Has something changed about chronic cocaine abuse over time? An instructive example from the forensic collection

Abstract

Introduction Here, we present an illustrative case from the Forensic Museum collection made by Professor Milovan Milovanovic (1884-1948). Museum specimen No 465 represents a jar containing three glass syringes and two small bottles of 10-20 ml, sealed with corks, found in the pockets of the deceased whose autopsy was performed in 1929. Case outline It was a 30-year-old male, found dead in the tavern shed, a former medical student, lieutenant, and Russian ?migr? who came to Belgrade in 1921 following commanding General of the anti-Bolshevik White Army, Pyotr Nikolayevich Wrangel. He was an alcoholic, drug user, and a member of the so-called Russian cocaine quartet gang. In the autopsy report, Professor Milovanovic described a textbook example of a drug user: extremely malnourished body, skin covered with scabs, multiple "purulent abscesses" and "livid infiltrations", and attenuated nasal septum with mucosa covered with scabs. Internal autopsy findings included fatty liver, pneumonia, and anemia of all internal organs. At the time, the whole brain, tissue of internal organs, and contents from the stomach and intestines were used for the analysis ("the Stas-Otto method for extraction of alkaloids"). Qualitative analyses showed "the presence of cocaine" in all the examined organs, and the analysis of the content from the "cloudy, colorless liquid" found in the dark bottle showed that it contained "0.0113 g of morphinum-hydrochloricum". Conclusion Contemporary analyses of the material from one of the syringes and the transparent glass bottle performed 90 years later showed the presence of cocaine, morphine, and codeine, confirming that the cause of death was drug-related.