1. To determine whether there are fundamental conclusions within the field of forensic pathology on which all or most of the consultants can agree;
   
2. To write a report containing descriptions and the medical evidence and detailed explanations supporting any conclusions;
   
3. To compile recommendations regarding those be outside the expertise of forensic pathologists; and
   
4. To conduct a detailed, objective critique of the professional manner in which the autopsy on President Kennedy was conducted.

• I. Procedures followed by the forensic pathology panel;
• II. Recommendations for additional examinations, procedures and consultations by nonpathology disciplines;
• III. Observations and conclusions derived from the examination of the available evidence, interviews, specifically requested ancillary procedures, and consultations;
  • Description of President Kennedy's wounds
    • Entrance (inshoot) wound of the upper back and neck:
    • Exit (outshoot) wound of the anterior (front) neck:
    • Course of the missile through the body:
    • Entrance (inshoot) wound of the back of the head:
    • Exit (outshoot) wound of the side of the head:
    • Course of the missile through the head
    • Other autopsy considerations:
  • Description of Governor Connally's wounds
    • Entrance (inshoot) wound of the right lateral back (thorax):
    • Exit (outshoot) wound of the right anterior chest:
    • Course of the missile through the back (thorax):
    • Reentry wound into the dorsum (top or back) of the right wrist:
    • Exit wound on the volar (lower) surface of the right wrist:
    • Course of the missile through the right wrist:
    • Reentry wound in the left thigh:
    • Nondestructive analysis of tissues from the right wrist and left thigh and of slides prepared from them
  • Summary of the forensic pathologists' perspective of wound ballistics
  • Summary of the Forensic Pathology Panel's conclusions concerning the missile wounds of President Kennedy and Governor Connally
• Part IV. Critique of the earlier examination, with presentation of suggested procedures to be followed in performing an investigation and examination on the remains of a gunshot victim:
• V. Suggested procedures to be followed in the event of subsequent assassinations of Federal officials;
• VI. Dissenting view to the forensic pathology panel report, submitted by Cyril H. Wecht, M.D., J.D.
• VII. Majority response to the dissent of Cyril H. Wecht, M.D., J.D.
• VIII. Glossary of terms (those appearing in the glossary are denoted in the text by an asterisk (*).
• Various addenda and the footnotes follow part VIII.

PART I: PROCEDURES FOLLOWED BY THE FORENSIC PATHOLOGY PANEL

PART II: RECOMMENDATIONS FOR ADDITIONAL EXAMINATIONS, PROCEDURES, AND CONSULTATIONS BY NONPATHOLOGY DISCIPLINES

• To insure validity of the identity of these X-rays by comparison with in-life-films;
• To insure that the X-rays have not been altered since being taken, except as otherwise noted.
• To evaluate more completely, in order to determine their significance, the somewhat randomly distributed, small, radiopaque :particles visible in the X-ray of the soft tissues lateral to the right, lower cervical spine of John F. Kennedy;
• To provide interpretation by a radiologist with experience in the examination of gunshot wounds.

PART III: OBSERVATIONS AND CONCLUSIONS DERIVED FROM THE EXAMINATION OF THE AVAILABLE EVIDENCE, INTERVIEWS, SPECIFICALLY REQUESTED ANCILLARY PROCEDURES, AND CONSULTATIONS

DESCRIPTION OF PRESIDENT KENNEDY'S WOUNDS.

Entrance (inshoot) wound of the upper back and neck

1) Clothing--Suit jacket (back)

Examination of the President's clothing revealed the presence of a small hole in the back of the coat and shirt. The hole in the back of the coat is positioned approximately5 3/8-inches below the top of the collar and 1 3/4-inches to the right of the middle seam.(1) (See figs. 1 and 2, photographs of the suit jacket.)

That report goes on to describe the defects of the shirt and then states "[t]hese holes are typical of bullet entrance holes."(2)

FIGURE 1.--Photograph of the suit jacket, taken from the back, showing the bullet hole entrance.
FIGURE 2.--Photograph of the suit jacket taken from the front, showing the bullet hole entrance in the back. The suit jacket, shirt and tie were cut during emergency procedures at Parkland Memorial Hospital, Dallas, Tex., to afford easy removal.

The hole in the back of the coat and the hole in the back of the shirt were, in general, circular in shape and the ends of the torn threads around the hole were bent inward. These characteristics are typical of bullet entrance holes. (3)

2) Clothing--shirt (back) The shirt is white with a thin triple gray stripe alternating with a thin triple brown stripe. The back; collar and upper sleeves are stiff and stained with a dark brown substance resembling dried blood. There is a defect in the shirt measuring 1.2 centimeters in vertical diameter and 0.8 centimeter in transverse diameter. It is in a location corresponding to the defect in the jacket, with its upper margin 14 centimeters (5.5 inches) below the upper margin of the shirt collar and 2.5 centimeters (approximately 1 inch) to the right of the midline of the shirt. This defect is also described in the FBI report:

FIGURE 3.--Photograph of the shirt, taken from the front, showing bullet hole entrance in the back.

3) Photographs

FIGURE 4.--Drawing of the posterior thorax of President John F. Kennedy, revealing the general location and appearance of the entrance wound in the upper back.
FIGURE 5.-Close-up photograph of the entrance wound in the upper back.

4) X-rays

5) Autopsy report

Situated on the upper right posterior thorax, just above the upper border of the scapula there is a 7 millimeter by 4 millimeter oval wound. This wound is measured to be 14 centimeters from the tip of the right acromion process and 14 centimeters below the tip of the right mastoid process. (7)

The original pathologists' localization of this wound by measurement to body landmarks which change with different body positions, and their failure to localize this wound relative to the usually accepted fixed body landmarks such as the heel, preclude reconstruction of the exact entrance point.

FIGURE 6.- Reproduction of "Autopsy Descriptive Sheet" drawing depicting anterior and posterior views of the body, with wounds as sketched by the autopsy pathologists. The panel considered the location of the wound as it appears in photograph No. 38 or figures 4 and 5 in relation to this drawing. The panel concludes that the drawing was merely a crude representation used as a worksheet primarily to assist in the preparation of the final report and was not necessarily an exact representation of the wound. The majority of the panel agrees that if the wound were located as low as represented on the worksheet, it probably would have penetrated and collapsed the right lung, an effect that would have been apparent on the initial chest X-ray.

Exit (outshoot) wound of the anterior (front) neck

1) Clothing--shirt (front)

2) Clothing--Necktie

A ragged, slit-like hole approximately one-half inch in length is located in the front of the shirt seven-eighths inch below the collar button. This hole is through both the button and buttonhole portions of the shirt due to the overlap. This hole has the characteristics of an exit hole for a projectile. bullet metal was found in the fabric surrounding the hole the front of the shirt. A small elongated nick was located in the left side of the knot of the tie, Q24 [FBI designation], which may have been caused by the projectile after it had passed through the front of the shirt. (9)

(See fig. 7, a photograph of the tie.)

FIGURE 7.- Photograph of the necktie, showing the bullet defects. X-ray and other examinations of the clothing revealed no additional evidence of value.

The hole in the front of the shirt was a ragged, slit-like hole and the ends of the torn threads around the hole, were bent outward. These characteristics are typical of an exit hole for a projectile. A small elongated nick was present in the left side of the knot of the tie. This nick may have been caused by the projectile after it passed through the front of the shirt. No additional observations relative to the nick could be made due to the characteristics of the nick. (10)

1. Determine if any particles of missile still remained on the clothing.
   
2. Analyze the missile fragments, if any, and define the elemental nature of them.
   
3. See if any correlation might be made between the elements found and missile behavior after striking J.F.K. and J.B.C.(11)

3) Photographs

FIGURE 8.--Drawing of the anterior neck and thorax, showing the general location and appearance of the tracheotomy incision.
FIGURE 9.--Close-up photograph of the tracheotomy incision.

4)X-rays

5) Autopsy Report

Situated in the low anterior neck at approximately the level of the third and fourth tracheal rings is a 6.5-centimeter long transverse wound with widely gaping irregular edges. (12)

The appearance of this wound was further characterized by Dr. Humes in his report as follows:

The wound presumably of exit was that described by Dr. Malcolm Perry of Dallas in the low anterior cervical region. When observed by Dr. Perry, "the wound measured" a few mm in diameter, however it was extended as a tracheotomy incision and thus its character is distorted at the time of autopsy. However, there is considerable ecchymosis of the strap muscles of the right side of the neck and of the fascia about the trachea adjacent to the line of the tracheotomy wound. (13)

6) Statements of the surgeons

In the lower part of the neck below the Adams Apple was a small, roughly circular wound of perhaps 5 min. in diameter from which blood was exuding slowly. (14).

In a committee interview, Dr. Perry further characterized the wound:

Dr. Perry began by stating that one of the wounds that JFK had suffered was "about 1/3 of the way" up on the anterior aspect of the neck. Dark blood (a sign of insufficient oxygen) was oozing from the wound when Dr. Perry first observed JFK. Dr. Perry believes that the wound measured approximately 6-7 millimeters in size and was roughly round, although he couldn't state for sure since combating the two primary medical emergencies of restoring breathing and stopping bleeding prevented him from even taking the time to wipe the blood from the wound.(15)

The report on the interview continued:

Dr. Perry said that Dr. Jones, who was already treating JFK when Perry arrived, had inserted a tube down the trachea to facilitate breathing but that the air passage still seemed blocked. Due to this dilemma, Dr. Perry determined that a tracheotomy was necessary "then or never" and therefore made a transverse incision straight through the bullet wound on the anterior aspect of the neck at approximately the second or third tracheal ring.(16)

I didn't clearly identify either an entrance or an exit wound. the press conference I indicated that the neck wound appeared like an entrance wound. and I based this mainly on its size and the fact that exit wounds in general tend to be somewhat ragged and somewhat different from entrance wounds. Now, this doesn't pertain, of course, in bullets that are tumblers. and many bullets, especially fired from-the hand guns and this sort of thing, tend to tumble, and as a result, they make keyhole injuries and various things. But, in general, full-jacketed bullets make pretty small entrance holes. And so I don't really know. I thought it looked like an entrance wound because it was small, but I didn't look for any others, and so that was just a guess. (17)

My total recollection of that wound, it was, a small, fairly circular wound, with material issuing from it. And that's really my total recollection. (19)

When asked whether he was able to draw any conclusions about the direction in which the missile had been passing, Dr. Carrico said "not for sure." (20)

Course of the missile through the body

1) Photographs

2) X-rays.

FIGURE 10.--Photograph of an anterior-posterior X-ray of the neck and chest (from autopsy X-ray No. 8), showing small radiopaque densities adjacent to the transverse process of C-6 and C-7.
FIGURE. 11.--Photograph of the anterior-posterior X-ray of the neck and chest (from film No. 9), showing small radiopaque densities adjacent to the transverse process of C-6 and 0-7.

Regarding the neck X-ray, Dr. Seaman said there was a fragment-like object present near the transverse process which was too dense to be bone (fairly confident). He said the transverse process appears normal with air present (possibly byproduct of tracheotomy), calling it " highly suspicious compared with the other side." He thinks he can " see the fragment separate (also in No. 9) and concludes there is a possible fracture in C-7. (22)"

3) Autopsy report

2. The second wound presumably of entry is that described above in the upper right posterior thorax. Beneath the skin there is ecchymosis of subcutaneous tissue and musculature. The missile path through the fascia and musculature cannot be easily probed. The wound presumably of exit was that described by Dr. Malcolm Perry of Dallas in the low anterior cervical region . However, there is considerable ecchymosis of the strap muscles of the right side of the neck and of the fascia about the trachea adjacent to the line of the tracheotomy wound. The third point of reference in connecting these two wounds is in the apex (supra-clavicular portion ) of the right pleural cavity. In this region there is contusion of the parietal pleura and of the extreme epical portion of the right upper lobe of the lung. In both instances the diameter of contusion and ecchymosis at the point of maximal involvement measures 5 centimeters. Both the visceral and parietal pleura are intact overlying these areas of trauma. (23)

FIGURE 12.-Drawing of the lateral cross-section of the chest, depicting the visceral and parietal pleura, lower neck and right lung, with the injuries described to them. Also depicted is a drawing demonstrating the possible trajectories through the neck of President Kennedy, depending on the position of the body.

The lungs are of essentially similar appearance the right weighing 320 gram, the left 290 grams. The lungs are well aerated with smooth glistening pleural surfaces and grey-pink color. A 5-centimeter diameter area of purplish red discoloration and increased firmness to palpation is situated in the apical portion of the upper right lobe. This corresponds to a similar area described in the overlying parietal pleura. Incision in this region reveals recent hemorrhage into pulmonary parenchyma. (24)

The bony cage is unremarkable. The thoracic organs are in their normal positions and relationships and there is no increase in free pleural fluid. The above described area of contusion in the apical portion of the right pleural cavity is noted.(25)

This wound cannot be probed with the soft probe available There is subpleural hemorrhage in the right apical mesialregion. The apex of the right lung is hemorrhagic, without laceration of the pleura. On the basis that there is a wound possibly of entrance, which cannot be probed through the body, I suggest X-ray films be taken, anteroposterior and lateral, of the entire body, before going any further with the autopsy. This radiologic survey does not reveal any major missile in the President's cadaver. There is a recent tracheotomy would (transversal incision) with moderate hemorrhage in the subcutaneous tissue. Thanks to a telephone call from commander Humes to Dallas, I found out later that the surgeon in Dallas had extended the exit would in the anterior aspect of the neck to make his tracheotomy. The tracheotomy wound was examined. Later, the permission was extended to the chest.(26)

entered the right superior posterior thorax above the scapula and traversed the soft tissues of the supra-scapular and supra-clavicular portions of the base of the right side of the neck. This missile produced contusions of the right apical parietal pleura and of the apical portion of the right upper lobe of the lung. The missile contused the strap muscles of the right side of the neck, damaged the trachea and made its exit through the anterior surface of the neck. As far as can be ascertained, this missile struck no bony structures in its path through the body.(27)

4) Interviews with the surgeons

I don't remember whether it was a third or a quarter of the circumference I can't remember exactly. There was a laceration. The bruising I mentioned was in the apical pleural and the strap muscles. The trachea was clearly lacerated. (28)

I surmised there might be a hemothorax (blood within the thoracic cavity) or pneumothorax (air within the thoracic cavity) because, not knowing the trajectory of the missile, and when I saw the bruised apical pleural and there was some bubbly blood in that area, I didn't know whether that blood had been frothed a little bit as a result of air coming out of the trachea in our attempt to breathe for him or whether it was coming out of a lung. And as a result, since a tension pneumothorax or serious chest injury could have obviously been a serious problem, why we elected to put in a chest tube. But the chest tube, I later learned, was not necessary because the chest cavity was not violated.(29)

Even if he had had a major arterial injury, why he might have bled out and there wouldn't have been much (blood); but there was no evidence of a major arterial injury. And the artery, of course that's closely applied to the trachea, is the common carotid artery at that level. But it was not injured.(31)

I was interested in the track and I had observed the conditions of bruising between the point of entry in the back of the neck and the point of exit at the front of the neck, which is entirely compatible with the bullet's path.

Entrance (inshoot) wound of the back of the head

1) Clothing

2) Photographs

FIGURE 13.--Drawing depicting the posterior head wound. Note also the position of the "white mass," described later.

FIGURE 14.--Close-up photograph of the posterior head wound.

FIGURE 15.--Close-up photograph of the "white mass," dried brain tissue, situated in the lower occipital region.

3) X-rays

In the underlying bone is a corresponding wound through the skull which exhibits beveling of the margins of the bone when viewed from the inner aspect

FIGURE 16.--Diagram depicting beveling which occurs on the interior surface the site of entrance and exterior surface at the site of exit when a missile perforates the skull.

FIGURE 17.--Photograph of the anterior-posterior X-ray of the skull (autopsy X-ray No. 1), showing the occipital defect and adjacent missile fragment.
FIGURE 18.--Photograph of the lateral X-ray of the skull (autopsy X-ray No.2), showing the occipital defect with beveling and adjacent missile fragment.

FIGURE 19.--Photograph of a computer-assisted image enhancement of anterior-posterior X-ray of the skull (autopsy X-ray No. 1)
FIGURE 20.--Photograph of a computer-assisted image enhancement of a lateral X-ray of the skull (autopsy X-ray No. 2).
FIGURE 21.--Photograph of a pre-mortem lateral X-ray of the skull of President John F. Kennedy, against which to compare the damage shown in the autopsy X-rays. Nos. 1 and 2.

4) Autopsy Report

Situated in the posterior scalp approximately 2.5 centimeters laterally to the right and slightly above the external occipital protuberance is a lacerated wound measuring 15 x 6 millimeters. In the underlying bone is a corresponding wound through the skull which exhibits beveling of the margins of the bone when viewed from the inner aspect of the skull. (34)

The "Autopsy Descriptive Sheet" shows a round circle overlying the occipital protuberance, with an arrow extending superiorly and to the left at approximately 11 o'clock and the notation "ragged, slanting, 15 by 6 millimeters." (See fig. 6.) Conspicuous by its absence is any descriptive legend which localizes this wound relative to body landmarks.

I also noticed another scalp wound, possibly of entrance, in the right occipital region, lacerated, and transversal, 15 by 6 millimeters. Corresponding to that wound, the skull shows a portion of a crater, the beveling of which is obvious on the internal aspect of the bone; on that basis, I told the prosecutors and Admiral Galloway that this occipital wound is a of entrance.

FIGURE 22.--Photograph of the posterior view of a human skull on which the autopsy pathologists, Drs. Humes, Boswell, and Finck, identified the approximate location of the entrance wound. The two initialed circles on the lower portion of the skull and to the right of the midline represent the general area where the autopsy doctors believe the entrance wound to be. (There arc two circles because Dr. Finck marked the skull independent of Drs. Humes and Boswell, and without knowing where Drs. Humes and Boswell had placed their circle.) The circle on the top portion of the skull and to the right of the midline represents the general area where the forensic pathology panel believes the entrance to be. (The fourth circle on the lower portion of the skull and approximately on the midline represents the location of the external occipital protuberance. )

FIGURE 23.- Photograph of the posterior-lateral view of the skull on which the autopsy pathologists identified the approximate location of the entrance wound. (See caption fig. 22.)

FIGURE 24. - A drawing of the posterior view of a human body depicting the location of the entrance wounds in the head and the upper back.

Exit (outshoot) wound of the side of the head

1) Photographs

FIGURE 25.--Closeup photograph of the semicircular exit defect in the margin of the fracture fragment in the right parietal region.

2) X-rays

FIGURE 26.--Photograph of an X-ray of the three bone fragments recovered from the limousine. These are depicted in X-ray films Nos. 4, 5, and 6. On the triangular fragment is the semicircular defect with outwardly beveled margins and radiopaque shadows which have the appearance of tiny missile fragments.

3) Autopsy Report

1. There is a large irregular defect of the scalp and skull on the right involving chiefly the parietal bone, but extending somewhat into the temporal and occipital regions. In this region there is an actual absence of scalp and bone producing a defect which measures approximately 13 centimeters in greatest diameter. From the irregular margins of the above scalp defect tears extend in stellate fashion into the more or less intact scalp as follows:

• a. From the right inferior temporo-parietal region anterior to the right ear to a point slightly above the tragus.
  
• b. From the anterior parietal margin anteriorly on the forehead to approximately 4 centimeters above the right orbital ridge.
  
• c. From the left margin of the main defect across the midline entero-laterally, for a distance of approximately centimeters.
  
• d. From the same starting point as 10 centimeters posterolaterally. (36)

No exit wound is identifiable at this time in the skull, but close to midnight, portions of cranial vault are received from Dallas, Tex. X-ray [sic] films of these bone specimens reveal numerous metallic fragments. Two of the bone specimens, 50 millimeters in diameter, reveal beveling when viewed from the external aspect, thus indicating a wound of exit. Most probably, these bone specimens are part of the very large right skull wound, 130 millimeter in diameter and mentioned above. This right fronto-parieto-occipital wound is therefore an exit. (37)

4) "Harper bone fragment"

The Harper fragment photographs show it as a roughly trapezoidal piece, 7 centimeters by 5.5 centimeters in size, coming mainly from the upper middle third of the right parietal bone. Near its short upper edge vascular foramina on the inside and a faint irregular line on the outside indicate saggital suture. Its posterior inferior pointed edge appears to fit the crack in the posterior section of the right parietal [bone] and its slightly wavy lower border can fit the upper edge of the loose lower section of right parietal [bone]. Its upper short border, on the left of the midline near vertex, may meet the left margin of the gap. Behind it there appears to be a large gap and in front a narrow one. (38)

(See figs. 27 and 28, photographs of both the interior and exterior surfaces of the "Harper bone fragment.")

FIGURE 27.--Photograph of the interior surface of the Harper bone fragment.
FIGURE 28.--Photograph of the exterior surface of the Harper bone fragment.

5) Attempted reconstruction of the skull fractures

FIGURE 29.--Scale drawing of the frontal and right side of a human skull, which depicts the displaced bone fragments and the extensive fragmentation of the skull.
FIGURE 30.--Scale drawing which shows the path of the bullet through the head.
FIGURE 31.--A drawing of a profile view of President Kennedy, showing the internal anatomic structures and the location of the entrance and exit wounds to the head (the entrance wound is only partially visible).

The two big loose fragments of skull vault, from upper frontal and parietal area more on the right than on the left side, do not articulate with each other and leave three appreciable gaps unfilled. (39)

Thus, the additional gaps may be accounted for by collapsed superimposed fragments of bone within the skull or there may still be fragments missing. Within one or several of these fragments, there might be an additional exit defect if the principal missile had divided into two major fragments within the skull, although in the experience of the members, the estimated size of the principal exit defect is consistent with the size of a single existing missile representing the mass of the two major fragments recovered outside the body.

[s]ince this kind of ammunition would not have penetrated deeply into the brain, there would be no evidence of damage to the left cerebral hemisphere, nor would there be fragments of such a missile deposited in the left side of the brain. (40)

Dr. Wecht points out further that "there would not be a separate exit wound if this kind of ammunition had been used."(41)

Course of the missile through the head

1) Photographs

FIGURE 32.--Drawing of the superior surface of the brain, showing the extensive lacerations.

2) X-rays

My preliminary (prior to analysis of computer-assisted enhanced images of these X-rays) interpretation follow (sic):

1. A nearly complete loss of structure in the right frontal and parietal bone.
2. A metallic fragment on the outer table of the right occipital bone approximately 10 centimeters above the external occipital protuberance. In the same area is a depressed fracture. In the anterior-posterior projection, there appears to be fracture lines to the occipital, parietal and temporal bone, radiating from the area of the fracture and metallic fragments. The metallic fragment is nearly spherical in this projection.
3. There is elevation of the galea roedial and lateral to the area of the fracture and metallic fragment in the occipital region. A small metallic fragment is located medial to the location of the spherical metallic fragment and fracture between the galea lying and the outer cranial table.
4. There is a fracture line through the floor of the sella turcica with bony fragments in the sphenoid sinus.
5. There are fracture lines through the anterior and posterior aspects of the anterior ethmoid cells with air in the right side anterior ethmoid. (42)

There is an extensive comminuted, open, explosive calvarial fracture which seems to radiate in various directions as described above from a central point which is located in the right parietal bone, 3 centimeters from the midline and about 9 or 10 centimeters from the external occipital protuberance. (43)

3) Autopsy report

Clearly visible in the above described large skull defect and exuding from it is lacerated brain tissue which on close inspection proves to represent the major portion of the right cerebral hemisphere. At this point it noted that the falx cerebri is extensively lacerated with disruption of the superior sagittal sinus. Upon reflecting the scalp, multiple complete fracture lines are seen to radiate from both the large defect at the vertex and the smaller wound at the occiput. These vary greatly in length and direction, the longest measuring approximately 19 centimeters. These result in the production of numerous fragments which vary in size from a few millimeters to 10 centimeters in greatest diameter. The complexity of these fractures and the fragments thus produced tax satisfactory verbal description and are better appreciated in photographs and roentgenograms which are prepared. (44)

Following formalin fixation the brain weighs 1500 grams. The right cerebral hemisphere is found to be markedly disrupted. There is longitudinal laceration of the right hemisphere which is a parasagittal in position approximately 2.5 centimeters to the right of the midline which extends from the tip of the occipital lobe posteriorly to the tip of the frontal lobe anteriorly. The base of the laceration is situated approximately 4.5 centimeters below the vertex in the white matter. There is considerable loss of cortical substance above the base of the laceration, particularly in the parietal lobe. The margins of this laceration are at all points jagged and irregular, with additional lacerations extending in varying directions and for varying distances from the main laceration. In addition, there is a laceration of the corpus cellosum extending from the genu to the tail. Exposed in this latter laceration are the interiors of the right lateral and third ventricles. When viewed from the vertex the left cerebral hemisphere is intact. There is marked engorgement of meningeal blood vessels of the left temporal and frontal regions with considerable associated subaracbnoid hemorrhage. The gyri sulci over the left hemisphere are of essentially normal size and distribution. Those on the right are too fragmented and distorted for satisfactory description. When viewed from the basilar aspect the disruption of the right cortex is again obvious. There is a longitudinal laceration of the midbrain through the floor of the third ventricle just behind the optic chiasm and mammillary bodies. This laceration partially communicates with an oblique 1.5 centimeter tear through the left cerebral peduncle. There are irregular superficial lacerations over the basilar aspects of the left temporal and frontal lobes. (46)

• a. From the margin of the laceration in the right parietal lobe.
• b. From the margin of the laceration in the corpus callosum.
• c. From the anterior portion of the laceration in the right frontal lobe.
• d. From the coatused left fronto-parietal cortex.
• e. From the line of transection of the spinal cord.
• f. From the right cerebellar cortex.
• g. From the superficial laceration of the basillar aspect of the left temporal lobe.

Microscopic examination--Brain.--Multiple sections from representative areas as noted above are examined. All sections examined are there significant abnormalities other brain tissue with associated hemorrhage. In none of the sections examined are there significant abnormalities other than those directly related to the recent trauma.(49)

The fatal missile entered the skull above and to the right of the external occipital protuberance. A portion of the projectile transversed the cranial cavity in a posterior-anterior direction (see lateral skull roentgenogram) depositing minute particles along its path. A portion of the projectile made its exit through the parietal bone on the right carrying with it portions of cerebrum, skull and scalp. The two wounds of the skull combined with the force of the missile produced extensive fragmentation of the skull, laceration of the superior sagittal sinus, and of the right cerebral hemisphere. (50)

In addition, it is our opinion that the wound of the skull produced such extensive damage to the brain as to preclude the possibility of the deceased surviving this injury.

The scalp of the vertex is lacerated. There is an open comminuted fracture of the crimal vault, many portions of which are missing. The autopsy had been in progress for 30 minutes when I arrived. Commander Humes told me that he only had to prolong the lacerations of the scalp before removing the brain. No sawing of the skull was necessary. The opening of the large head wound, in the right fronto-parieto occipital region, is 130 millimeters in diameter.(51)

Other Autopsy considerations

1) Other wounds

Situated on the anterior chest wall in the nipple line are bilateral 2 centimeters long recent transverse surgical incisions into the subcutaneous tissue. The one on the left is situated 11 centimeters cephalad to the nipple and the one on the right 8 centimeters cephalad to the nipple. There is no hemorrhage or ecchymosis associated with these wounds. A similar clean wound measuring 2 centimeters in length is situation on the anterolateral aspect of the left mid arm. Situated on the anterolateral aspect of each ankle is a recent 2 centimeters transverse incision into the subcutaneous tissue. (52)

No other wounds.--The X-ray films established that there were small metallic fragments in the head. However, careful examination at the autopsy, and the photographs and X-rays taken during the autopsy, revealed no evidence of a bullet or of a major portion of a bullet in the body of the President and revealed no evidence of any missile wounds other than those described above. (53)

2) Examination of the Abdominal Organs

Abdominal Cavity.--The abdominal organs are in their normal positions and relationships and there is no increase in free peritoneal fluid. The vermiform appendix is surgically absent and there are a few adhesions joining the region of the cecum to the ventral abdominal wall at the above described old abdominal incisional scar. (54)

Liver.--Sections show the normal hepatic architecture to be well preserved. The parenchymal cells exhibit markedly granular cytoplasm indicating high glycogen content which is characteristic of the "liver biopsy pattern" of sudden death.
Spleen.--Sections show no significant abnormalities. Kidneys.--Sections show no significant abnormalities aside from dilatation and engorgement of blood vessels of all calibers. (55)

1. Nichols, John, M.D., "President Kennedy's Adrenals," Journal of the American Medical Association, July 10, 1967, vol.201, No. 2, pp. 115-116.
2. Nicholas, James A., M.D., Philip D. Wilson, M.D., and Charles J. Umberger, Ph.D., "Induced Hypoadrenalism in Patients Requiring Orthopedic Surgery," Journal of the American Medical Association, May 18, 1957, vol. 164, No. 3, pp. 261-265.
3. Nicholas, James A., M.D., Charles L. Burstein, M.D., Charles J. Umberger, Ph. D, and Philip D. Wilson, M.D., "Management of Adrenal Cortical Insufficiency During Surgery," Archives of Surgery, vol. 771, 1955, p. 737.

3) Organs and histologic sections

DESCRIPTION OF GOVERNOR CONNALLY'S WOUNDS

Entrance (inshoot) wound of the right lateral back (thorax)

1) Clothing--suit jacket (back)

FIGURE 33.--Photograph of the back of Governor Connally's suit jacket, showing the posterior entry hole.

Reference is made to your letter dated April 9, 1964, covering transmittal to the FBI laboratory of Gov. John Connally's coat, shirt, trousers and tie, and requesting an examination of these items. The results of the examination are set forth below.

For your information the coat has been designated C311, the trousers C312, the shirt C313, and the tie C314.
Nothing was found to indicate which holes were entrances and which holes were exits. The coat, shirt and trousers were cleaned prior to their receipt in the laboratory, which might account for the fact that no foreign deposits of metal or other substances were found on the cloth surrounding the holes. Further, no characteristic position of the fibers of the cloth around the holes, which is one of the factors considered in determining whether a hole is an entrance or an exit hole, was found. The sizes of the holes in the clothing do not necessarily aid in this determination, since a hole can be enlarged if the bullet strikes at an angle, sideways or partially sideways, or if it passes through a fold in the cloth. Also, if a bullet is irregularly mutilated, an entrance hole could be larger than an exit hole.
It was not possible from an examination of the clothing to determine whether or not all of the holes were made by the same projectile or projectile fragments.(56)

In regard the J.B.C.'s clothing: It should be noted that the clothing had been subjected to dry cleaning at some time after the shootings. The validity of the results may therefore be questioned. One aberrant result, unexplained, possibly due to a misrecording of data or a temporary malfunction of the instrument (EDX) or perhaps an ephemeral contamination, was encountered. Reanalysis of the questioned area proved the aberrance. Copper was found in quantity in the region of the defect in the right front. The results would indicate that the apparent borderline copper analysis is due to the lining containing some copper. Iron, apparently from blood, was still detectable near the right front defect in the coat, despite dry cleaning.
The analytical results are of interest, because there is proof of very little fragmentation of the missile (missiles) as it (they) passed through the person(s) of J.F.K. and J.B.C. Indeed, the only indication of copper in any quantity was in the region of the front defect of the coat of J.B.C.,. The term "in quantity" means only that copper was found in clearly detectable amounts by the use of the EDX [energy-dispersive X-ray] equipment. The actual amount is very small, and the absence of particulate material on the SC [soft X-ray] film is not surprising. (57)

2) Clothing--Shirt (back)

FIGURE 34.--Photograph of the back of Governor Connally's shirt.

3) Surgical report and interview with the surgeon

It was found that the wound of entrance was just lateral to the right scapula close [to] the axilla yet had passed through the latysmus [latissimus] dorsi muscle the wound of entrance was approximately three centimeters in its longest diameter(58)

The rear entrance wound was not 3 centimeters [in diameter] as indicated in one of the operative notes. It was a puncture-type wound, as if a bullet had struck the body at slight declination [i.e., not at a right angle]. The wound was actually approximately 1.5 centimeters in diameter. The ragged edges of the wound were surgically cut away, effectively enlarging it to approximately 3 centimeters. (59)