madam de la Fague, an Urseline Nun, at Bourdeaux, forty-five years old; to see a tumor upon the upper-lid of the right eye, which she had for twenty years: it begun by a small wen, and increased by degrees, so as very much to incommode the patient. She applied to a surgeon, who began by applying some drops of a liquid caustic, which enraged the tumor still more; which he appeased again by analgesic medicines; and then the tumor remain'd a long time without any sensible increase; although the patient felt a continual sharp pain in it. But, as even the least disorders are impatiently borne, she was willing to be relieved, and consulted another surgeon, who took off the tumor with a cutting instru- instrument, and who, seeing that the ulcer, which was the result of the operation, did not heal; but on the contrary made great progress in its erosion, and became callous, he touched it with lapis infernalis; and sometimes with a liquid caustic: which so much the more increased the evil, and made her resolve to suffer no more applications, because, all that had been tried, made her worse and worse. She was now a long time in this state, when I was called to consult with Messieurs Doussan, Caudole, and Senis, physicians of note in the same town, and with Monsieur Costade, surgeon major of the hospital; who, having examined the case, agreed with me, that there was no other method to be taken but the operation, not only to save the eye, but to prevent an incurable cancer, which threatened her life; whilst it had already made great progress under the eye-lid; and it was much to be feared that it would spread into the very eye, and even over the whole face. Then the operation would be fruitless, and the patient would suffer the loss of the use of that eye, and perhaps of her life. Wherefore I did not hesitate to propose the total extirpation of the lid: my proposal was approved of by all, as the only method of saving the eye; and the operation was as follows: I passed a crooked needle, with a wax'd thread, under the lid, by which I suspended and drew up the lid and tumor, which I cut off with my crook'd scissors, as much as I could under the orbit, separating the whole to the division of the lids; a small hemorrhage ensued, but was soon stopped with dry lint, and a dry compress and bandage. She remained twenty-four hours without being dressed; was bled twice in the arm, after the operation: I then dressed her up with light dossils, arm'd with the linimentum Arcæi, and she had not the least accident from the day of the operation to the 25th of the same month, when she was perfectly cured, without any deformity in her eye: and although the lid was cut away very high, the eye remained very neat and well, performing its several functions properly when I left Bourdeaux; and the 13th of August 1742, having had an opportunity of taking a journey to that town, I saw the patient again, whom I found extremely well, seeing perfectly with that eye: but what I found very singular was, that the skin of the lid descended pretty low, to the cornea, which it almost covered; so that the whole globe was in a manner hid. We only observed, that this resembled a lid without hairs. Observation II. upon another cancerous tumor in the great angle of the eye. July 2, 1736. Margaret Combaucaut, of Carcassone in Languedoc, sixty years old, had a cancerous tumor, for sixteen years, in the great angle of the right eye: it began by a little wart, which itched violently, and made her scratch it very often, which so irritated the tumor, that in a little time it became as large as a dried fig flatted, with its edges turn'd outward and callous. It reached from the commissure of the lower lid, an inch and half below it, even to the right ala of the nose, which proved extremely troublesome to the woman. I found, after a strict examination, that it adhered to the bone. She said she tried all the remedies that she imagined would do her any good; but that, far from relieving her, they rather made her worse, and her disease became the more insupportable; and that she had taken a resolution to undergo anything to be freed from a disorder which had afflicted her for sixteen years. Having consulted Mr. Fabre, an able physician of that place, we were both of opinion, that she could not be cured without an operation, which I accordingly proceeded to as follows: I took off the tumor entirely to the periosteum, but did not lay the bone bare; for I thought it sufficient for a complete cure to take away all the callosities; but I was mistaken; for, instead of the prospect of a succeeding cure, I was unhappy enough to see the swelling increase, and the wound seem larger than before. I used in vain all the remedies commonly thought of in such cases; I scarified the edges of the ulcer, to bring it to suppuration; but it became thereby more hard and callous than before the operation, and much more painful. Upon which I resolved to cut away all that remained of the tumor, with the periosteum, which appeared very much swelled. This second operation had so much success, that the swelling, and every other bad symptom, disappeared almost suddenly; and in three days the wound looked red and very well, without any pain, and the cicatrix was perfectly form'd on the 15th day from the operation, without any sensible exfoliation of the bone, or the least deformity or staring of the eye. She has remained very well ever since; for I saw her the 10th of August 1741, at Carcastone, in perfect health; and the cicatrix of the part very even. I must I must observe here, that I laid the entire bone bare, wherever the tumor touched, even down to the ala of the nose of that side. Observation the 3d, is upon a cancerous tumor of the same nature, and in the same situation, and the treatment just the same: it was as big as a filbert, and the officer was afflicted with it twenty years. It differs from the former only in this, that the year before the officer came to Marseilles, to put himself under Monsieur Daviel's cure, the tumor broke, and discharged a very fetid acrimonious matter, which, running into the eye, brought on a troublesome opthalmia, and the edges were livid, and had a very terrible aspect. As to his operation, it consisted, as before, of a total extirpation of the cancer, periosteum and all, to the bare bone. He dressed the bone with dry lint only, and his digestive was a mixture of the linimentum Arcæi, with the unguentum styracis: and in about nineteen days he was so perfectly cured, that when he returned to his friends, several of them asked him, upon which eye the operation had been made? Observation 4, differs in nothing from the former. Observation 5, upon a cancerous tumor upon the nose, which reached from the root of the nose down to the middle of the cartilage. He treated it in the same manner, taking off the whole with the periosteum; and, as it was partly upon the cartilage, he also cut away the perichondrium, laying that, as well as the bone, bare: and the cure was completed, without leaving any deformity behind, in eighteen days. Observation 6, of a cancerous tumor upon the great angle of the right eye of a woman at Marseilles, of seventy years old. This he treated exactly in the same manner, and she was cured in twenty days. The 7th Observation mentions another cancerous tumor upon the nose, and its cartilage, of a gentleman, which is circumstantially the same with the former: it was cured in five days. After this case he makes this conclusion: that from all that has been already said, it is plain, that the seat of the cancers of the eye-lids, nose, and other neighbouring parts, is absolutely in the periosteum and perichondrium, as well as the fat; and that there can be no hopes of a cure without taking off these membranes, the fat, and even any parts of the very cartilages that may be contaminated: but that in this manner they are as curable as cancers upon other parts of the body, notwithstanding what all oculists have said to the contrary. The 8th Observation is upon a cancer upon the lower eye-lid of a woman, cured in the same manner. The 9th Observation treats of a cancer, as big as a large filbert, in the angle, and upon the lower lid of the eye, of a gentleman; which began by a small tubercle in the angle, and was pulled off, and grew again several times. Monsieur Daviel was consulted, in the presence of another surgeon, Monsieur Maillot, and declared for taking the tumor and eye-lid entirely off; making this prognostic, that if any part was left behind, the eye would be deformed and staring; but the other surgeon thought, that half the lid with the tumor would be sufficient for the cure: Monsr. Daviel therefore only cut away half the lid with the tumor; with which he also took off a large quantity of hard white fat, and dressed up the part as usual; but in the progress the lid was turned outward, and then they resolved upon the total extirpation of the lid; which, being obliged to depart from thence, he left to Monsr. Maillot, who performed it with such success, that his cure was complete in fifteen days, without the least deformity whatever. The 10th Observation is a case of the same nature with the former, with this difference, that when he had taken off the tumor and under lid in the same manner as usual; the patient continued growing well till the ninth day from the operation; when Monsr. Daviel perceived a small fungus in the middle of the tumor, which he touched with the lapis infernalis, which produced very ill effects: the eye grew painful, the conjunctive swelled very much, the wound, which was half healed up, opened afresh, and grew ragged. This made him set about cutting away all the bad flesh he could perceive, with the inequalities of the conjunctive, which was much swelled: he scarified the cornea, and the inner surface of the upper lid, which was also greatly tumefied, and even opened it on the upper surface. Thus, after having emptied the vessels well, he fomented the whole with a decoction of marshmallows, mullein, violet-leaves, camomile-flowers, melilot, leaves and flowers of rosemary, thyme, lavender, rue, and marjoram, of each half a handful, in a sufficient quantity of water; to a quart of which he put a bit of camphire as big as a nut. The frequent applica- tion of this that day produced so good an effect, that all her pain ceased: he also bled her in the arm and foot, ordering emollient clysters. She was purged some days after, with manna and cassia, which did very well; and she was perfectly cured, without the least deformity, and could see better than before the operation. XXXI. An Account of four Roman Inscriptions, cut upon three large Stones, found in a ploughed field near Wroxeter in Shropshire, in the year 1752: With some Observations upon them, by John Ward, LL.D. Rhet. Prof. Gresh. and V.P.R.S. Read May 15, 1755. Before I attempted to offer my thoughts upon these inscriptions, I judged it necessary to get the best information in my power, with regard to the place and manner, in which the stones, that contained them, were first discovered, together with some other circumstances, which attended them at that time. For this purpose I applied myself to the Reverend Mr. William Adams, Minister of St. Chad in Shrewsbury, by whose means the draughts of these inscriptions were communicated to this Society (1). And that gentleman was so obliging, as to procure for me a very particular account concerning them, in a letter from the Reverend Mr. Robert Cartwright, Vicar of Wroxeter, the substance of which is as follows. The stones (1) See Tab. V.