Think Forward.

GERIATRIE : COMMENT PRÉVENIR LES ESCARRES CHEZ LES PERSONNES ÂGÉES ? 1407

DES ESCARRES MAL SOIGNEES PEUVENT PRECIPITER LA PERSONNE ÂGEE DANS LA DEPRESSION ET MÊME LA MORT L’escarre est une plaie ouverte, qui se forme à l’endroit où la chair est prise en étau entre l’os et le support (matelas, fauteuil) pendant plusieurs heures chez une personne obligée de garder le lit ou ayant perdue son autonomie. Sa fréquence n’est pas toujours bien appréciée mais on peut estimer néanmoins qu’au moins une personne âgée sur deux en sera touchée plus ou moins gravement. Outre les souffrances physiques, elle est en effet dévalorisante. Elle provoque souvent la survenue ou l’accentuation d’un phénomène dépressif. QU'EST CE EXACTEMENT QU'UNE ESCARRE Quand une personne alitée repose plusieurs heures sur les mêmes points d’appui, la chair est alors compressée à ces endroits, freinant ainsi la bonne circulation du sang et l’oxygénation du sang. Une fois en état d’hypoxie (terme médical pour désigner un manque d’apport en oxygène au niveau des tissus de l’organisme), les tissus vont se dégrader très vite. Le passage du stade d’érythème (rougeur cutanée) à celui d’ulcère (plaie ouverte) peut prendre seulement quelques heures. Selon la classification la plus utilisée, le processus se décline en plusieurs phases de développement : - stade 0, rougeur apparaissant mais disparaissant quand on appuie dessus ; - stade 1, rougeur ne blanchissant pas sous la pression du doigt ; - stade 2, désépidermisation : arrachement cutané touchant l’épiderme et éventuellement le derme, dont une variante au niveau du pied est la phlyctène (ou ampoule) hémorragique ou séreuse, selon qu’elle contient ou non du sang ; - stade 3, nécrose : plaie profonde avec plaque de nécrose recouvrant en général des tissus sous-jacents dévitalisés ; - stade 4, ulcère : plaie ouverte profonde, résultant le plus souvent d’une escarre de stade 3 après élimination des tissus nécrotiques ; les muscles sont touchés, au point que l’on peut voir tendons et articulations à nu. Une autre classification utilisée repose sur une cartographie des couleurs et un raisonnement en termes de pourcentage des couleurs QUELS ENDROIT DU CORPS DOIVENT ÊTRE SURVEILLES ? 40 % des escarres siègent au sacrum (le sacrum, au bas du dos, est formé de la soudure des 5 vertèbres sacrées) et 40% aux talons. Les autres localisations les plus fréquentes sont les ischions (l’ischion est l‘ un des trois os qui sont soudés chez l’adulte pour former le bassin : il supporte le poids du corps en position assise) et le trochanter (les protubérances de la partie supérieure du fémur) ainsi que, par ailleurs, l’occiput en pédiatrie. Pour le malade en fauteuil, roulant ou non, on surveillera : la nuque, les omoplates, les fesses et les talons. Pour le malade couché sur le côté, on surveillera : les trochanters, la face interne des genoux et les faces internes/externes des pieds. Pour le malade sur le dos, on surveillera : l’occiput, la nuque, les omoplates, les coudes, les crêtes iliaques, le sacrum, les fesses, la face interne des genoux et les talons. QUELS SONT LES FACTEURS DE RISQUES ? Ils sont multiples. Quelqu’un qui ne gère pas bien son capital santé, ne se nourrit pas et/ou ne s’hydrate pas correctement présente plus de risque. L’escarre guette également, tout particulièrement les sujets atteints : - de troubles de la conscience et de neuropathie ; - d’artérite, de problèmes vasculaires, d’hypertension ou d’insuffisance cardiaque ; - des conséquences physiques de maladies auto-immunes (polyarthrite rhumatoïde, lupus, scléroses en plaques…) - d’anémie et, de façon générale, de tout problème nécessitant une hospitalisation. QUELS GESTES PRÉVENTIFS ? - Observation régulière de l’état cutané à chaque changement de position et lors des soins d’hygiène. Une rougeur qui subsiste à la pression d’une palpation doit immédiatement alerter. - Corps étrangers : les sondes urinaires ou les lunettes à oxygène sont à surveiller car sources d’escarres. - Nutrition : l’entourage (famille, personnel soignant) doit surveiller l’appétit de la personne âgée, une perte de poids rapide favorisant en effet l’escarre. Au besoin, il faut enrichir ses plats et veiller à ce qu’il reçoive, notamment, une ration protéinique identique à une personne plus jeune et active car la personne âgée synthétise moins bien les protéines et va avoir besoin d’en consommer plus en cas d’escarre. Il faut également veiller à une bonne hydratation, variée si possible (eau, tisanes, jus de fruits…). La capacité à se nourrir correctement est centrale dans le processus de cicatrisation. - Sensibilité : la sensibilité cutanée de la personne est diminuée si on s’aperçoit qu’elle ne change pas de position spontanément en l’espace d’une demi-heure. Il faut alors planifier des changements de position environ toutes les 2 heures pour solliciter d’autres points d’appui. - Hygiène : Il est important de maintenir la personne au sec en évitant les risques de macération QUELS SONT LES PREMIERS SOINS ? – Nettoyage de la plaie et de son pourtour : employer l’eau et le savon ou du sérum physiologique. L’intérêt des antiseptiques ou des antibiotiques n’est pas démontré en l’absence d’infection. La plaie ne doit pas être asséchée mais, après les soins, on peut tamponner légèrement avec une serviette douce. – Traitement de l’escarre constituée : La détersion est nécessaire sur les plaies nécrotiques et/ou fibrineuses, soit mécaniquement soit à l’aide de pansements. Les matières mortes et le sang issu des capillaires sanguins endommagés produisent en effet une masse au fond de la plaie. Cette masse, souvent dure et sèche, s’oppose au processus de reconstruction cellulaire et donc à la cicatrisation. La colonisation bactérienne est, par ailleurs, constante dans les plaies chroniques : différente de l’infection, elle est utile à la cicatrisation et doit être simplement contrôlée par un nettoyage et une détersion soigneuses des tissus morts. QUELS SONT LES GESTES A PROSCRIRE – Pas d’utilisation de produits agressifs (éosine, alcool, antiseptique), de glace sur la plaie, de chaleur (sèche-cheveux par exemple) pour sécher la plaie. Ces gestes détruisent la flore cutanée alors qu’elle est une barrière aux infections. – Pas d’utilisation d’huile essentielle. – Pas de massage des rougeurs – Pas de gestes brusques pour lever le malade ou lui tirer les draps, sous peine de provoquer des coupures de la peau. Dr MOUSSAYER KHADIJA Spécialiste en Gériatrie EN SAVOIR PLUS 1/Liens utiles : - Société Française et Francophone des Plaies et Cicatrisations, rubrique Escarres http://www.sffpc.org/index.php?pg=connaiss&rubrique=escarre - Conférence de consensus publiée par la Haute Autorité de Santé http://www.has-sante.fr/portail/jcms/c_271996/prevention-et-traitement-des-escarres-de-ladulte-et-du-sujet-age - Claire Dubois, Prévenir et soigner les escarres : nouvelles recommandations, 2013 http://www.actusoins.com/13601/prevenir-et-soigner-les-escarres-nouvelles-recommandations.html
Dr Moussayer khadija

Dr Moussayer khadija

Dr MOUSSAYER KHADIJA الدكتورة خديجة موسيار Spécialiste en médecine interne et en Gériatrie en libéral à Casablanca. Présidente de l’Alliance Maladies Rares Maroc (AMRM) et de l’association marocaine des maladies auto-immunes et systémiques (AMMAIS), Vice-présidente du Groupe de l’Auto-Immunité Marocain (GEAIM)


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THE WAR OF THE WORLDS - BOOK ONE THE COMING OF THE MARTIANS - I. THE EVE OF THE WAR. [1/2] 1718

No one would have believed in the last years of the nineteenth century that this world was being watched keenly and closely by intelligences greater than man’s and yet as mortal as his own; that as men busied themselves about their various concerns they were scrutinised and studied, perhaps almost as narrowly as a man with a microscope might scrutinise the transient creatures that swarm and multiply in a drop of water. With infinite complacency men went to and fro over this globe about their little affairs, serene in their assurance of their empire over matter. It is possible that the infusoria under the microscope do the same. No one gave a thought to the older worlds of space as sources of human danger, or thought of them only to dismiss the idea of life upon them as impossible or improbable. It is curious to recall some of the mental habits of those departed days. At most terrestrial men fancied there might be other men upon Mars, perhaps inferior to themselves and ready to welcome a missionary enterprise. Yet across the gulf of space, minds that are to our minds as ours are to those of the beasts that perish, intellects vast and cool and unsympathetic, regarded this earth with envious eyes, and slowly and surely drew their plans against us. And early in the twentieth century came the great disillusionment. The planet Mars, I scarcely need remind the reader, revolves about the sun at a mean distance of 140,000,000 miles, and the light and heat it receives from the sun is barely half of that received by this world. It must be, if the nebular hypothesis has any truth, older than our world; and long before this earth ceased to be molten, life upon its surface must have begun its course. The fact that it is scarcely one seventh of the volume of the earth must have accelerated its cooling to the temperature at which life could begin. It has air and water and all that is necessary for the support of animated existence. Yet so vain is man, and so blinded by his vanity, that no writer, up to the very end of the nineteenth century, expressed any idea that intelligent life might have developed there far, or indeed at all, beyond its earthly level. Nor was it generally understood that since Mars is older than our earth, with scarcely a quarter of the superficial area and remoter from the sun, it necessarily follows that it is not only more distant from time’s beginning but nearer its end. The secular cooling that must someday overtake our planet has already gone far indeed with our neighbour. Its physical condition is still largely a mystery, but we know now that even in its equatorial region the midday temperature barely approaches that of our coldest winter. Its air is much more attenuated than ours, its oceans have shrunk until they cover but a third of its surface, and as its slow seasons change huge snowcaps gather and melt about either pole and periodically inundate its temperate zones. That last stage of exhaustion, which to us is still incredibly remote, has become a present-day problem for the inhabitants of Mars. The immediate pressure of necessity has brightened their intellects, enlarged their powers, and hardened their hearts. And looking across space with instruments, and intelligences such as we have scarcely dreamed of, they see, at its nearest distance only 35,000,000 of miles sunward of them, a morning star of hope, our own warmer planet, green with vegetation and grey with water, with a cloudy atmosphere eloquent of fertility, with glimpses through its drifting cloud wisps of broad stretches of populous country and narrow, navy-crowded seas. And we men, the creatures who inhabit this earth, must be to them at least as alien and lowly as are the monkeys and lemurs to us. The intellectual side of man already admits that life is an incessant struggle for existence, and it would seem that this too is the belief of the minds upon Mars. Their world is far gone in its cooling and this world is still crowded with life, but crowded only with what they regard as inferior animals. To carry warfare sunward is, indeed, their only escape from the destruction that, generation after generation, creeps upon them. And before we judge of them too harshly we must remember what ruthless and utter destruction our own species has wrought, not only upon animals, such as the vanished bison and the dodo, but upon its inferior races. The Tasmanians, in spite of their human likeness, were entirely swept out of existence in a war of extermination waged by European immigrants, in the space of fifty years. Are we such apostles of mercy as to complain if the Martians warred in the same spirit? The Martians seem to have calculated their descent with amazing subtlety—their mathematical learning is evidently far in excess of ours—and to have carried out their preparations with a well-nigh perfect unanimity. Had our instruments permitted it, we might have seen the gathering trouble far back in the nineteenth century. Men like Schiaparelli watched the red planet—it is odd, by-the-bye, that for countless centuries Mars has been the star of war—but failed to interpret the fluctuating appearances of the markings they mapped so well. All that time the Martians must have been getting ready. During the opposition of 1894 a great light was seen on the illuminated part of the disk, first at the Lick Observatory, then by Perrotin of Nice, and then by other observers. English readers heard of it first in the issue of Nature dated August 2. I am inclined to think that this blaze may have been the casting of the huge gun, in the vast pit sunk into their planet, from which their shots were fired at us. Peculiar markings, as yet unexplained, were seen near the site of that outbreak during the next two oppositions. The storm burst upon us six years ago now. As Mars approached opposition, Lavelle of Java set the wires of the astronomical exchange palpitating with the amazing intelligence of a huge outbreak of incandescent gas upon the planet. It had occurred towards midnight of the twelfth; and the spectroscope, to which he had at once resorted, indicated a mass of flaming gas, chiefly hydrogen, moving with an enormous velocity towards this earth. This jet of fire had become invisible about a quarter past twelve. He compared it to a colossal puff of flame suddenly and violently squirted out of the planet, “as flaming gases rushed out of a gun.” A singularly appropriate phrase it proved. Yet the next day there was nothing of this in the papers except a little note in the Daily Telegraph, and the world went in ignorance of one of the gravest dangers that ever threatened the human race. I might not have heard of the eruption at all had I not met Ogilvy, the well-known astronomer, at Ottershaw. He was immensely excited at the news, and in the excess of his feelings invited me up to take a turn with him that night in a scrutiny of the red planet.

GRIMMS’ FAIRY TALES - THE GOLDEN BIRD [1/2] 1599

A certain king had a beautiful garden, and in the garden stood a tree which bore golden apples. These apples were always counted, and about the time when they began to grow ripe it was found that every night one of them was gone. The king became very angry at this, and ordered the gardener to keep watch all night under the tree. The gardener set his eldest son to watch; but about twelve o’clock he fell asleep, and in the morning another of the apples was missing. Then the second son was ordered to watch; and at midnight he too fell asleep, and in the morning another apple was gone. Then the third son offered to keep watch; but the gardener at first would not let him, for fear some harm should come to him: however, at last he consented, and the young man laid himself under the tree to watch. As the clock struck twelve he heard a rustling noise in the air, and a bird came flying that was of pure gold; and as it was snapping at one of the apples with its beak, the gardener’s son jumped up and shot an arrow at it. But the arrow did the bird no harm; only it dropped a golden feather from its tail, and then flew away. The golden feather was brought to the king in the morning, and all the council was called together. Everyone agreed that it was worth more than all the wealth of the kingdom: but the king said, ‘One feather is of no use to me, I must have the whole bird.’ Then the gardener’s eldest son set out and thought to find the golden bird very easily; and when he had gone but a little way, he came to a wood, and by the side of the wood he saw a fox sitting; so he took his bow and made ready to shoot at it. Then the fox said, ‘Do not shoot me, for I will give you good counsel; I know what your business is, and that you want to find the golden bird. You will reach a village in the evening; and when you get there, you will see two inns opposite to each other, one of which is very pleasant and beautiful to look at: go not in there, but rest for the night in the other, though it may appear to you to be very poor and mean.’ But the son thought to himself, ‘What can such a beast as this know about the matter?’ So he shot his arrow at the fox; but he missed it, and it set up its tail above its back and ran into the wood. Then he went his way, and in the evening came to the village where the two inns were; and in one of these were people singing, and dancing, and feasting; but the other looked very dirty, and poor. ‘I should be very silly,’ said he, ‘if I went to that shabby house, and left this charming place’; so he went into the smart house, and ate and drank at his ease, and forgot the bird, and his country too. Time passed on; and as the eldest son did not come back, and no tidings were heard of him, the second son set out, and the same thing happened to him. He met the fox, who gave him the good advice: but when he came to the two inns, his eldest brother was standing at the window where the merrymaking was, and called to him to come in; and he could not withstand the temptation, but went in, and forgot the golden bird and his country in the same manner. Time passed on again, and the youngest son too wished to set out into the wide world to seek for the golden bird; but his father would not listen to it for a long while, for he was very fond of his son, and was afraid that some ill luck might happen to him also, and prevent his coming back. However, at last it was agreed he should go, for he would not rest at home; and as he came to the wood, he met the fox, and heard the same good counsel. But he was thankful to the fox, and did not attempt his life as his brothers had done; so the fox said, ‘Sit upon my tail, and you will travel faster.’ So he sat down, and the fox began to run, and away they went over stock and stone so quick that their hair whistled in the wind. When they came to the village, the son followed the fox’s counsel, and without looking about him went to the shabby inn and rested there all night at his ease. In the morning came the fox again and met him as he was beginning his journey, and said, ‘Go straight forward, till you come to a castle, before which lie a whole troop of soldiers fast asleep and snoring: take no notice of them, but go into the castle and pass on and on till you come to a room, where the golden bird sits in a wooden cage; close by it stands a beautiful golden cage; but do not try to take the bird out of the shabby cage and put it into the handsome one, otherwise you will repent it.’ Then the fox stretched out his tail again, and the young man sat himself down, and away they went over stock and stone till their hair whistled in the wind. Before the castle gate all was as the fox had said: so the son went in and found the chamber where the golden bird hung in a wooden cage, and below stood the golden cage, and the three golden apples that had been lost were lying close by it. Then thought he to himself, ‘It will be a very droll thing to bring away such a fine bird in this shabby cage’; so he opened the door and took hold of it and put it into the golden cage. But the bird set up such a loud scream that all the soldiers awoke, and they took him prisoner and carried him before the king. The next morning the court sat to judge him; and when all was heard, it sentenced him to die, unless he should bring the king the golden horse which could run as swiftly as the wind; and if he did this, he was to have the golden bird given him for his own. So he set out once more on his journey, sighing, and in great despair, when on a sudden his friend the fox met him, and said, ‘You see now what has happened on account of your not listening to my counsel. I will still, however, tell you how to find the golden horse, if you will do as I bid you. You must go straight on till you come to the castle where the horse stands in his stall: by his side will lie the groom fast asleep and snoring: take away the horse quietly, but be sure to put the old leathern saddle upon him, and not the golden one that is close by it.’ Then the son sat down on the fox’s tail, and away they went over stock and stone till their hair whistled in the wind. All went right, and the groom lay snoring with his hand upon the golden saddle. But when the son looked at the horse, he thought it a great pity to put the leathern saddle upon it. ‘I will give him the good one,’ said he; ‘I am sure he deserves it.’ As he took up the golden saddle the groom awoke and cried out so loud, that all the guards ran in and took him prisoner, and in the morning he was again brought before the court to be judged, and was sentenced to die. But it was agreed, that, if he could bring thither the beautiful princess, he should live, and have the bird and the horse given him for his own.

THE ENCHIRIDION - I 1479

There are things which are within our power, and there are things which are beyond our power. Within our power are opinion, aim, desire, aversion, and, in one word, whatever affairs are our own. Beyond our power are body, property, reputation, office, and, in one word, whatever are not properly our own affairs. Now the things within our power are by nature free, unrestricted, unhindered; but those beyond our power are weak, dependent, restricted, alien. Remember, then, that if you attribute freedom to things by nature dependent and take what belongs to others for your own, you will be hindered, you will lament, you will be disturbed, you will find fault both with gods and men. But if you take for your own only that which is your own and view what belongs to others just as it really is, then no one will ever compel you, no one will restrict you; you will find fault with no one, you will accuse no one, you will do nothing against your will; no one will hurt you, you will not have an enemy, nor will you suffer any harm. Aiming, therefore, at such great things, remember that you must not allow yourself any inclination, however slight, toward the attainment of the others; but that you must entirely quit some of them, and for the present postpone the rest. But if you would have these, and possess power and wealth likewise, you may miss the latter in seeking the former; and you will certainly fail of that by which alone happiness and freedom are procured. Seek at once, therefore, to be able to say to every unpleasing semblance, “You are but a semblance and by no means the real thing.” And then examine it by those rules which you have; and first and chiefly by this: whether it concerns the things which are within our own power or those which are not; and if it concerns anything beyond our power, be prepared to say that it is nothing to you.

THE ADVENTURES OF TOM SAWYER - PREFACE 1564

Most of the adventures recorded in this book really occurred; one or two were experiences of my own, the rest those of boys who were schoolmates of mine. Huck Finn is drawn from life; Tom Sawyer also, but not from an individual—he is a combination of the characteristics of three boys whom I knew, and therefore belongs to the composite order of architecture. The odd superstitions touched upon were all prevalent among children and slaves in the West at the period of this story—that is to say, thirty or forty years ago. Although my book is intended mainly for the entertainment of boys and girls, I hope it will not be shunned by men and women on that account, for part of my plan has been to try to pleasantly remind adults of what they once were themselves, and of how they felt and thought and talked, and what queer enterprises they sometimes engaged in. THE AUTHOR. HARTFORD, 1876.

THE MEDITATIONS - Book I.[1/3] 1597

1. I learned from my grandfather, Verus, to use good manners, and to put restraint on anger. 2. In the famous memory of my father I had a pattern of modesty and manliness. 3. Of my mother I learned to be pious and generous; to keep myself not only from evil deeds, but even from evil thoughts; and to live with a simplicity which is far from customary among the rich. 4. I owe it to my great-grandfather that I did not attend public lectures and discussions, but had good and able teachers at home; and I owe him also the knowledge that for things of this nature a man should count no expense too great. 5. My tutor taught me not to favour either green or blue at the chariot races, nor, in the contests of gladiators, to be a supporter either of light or heavy armed. He taught me also to endure labour; not to need many things; to serve myself without troubling others; not to intermeddle in the affairs of others, and not easily to listen to slanders against them. 6. Of Diognetus I had the lesson not to busy myself about vain things; not to credit the great professions of such as pretend to work wonders, or of sorcerers about their charms, and their expelling of Demons and the like; not to keep quails (for fighting or divination), nor to run after such things; to suffer freedom of speech in others, and to apply myself heartily to philosophy. Him also I must thank for my hearing first Bacchius, then Tandasis and Marcianus; that I wrote dialogues in my youth, and took a liking to the philosopher’s pallet and skins, and to the other things which, by the Grecian discipline, belong to that profession. 7. To Rusticus I owe my first apprehensions that my nature needed reform and cure; and that I did not fall into the ambition of the common Sophists, either by composing speculative writings or by declaiming harangues of exhortation in public; further, that I never strove to be admired by ostentation of great patience in an ascetic life, or by display of activity and application; that I gave over the study of rhetoric, poetry, and the graces of language; and that I did not pace my house in my senatorial robes, or practise any similar affectation. I observed also the simplicity of style in his letters, particularly in that which he wrote to my mother from Sinuessa. I learned from him to be easily appeased, and to be readily reconciled with those who had displeased me or given cause of offence, so soon as they inclined to make their peace; to read with care; not to rest satisfied with a slight and superficial knowledge; nor quickly to assent to great talkers. I have him to thank that I met with the discourses of Epictetus, which he furnished me from his own library. 8. From Apollonius I learned true liberty, and tenacity of purpose; to regard nothing else, even in the smallest degree, but reason always; and always to remain unaltered in the agonies of pain, in the losses of children, or in long diseases. He afforded me a living example of how the same man can, upon occasion, be most yielding and most inflexible. He was patient in exposition; and, as might well be seen, esteemed his fine skill and ability in teaching others the principles of philosophy as the least of his endowments. It was from him that I learned how to receive from friends what are thought favours without seeming humbled by the giver or insensible to the gift. 9. Sextus was my pattern of a benign temper, and his family the model of a household governed by true paternal affection, and a steadfast purpose of living according to nature. Here I could learn to be grave without affectation, to observe sagaciously the several dispositions and inclinations of my friends, to tolerate the ignorant and those who follow current opinions without examination. His conversation showed how a man may accommodate himself to all men and to all companies; for though companionship with him was sweeter and more pleasing than any sort of flattery, yet he was at the same time highly respected and reverenced. No man was ever more happy than he in comprehending, finding out, and arranging in exact order the great maxims necessary for the conduct of life. His example taught me to suppress even the least appearance of anger or any other passion; but still, with all this perfect tranquillity, to possess the tenderest and most affectionate heart; to be apt to approve others yet without noise; to have much learning and little ostentation. 10. I learned from Alexander the Grammarian to avoid censuring others, to refrain from flouting them for a barbarism, solecism, or any false pronunciation. Rather was I dexterously to pronounce the words rightly in my answer, confining approval or objection to the matter itself, and avoiding discussion of the expression, or to use some other form of courteous suggestion. 11. Fronto made me sensible how much of envy, deceit and hypocrisy surrounds princes; and that generally those whom we account nobly born have somehow less natural affection. 12. I learned from Alexander the Platonist not often nor without great necessity to say, or write to any man in a letter, that I am not at leisure; nor thus, under pretext of urgent affairs, to make a practice of excusing myself from the duties which, according to our various ties, we owe to those with whom we live. 13. Of Catulus I learned not to condemn any friend’s expostulation even though it were unjust, but to try to recall him to his former disposition; to stint no praise in speaking of my masters, as is recounted of Domitius and Athenodorus; and to love my children with true affection. 14. Of Severus, my brother, I learned to love my kinsmen, to love truth, to love justice. Through him I came to know Thrasea, Helvidius, Cato, Dion, and Brutus. He gave me my first conception of a Commonwealth founded upon equitable laws and administered with equality of right; and of a Monarchy whose chief concern is the freedom of its subjects. Of him I learned likewise a constant and harmonious devotion to Philosophy; to be ready to do good, to be generous with all my heart. He taught me to be of good hope and trustful of the affection of my friends. I observed in him candour in declaring what he condemned in the conduct of others; and so frank and open was his behaviour, that his friends might easily see without the trouble of conjecture what he liked or disliked.