Psychogenic non epileptic seizures (PNES) are clinical events of psychological nature. Video-electroencephalography monitoring (V-EEGM) is a valuable method for the diagnosis of PNES and may be combined with provocative tests to induce seizures. The use of placebo in provocative tests for the diagnosis of PNES is controversial because of associated deception, and contrasts with the use of truly decreasing epileptogenic threshold techniques such as hyperventilation and photo stimulation. We present a clinical case of a pregnant woman with a past history (...) of refractory epilepsy, admitted in the obstetric department due to unremitting seizures. In this clinical context, non-deceiving provocative tests such as hyperventilation and photo stimulation could be potentially harmful, nevertheless, the use of intravenous saline injection presented as a safer alternative to diagnose PNES and hence obviate an urgent caesarean. This case illustrates a disproportionate risk of causing harm when telling the truth, in comparison with the benefit of avoiding such risk, although deceiving the patient. This is a clinical example of how considerations concerning the use of placebo must be evaluated in an individual basis. (shrink)

This paper explores the endeavours of José Celestino Mutis before and during his directorship of the Royal Botanical Expedition to the New Kingdom of Granada. Firstly, it will consider various aspects of Mutis’ activities as a naturalist and entrepreneur, in particular his efforts to promote the identification and commercial exploitation of three natural products associated with the Viceroyalty of New Granada: quina, cinnamon, and tea. Secondly, the paper will focus on the complex dynamics of the expedition’s artistic workshop, whose outcome (...) was the monumental compilation of botanical illustrations known as the Flora de Bogotá. The overall aim is to offer a reflection on the challenges posed by the practices of accumulation and management in the context of a scientific expedition inspired by the new policies of the reformist movement in Spain and designed to make profit out of the nature of the New World and its knowledge. (shrink)