1. * Dr. Loquvam prepared the initial draft and conclusions of this report. Subsequently it was redrafted and edited by Dr. Weston at the Center of Forensic and Environmental Science, School of Medicine, University of New Mexico, Albuquerque, N. Mex.

  1. The charge addressed to the members of the Panel within the appointing letter of August 8, 1977 was as follows:

    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.

  2. In accordance with the wishes of the committee, this report is divided into several parts as follows:


  3. The larger subpanel, which had not previously reviewed the medical evidence, convened initially on Sept. 15, 1977, at the House Office Building, Annex II; on Sept. 16 and 17, 1977 at the National Archives; and on Sept. 18, 1977, at the House Office Building, Annex II. The material listed in addendum A to this report was made available to the subpanel at the initial meeting. The material listed in addendum B was made available the second and third days at the National Archives.
    *Paragraphs (192) to (202) represent duplicated materials.

  4. The second subpanel convened initially on Sept. 22, 1977, at the House Office Building, Annex II; and on the next day, Sept. 23, 1977, at the National Archives; and, subsequently at the House Office Building, Annex II. The material listed in addendum A was made available to this subpanel at the initial meeting. The material listed in addendum B was made available at the second meeting at the National Archives. All members of both subpanels were allowed unlimited access to these materials for individual examination.

  5. On September 17, members of the larger subpanel met with Drs. James J. Humes and J. Thornton Boswell, who had performed the autopsy on Nov. 22, 1963, and with Dr. J. Lawrence Angel, a forensic anthropologist with the Smithsonian Institution, to discuss the procedures followed during President Kennedy's autopsy and the degree of fragmentation of the President's skull. On Sept. 22, 1977, the second subpanel was afforded the opportunity to hear the tape recording of the interview of Drs. Humes and Boswell conducted by the first subpanel. Both subpanels were shown a film and slide presentation of the assassination prepared by Robert Groden, which included the Zapruder film.

  6. The larger subpanel met on the afternoon of Sept. 18, 1977, at the House Office Building, Annex II, to discuss the individual findings and to commit to writing its opinions relative to the evidence viewed. At that meeting, it became apparent that the members were in substantial agreement with respect to the interpretation of the evidence.

  7. Members of the other subpanel met on the afternoon of Sept. 24, 1977, at the House Office Building, Annex II, to discuss their findings and opinions relative to their examination and reexamination of the evidence. Members of this group, who had previously publicly expressed differing interpretations of the evidence, were not in agreement as to the interpretation of all the evidence.

  8. The two subpanels selected Dr. Loquvam and Dr. Weston, respectively, to draft preliminary working reports. Dr. Weston subsequently drafted a report that incorporated the views of both subpanels

  9. The members of the subpanels met together on Friday, Mar. 10, 1978, at the National Archives. Drs. Weston, Loquvam, and Baden also met with members of the photographic evidence panel that day to review selected photographs that had been enhanced using photographic reexposure technique, as well as several other photographs arranged in pairs to permit stereoscopic visualization. Following that, all members of the forensic pathology panel met with members of the photographic panel to hear presentations concerning the photographic panel's interim work that might be relevant to that the forensic pathology panel.

  10. The reports of the two pathology subpanels, being in essential agreement as to the pathology evidence, were then combined, with the understanding that any panel member not concurring with any statement could express a dissenting opinion that would be noted and incorporated in the body of the report.

  11. On Saturday, Mar. 11, 1978, members of the forensic pathology panel met again at the National Archives and deposed Dr. John H. Ebersole, the radiologist who had taken the autopsy X-rays, and subsequently Dr. Pierre A. Finck, one of the pathologists who assisted in the autopsy. The pertinent portions of their testimony is summarized in section III of this report.

  12. During the early evening of Saturday, Mar. 11, members of the forensic pathology panel met with members of the photographic evidence and firearms panels, other experts, and members of the select committee staff to discuss and present each panel's findings and observations.

  13. On Sunday, March 12, members of the panel once again met at the House Office Building, Annex II, and discussed joint observations and the report previously prepared by Dr. Loquvam. During the discussion, Dr. Finck was interviewed at his request because of his concern that the views he expressed during his deposition the previous day may have been misunderstood. The panel adjourned in midafternoon on that date with the understanding that members of the photographic panel, assisted by either or both Drs. Petty and Coe, if necessary, would attempt to enhance further selected photographs of the President's posterior head and neck, anterior neck, and back, while Dr. Weston would represent the panel at a preliminary. review of the computer-assisted image enhancement of selected photographs and X-rays. It was further agreed that Dr. Weston would prepare a second draft of the panel's report on behalf of the entire panel, using Dr. Loguvam's earlier draft and incorporating new information and suggestions from panel members and the committee.


  14. The initial review of evidence available, listed in addenda A and B, led members of the subpanels and then the panel as a whole to offer the following suggestions for additional procedures examinations and consultations to be conducted by specialists in nonpathology disciplines with the understanding that such evidence might have significance in the panel's final observations and conclusions:

  15. 1) Photographic experts should examine the individual photographs to insure that none of them has been retouched or otherwise altered.

  16. 2) The X-rays identified as those taken of President Kennedy prior to and during the course of the autopsy, and of Governor Connally during his hospitalization, should be examined by a photographic expert and subsequently by a forensic odontologist, and a radiologist for the following purposes:

  17. 3) The X-rays of particular importance should be examined to determined the desirability of subjecting all, or portions of them to a computer-assisted image enhancement process which might make possible more definitive interpretation, particularly of fracture lines. These X-rays include: the anterior-posterior and lateral views of the skull (numbered 1, 2, and 3 on the films); those of the thoracolumbar region (7 and 11); the chest anterior-posterior view (9).; the right hemithorax, shoulder and upper arm, anterior-posterior view (8); and the left hemithorax, shoulder and upper arm, anterior-posterior view (10).

  18. 4) Those photographs considered most important should be considered for photographic enhancement. One procedure, regraphy for definition, with varying degrees of exposure, might increase contrast. computer-assisted image enhancement could be used to modify the photographs, rendering recognizable the variations in color or shade otherwise imperceptible to the human eye.

  19. These photographs include: the entrance wound in the upper back (4- by 5-inch positive color transparency No. 38. or 39 or correspondingly numbered 8- by 10-inch prints); the entrance wound at the back of the head (4 by 5-inch positive color transparency No.43 or correspondingly numbered 8- by 10-inch color prints); the exit defect on the anterior neck (4- by 5-inch positive color transparency No. 40 or 41 or correspondingly numbered 8- by 10-inch black and white positive prints No. 13 or 14); and the area of the exit defect on the skull showing a semicircular defect in the bone by 5-inch positive color transparency No. 44 or 45 or correspondingly numbered 8- by 10-inch color prints).

  20. 5) Soft X-ray and energy dispersive X-ray examination of pertinent portions of the clothing of President Kennedy and Governor Connally, particularly around the entrance and exit. wounds, should be conducted to determine if they reveal particles of metal deposited by the missile. Any particles found should then be examined by neutron activation analysis to correlate their composition With missiles suspected of having perforated the clothing in these areas.

  21. 6) The panel should interview each member of the pathology team that conducted the original autopsy:
    Drs. Humes, Finck, and Boswell, and the radiologist assisting with the examination, Dr. Ebersole. These interviews are suggested as a means of elucidating the circumstances surrounding the autopsy, the restrictions, if any, perceived by the prosecutors, and the apparent discrepancy between the findings of the panel and the original pathologists as to the location of the entrance wound of the head. The interviews would also help in evaluating more fully the entire autopsy examination and report.

  22. 7) The panel should meet with Dr. J. Lawrence Angel, a forensic anthropologist at the Smithsonian Institution, to review the X-rays and photographs of the skull and skull bones to assist it in simulating the repositioning of the skull fragments within the defect of the right side of the skull and in locating more precisely the missile exit defect indicated by the beveling on two separately recovered skull fragments. (This meeting occurred on Sept. 17, 1977.)

  23. 8) Members of the panel or the committee or both should interview the surgeons who provided emergency care to President Kennedy to determine more precisely the characteristics of the wounds as first noted on the President and to ascertain that medical information was not overlooked. It was further suggested that similar interviews be conducted with the surgeons and radiologists who provided treatment to Governor Connally in anticipation that such interviews might provide more precise and detailed information on the Governor's in juries, both external and internal, than had been documented in previous testimony or available reports.

  24. 9) The panel considered the potential value of additional ballistics tests with cadavers to simulate the wounds suffered by President Kennedy and Governor Connally, particularly because the panel determined that the entrance wound in the head was located considerably above the point described in the autopsy report, which had been used as the point of aim in previous experimental shootings. The actual, higher entrance location is on a more convex superior portion of the head, which would be an important fact to know to replicate more accurately the known injuries to the scalp and underlying skull than was accomplished in previous experiments. The panel considered experiments, using a comparable weapon, ammunition and target distance, wherein a wound or wounds would be inflicted in the upper back of cadavers, in an attempt to simulate the damage, angle and bullet track of the missile(s) which proceeded through President Kennedy and Governor Connally.

  25. The majority of the panel concurs that the difference between the effects of missiles on cadavers and living persons, the inability to duplicate completely all the factors that were present in the original shooting, and the limitations of information concerning the location of the entrance and exit wounds and the precise bullet track, would render such an experiment of limited and controversial value. While the experiment might eventually replicate the conditions of impact on the bodies of president Kennedy and Governor Connally, many attempts might have to be made before a valid replication could be obtained. To determine whether the replication was in fact valid or fortuitous would be difficult and might itself generate controversy.

  26. One panel member, Dr. Wecht, does not concur, but urges that such additional experiments be conducted, directed at the approximate wound locations, with several cadavers appropriately arranged so as to simulate the possible bullet track through the body. It is Dr. Wecht, opinion that without such tests, the single bullet theory cannot, be scientifically defended; hence, he cannot but continue to reject this conclusion of the Warren Commission.

  27. 10) The panel requested a new medical examination of Governor Connally relative to the injuries he received in 1963. The panel considered the possibility that there might still be missile fragments in the Governor. The panel also requested consideration by experts in the field of neutron activation analysis. as to any potential value of an analysis of such fragments at this date.

  28. 11) The panel members discussed the possible value of disinterring the remains of President Kennedy. All agreed that such examination could confirm the exact entrance point of the bullet that struck the back of the President's head initially a point of disagreement between the pathologists who conducted the autopsy and the panel. (Subsequently, in his public testimony, Dr. Humes agreed with the panel's conclusion as to the location and disagreed with his Warren Commission testimony and his earlier statement to the forensic pathology subpanel.) In addition, an examination of the remains would probably permit determination of both the nature and extent of the bony injury and skull defects, thus enabling, through reconstruction, a more precise determination of the location of the exit wound from the skull. Further, it might be possible to pinpoint the entrance wound in the upper back and the exit wound in the anterior neck with reference to fixed body landmarks and thus enable more precise determination of the angle of the bullet track through the thorax (back) relative to the body's axis. The majority of the panel concurs, however, that in the absence of photographic documentation of the body's precise position at the moment the missile struck the back, more accurate wound locations would be of limited value in determining the bullet's point of origin.

  29. Dr. Wecht, in disagreeing, points out that in the Zapruder film, the Stemmons Freeway sign obstructed the President from view for an interval of only approximately 0.9 second, during which Wecht assumes the shooting occurred. In his opinion, this interval was too short for there to have been sufficient movement to result in an alignment consistent with one bullet passing through both men.

  30. Neither the autopsy pathologists nor the panel, at this time, can determine the exact pathway and angle of this missile track in the President for reasons discussed subsequently in this report.

  31. 12) The panel strongly suggested that the committee undertake a vigorous effort to determine the fate. of the missing microscopic slides, paraffin blocks, tissues from which they were prepared, and brain, and make these available to the panel for review. (A search was conducted, as described in an attached staff report.)


  32. The following is the consensus of the panel as to the medical facts of this homicide, based on the evidence available, listed in addenda A and B and developed from interviews and examinations.


  33. The President sustained two wounds from behind, caused by two missiles, one entering the upper right back and exiting the anterior (front) neck, the second entering high on the back of the head, partially fragmenting in the head, add exiting from the right side, front-parietal region, of the head. Documentation of these wounds is as follows:

    Entrance (inshoot) wound of the upper back and neck

    1) Clothing--Suit jacket (back)

  34. The suit is made of a lightweight, gray fabric that resembles a tropical worsted in a sack weave. The jacket collar, back and upper sleeves are stiff and stained with a dark brown substance resembling dried blood. The sleeves are slit, as are the front panels across the nipple line; this was done to facilitate rapid removal in the Parkland emergency room.

  35. Two defects are noted in the back of the jacket. The defect caused by the missile is described in an FBI report as follows:

    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.

  36. The second defect was artificially created in the FBI laboratory to obtain a sample of material for subsequent studies. It is located just below the collar and 3.3 centimeters to the right of the midline. It measures 0.9 centimeter in vertical diameter and 0.8 centimeter in transverse diameter. This defect does not penetrate the full thickness of the coat and was identified in the testimony of Special Agent R. A. Frazier of the FBI laboratory as the site of a control cloth sample removed and analyzed by the laboratory.

  37. The panel locates the defect created by the missile at 5 centimeters (approximately 2 inches) to the right of the middle of the coat and 13.5 centimeters (5.3 inches) below the top margin of the collar and identifies it as a gunshot defect measuring 1.5 centimeters in vertical diameter and 1 centimeter in transverse diameter and passing through all layers of cloth.

  38. Correspondence from J. Edgar Hoover, Director of the FBI, to J. Lee Rankin, General Counsel, Warren Commission, characterized the posterior holes in the clothing as follows:

    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)

  39. The panel concurred that such a description of the undisturbed clothing would characterize entrance defects. No earlier reports indicated the dimensions of the defect in the coat, nor of that in the shirt. The intervening handling of the clothing prevents the panel from drawing any independent conclusions based on its own observations of the defect and surrounding fibers.
    The panel had access to the results of an earlier spectrographic analysis detailed within the above-referenced FBI report that states:

  40. The evidence bullets submitted in this case are clad with copper metal. Spectrographic examination of the fabric surrounding the holes in the back of the coat and shirt revealed minute traces of copper. (4)

    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:

  41. The hole in the shirt back is located in the same relative area, being 53/4 inches below the top of the collar and 11/3 inches to the right of the middle. (5)

  42. A second defect was created in the shirt in order to obtain control cloth for FBI spectrographic analysis, as described in the above-referenced report. This manmade defect measures 1.7 centimeters (approximately O.7 inch) in vertical diameter and 0.3 centimeter in horizontal diameter, and is located 14 centimeters below the upper collar border and 2.5 centimeters to the right of the midline of the shirt. (See fig. 3, a photograph of the missile defect in the back of the shirt. )

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

    3) Photographs

  43. The Panel examined photographs of the upper right back with the body on its left side; these included 8 inch by 10 inch black and white negatives and prints Nos. 11 and 12 and 4 inch by 5 inch positive color transparencies and prints. Nos. 38 and 39. (All photographs and X-rays were examined with and without the aid of a 10X magnifying lens.) stereoscopic visualization of paired photographs Nos. 38 and 39 revealed a slight change in the position of the camera between the two exposures. Essentially the photographs consist of a view of the right upper posterior thorax (back), with the camera in a position such that it would be approximately horizontal to the body if the body were erect, or at right angles to the skin surface and parallel to a sagittal plane of the body. Within each photograph is a centimeter ruler which overlies the midline of the back, extending approximately 2.5 centimeters above the upper wound margin and 2 centimeters below the lower wound margin, with its edge approximately 2.5 centimeters medial to the wound margin. The ruler is in the plane of focus of the wound, enabling reasonably accurate measurement of the wound, which is oval, with one end of the long axis between 2 o'clock and 3 o'clock and the opposite end between 8 o'clock and 9 o'clock. The maximum wound diameter, determined by interpolation from the photos, is 0.9 by 0.9 centimeter. The midpoint is estimated to be 13.5 centimeters below the right mastoid process , with the head and neck, as positioned within the photograph, 6 centimeters below the most prominent neck crease and 5 centimeters below the upper shoulder margin. (See fig. 4, a drawing of this wound, and fig. 5, a close-up photograph of it.)

    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.

  44. There is a sharply outlined area of red-brown to black around the wound in which there is dried, superficial denudation of the skin, representing a typical abrasion collar resulting from the bullet's scraping the margins of the skin at the moment of penetration. This is characteristic of gunshot wounds of entrance and not typical of exit wounds. This abrasion extends around the entire circumference, but, is most prominent between 1 o'clock and 7 o'clock about the defect (with the head at 12 o'clock). In addition, there are several small linear, superficial lacerations or tears of the skin extending radically from the margins of the wound at 10 ,o'clock, 198 o'clock and 1 o'clock. These measure 0.1, 0.2 and 0.1 centimeter respectively. Photographically enhanced prints of photographs Nos. 38 and 39 reveal much more sharply contrasted color determination and, to some degree, more sharply outlined detail of the abrasion collar described above.

  45. Several members of the panel believe, based on an examination of these enhancements, that when the body is repositioned in the anatomic position (not the position at the moment of shooting) the direction of the missile in the body on initial penetration was slightly upward, inasmuch as the lower margin of the skin is abraded in an upward direction. Furthermore, the wound beneath the skin appears to be tunneled from below upward.

  46. The panel concurs with the assessment that the color photographs made during the autopsy of President Kennedy are authentic, as described in correspondence of Frank Scott of the photographic evidence panel, dated June 13, 1978. (6)

    4) X-rays

  47. As is detailed in a late section, "Course of the Missile Through the Body," the X-rays demonstrate that the missile did not strike the scapula (wing bone) or ribs and did not remain in the body. This evidence, coupled with the photographs, indicates that the entrance perforation is radial to the scapula and superior to the ribs.

    5) Autopsy report

  48. The autopsy report, known technically as the autopsy protocol, submitted by Drs. James J. Humes, J. Thornton Boswell, and Pierre A. Finck, localized and characterized the wound in the right upper back:

    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.

  49. An attempt to localize this wound more accurately is further frustrated by its designation on a drawing contained within the "autopsy descriptive sheet," which was prepared during the autopsy. In this drawing (see fig. 6, a reproduction of the drawing), a small circle at the junction of the upper one-third and lower two-thirds of the right posterior back is characterized with the legend "7 millimeters by 4 millimeters 14 centimeters from the rt. [right] acromion plus 14 centimeters below tip of rt. [right] mastoid process."(8)

    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)

  50. Examination of the shirt reveals a slit-like defect in the upper left front portion, 1.4 centimeters below the topmost buttonhole. This defect measures 1.4 centimeters in length, with its long axis parallel to the long axis of the body. There is a corresponding slit-like defect 1.5 centimeters below the center of the button on the right. This defect measures 1.5 centimeters in length and is also parallel to the long axis of the body (See fig. 3, a photograph of the shirt.)

    2) Clothing--Necktie

  51. Examination of the necktie in the normal knotted position reveals a linear defect along the left lateral margin of the knot. This defect measures 0.7 by 0.4 centimeter and involves only the outer facing of the tie. The lining is not altered.

  52. These clothing changes were characterized in initial examination by the FBI laboratory:

    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.

  53. In the correspondence from Hoover to Rankin. referred to earlier; Hoover further characterized the defect in the shirt:

    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)

  54. While the FBI laboratory's initial description did not offer evidence concerning the direction of the fibers, the observations in this letter were substantive evidence of the direction of the penetration. provided that the position of the threads had not changed in the interim. As stated previously, the panel itself cannot assess evidentiary significance to the fiber direction because of the numerous intervening examinations.

  55. Careful attention was paid to the possible presence of any contaminant visible at the margins of any of these defects. The panel suggested examination of appropriate portions of the clothing of the President and the Governor by soft X-ray and energy dispersive X-ray( ) and, if warranted thereafter, by neutron activation analysis. The first two types of nondestructive examinations were concluded, but there was insufficient metal present for neutron activation analysis. (The report of the tests is contained in addendum F.)

  56. The tests were undertaken to:

    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)

  57. The soft X-ray examination revealed the presence of some very tiny particles of foreign material in the back of the shirt at the margins of the defect, but no copper or lead was found by energy dispersive X-ray analysis. The energy dispersive X-ray analysis yielded a borderline count for copper in the area of the back defect on the President's jacket and in the area of the right front defect on his shirt. Iron, apparently from the bloodstain, was detected about the defect in the jacket.

  58. The panel considers that at this time the appearance of the upper hack skin wound, particularly its abrasion collar, is more significant in determining the direction of the missile's passage than examination of the clothing. The limited amount of foreign material demonstrated by soft X-ray and energy dispersive X-ray analysis was considered insufficient for further characterization by neutron activation analysis by Vincent P. Guinn, Ph.D., of the University of California at Irvine, the committee's consultant in this area. The panel agrees that slit-like defects in clothing are common and typical at missile exit sites.

    3) Photographs

  59. The panel examined photographs of the President's face, neck. and upper torso taken from above and to the right which reveal the
    scalp lacerations in the right frontal and temporal regions and a tracheotomy incision in the neck. The photographs included: Black and white 8-by 10-inch prints No. 13 and 14; 4- by 5-inch positive color transparencies and prints Nos. 40 and 41; and correspondingly numbered 8- by 10-inch color prints. There is no ruler in the
    so measurements are approximate. The maximum transverse diameter of the incision in the neck is approximately 5 centimeters, while the maximum vertical diameter is approximately 1.5 to 2 centimeters; it is approximately 4 centimeters below the shoulder line and 3 centimeters above the suprasternal notch. (See fig. 8, a drawing of the tracheotomy incision and fig. 9, a close-up photograph of the tracheotomy incision.)

    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.

  60. There is a semicircular missile defect near the center of the lower margin or the tracheotomy incision, approximately in the midline of the neck, with margins which are slightly denuded and reddish-brown.

  61. Although the black and white prints are more sharply focused than the color photographs, none are clear. Figure 19 shows the wound approximately in the midline of the anterior neck. The panel suggested photographic or computer-assisted enhancement of either one or both of black and white photographs Nos. 13 and 14, inasmuch as they were in sharper focus and the results might better delineate the margins of the exit defect in the anterior neck which was not properly identified and documented at the time of autopsy.


  62. As is detailed in a later section ("Course of the Missile Through the Body"), the X-rays indicate that the missile track proceeds toward the midline of the body. This analysis is based on the fracture ,of the transverse process of T-I and the air in the soft tissues, which probably resulted from the laceration of the trachea. The air could have been caused by either a bullet laceration of the trachea or the surgeon's tracheotomy. The X-rays show that no missile is present and therefore that the bullet exited the body without causing any fracture other than of the later transverse process.

    5) Autopsy Report

  63. The autopsy report characterized the anterior neck wound as:

    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)

  64. This wound is further depicted in the Autopsy Descriptive Sheet, in which the anterior view, showing a semicircular line with its convex border pointing inferiorly below the lower crease of the neck, bears the legend "6.5 centimeter." (See fig. 6.) It is conspicuously unclear from the autopsy report alone that during autopsy, the pathologists were unaware and failed to recognize that there was a missile perforation in the anterior neck. This may account for the fact that the neck, trachea, strap muscles, and spine were not dissected and examined.

    6) Statements of the surgeons

  65. Dr. Perry testified before the Warren Commission that:

    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)

  66. Dr. Perry declined to express an opinion to the Warren Commission on the origin of the missiles that caused the damage. He explained:

    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)

  67. Dr. C. James Carrico characterized the wound in the anterior neck as: "One small penetrating wound of the ant,. (anterior) neck in lower third."(18) Dr. Carrico further characterized this wound in a Select Committee staff interview:

    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)

  68. The panel considered the appearance of the wound in the anterior neck as initially described and subsequently altered. It is of the opinion that such a wound, uniformly regular in shape and small in size, might be anticipated from an intermediate or even high velocity missile if the tissues through which the missile exited were shored, buttressed or otherwise reinforced by clothing or other external objects that would minimize the outward displacement of the skin and underlying superficial tissue and consequent tearing and distortion of these tissues. The similarity between entrance and shored exit wounds may extend to the production of clothing abrasion patterns, that is, the imprint of the fabric of the clothing on the skin, because the missile, prior to exiting through the skin, forces the skin against the overlying restraining clothing.

  69. The panel members agree that the fabric of the shirt and tie and their anatomic relationship to the underlying missile wound might have served as sufficient reinforcement to diminish distortion of the skin. Several panel members are also of the opinion that an unshored exit wound of a missile of comparable size and velocity might be similar if the missile were not misshapen by striking a substantial bone within the body. The panel believes that it would be reasonable for a surgeon not to appreciate or even consider the significance of the clothing in terms of the wound shape produced, especially if the clothing had been removed prior to his initial examination, as was described within the above-referenced exhibits and interviews. The panel further notes that the shoring or buttressing effect of the wound by the clothing might. serve to seal the defect in the President's trachea if he rotated his head, thus permitting him to speak after this wound was inflicted.

    Course of the missile through the body

    1) Photographs

  70. There is no photographic evidence available that shows any of the internal injuries described by the pathologists within the trunk of the body. Dr. Humes recalled directing that a single photograph of the upper interior aspect of the right thoracic (chest) cavity be taken to illustrate the hemorrhage just exterior to the pleura (lining) of this cavity, adjacent to the missile track(21). There is, however, no such photograph among those in the collection, although there is one by 5 inch positive color transparency on which there is no image.

    2) X-rays.

  71. The panel examined X-rays of the anterior-posterior view of the thoracicolumbar region (No. 7); the anterior-posterior view of the right neck, thorax (chest) and upper arm (No. 8); the anterior-posterior view of the chest (No. 9) ;the anterior-posterior view of the left neck, thorax (chest) and upper arm (No. 10); and the anterior-posterior view of the thoracicolumbar region (No. 11).
    X-ray No. 9 had been taken before the start of the autopsy; X-rays (Nos. 7, 8, 10, 11, and 14) were taken after removal of the internal organs. (See addendum J for a statement regarding the authenticity and description of the X-rays.)

  72. The panel noted a general haziness and poorly defined decrease in radiodensity in the neck tissues just above the right chest cavity in films 8 and 9, and attributed this to interstitial emphysema. This was probably related to the surgical tracheotomy or missile injury to the trachea, followed by positive pressure insufflation , with a slight escape of air into the adjacent tissues. Continued breathing by the President, possible even after the trachea had been perforated by the missile because the overlying defect was more or less sealed by the shirt and necktie, could also have caused air to leak into the adjacent soft tissues.

  73. The panel noted a number of small, radiopaque densities apparent in the No. 8 film and not apparent in No. 9. With one exception, these densities measured less than 0.1 centimeter in diameter and appeared to be more densely aggregated in the area immediately lateral to the right transverse processes of the seventh cervical (C-7) and first thoracic vertebrae (T-1). The panel took special note of a slightly larger shadow immediately lateral to the right transverse process of the seventh cervical vertebra. (See figs. 10 and 11, photographs of X-rays 8 and 9.)

    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.

  74. The forensic pathology panel requested that consultant radiologists review these opacities. Dr. G. M. McDonnel of Los Angeles indicated that the smaller shadows were randomly distributed on the X-rays in other locations far removed from this portion of the body. They were found even in films that did not overlie the trunk itself, such as in X-ray film No. 13 of the President's pelvis and upper thighs. Dr. McDonnel, who had served as an X-ray consultant to the coroner/ medical examiner in Los Angeles and had had experience in such analysis, interpreted the shadows as artifacts not uncommonly caused by foreign materials on the film or in the developing solutions.

  75. Dr. McDonnel further noted that the larger shadow was not present in the initial films of the thorax (film No. 9), but only in subsequent films taken after removal of the thoracic organs, suggesting again that this shadow was an artifact. Dr. McDonnel's complete report, which also authenticates the X-rays by comparison with films taken while the President was living, is contained in a letter dated August 4, 1978, addressed to the select committee, and is incorporated in its entirety into this report as addendum C.

  76. The panel noted an interruption in the continuity of the right transverse process of the 1st thoracic vertebra, much more clearly delineated in the computer-assisted enhancement of film No. 8. Dr. David O. Davis, M.D., professor and chairman of the department of radiology at the George. Washington University Hospital and Medical School, Washington, D.C., also observed these same findings, both on the original X-ray films and on the computer-assisted enhancement of these films. Dr. Davis' complete report is contained in a memorandum to the committee dated August 23, 1978. (This letter, in its entirety, is incorporated in this report as addendum D.)

  77. Increased radiolucency, most probably caused by the interstitial emphysema noted earlier, rendered it virtually impossible to ascertain whether or not there was a similar fracture of the right transverse process of the seventh cervical vertebra. Norman Chase, M.D., professor and chairman of the department of radiology of New York University School of Medicine--Bellevue Hospital Medical Center, also examined the X-rays and their computers-assisted enhancements on Feb. 27, 1978. He noted the presence of a metal fragment or artifact in the area of the transverse process that. was definitely not a bone fragment. He observed air in the subcutaneous tissue in the same region, which he concluded was caused by the passage of a missile or air or both entering the region due to the tracheotomy incision. He said the 1 by 2.5 millimeter object was too small and dense to be bone; rather, the little trail of dots near the fragment was indicative of artifacts. Dr. Chase said that if a fracture was present in T-l, it was peculiar in that there was no displacement of the bone. He suggested that enhancement of X-ray No. 9 might provide additional information.

  78. William B. Seaman, M.D., professor and chairman of radiology of Columbia Presbyterian Hospital and Physicians and Surgeons Medical School in New York City, also examined the X-rays:

    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

  79. The autopsy report characterized the internal injuries and missile path:

    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)

  80. See figure 12, a drawing of these anatomic structures, injuries to them, and possible trajectories on the position of the body.

    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.

  81. Further evidence of internal injury in the thorax is reflected the autopsy pathologists' description of the lungs:

    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)

  82. The autopsy report makes no reference to any defect in the trachea, although this was described by the attending surgeons. Of particular interest relative to the location of the missile wound in the right neck is the description of the thoracic cavity within the report:

    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)

  83. Again, had the wound of entrance been below the uppermost extension of the right lung, this lung would have collapsed and blood would have been present within the cavity.

  84. Correspondence of Dr. Finck, dated February 1, 1965, and addressed to Brig. Gen. J.M. Blumberg, contained these observations concerning the pathway of the missile in the neck:

    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)

  85. The summary in the autopsy report includes additional reference to the pathway of this missile:

    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)

  86. The autopsy report makes no further reference to the wound in the front of the neck.

    4) Interviews with the surgeons

  87. In his interview with the committee, Dr. Petty described a laceration on the right lateral side of the trachea. He did not recall precisely how he initially characterized it, but in his interview said, "it was on the right side of the trachea it was incomplete ." Further,

    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)

  88. Dr. Perry's interview was also of interest relative to the possibility of the wound being low enough to have penetrated the right thoracic cavity. He said that he had placed a chest tube in the right thoracic cavity. Specifically:

    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)

  89. He later explained that he did not become aware that the chest cavity had not been violated until he reviewed the autopsy report. (292) Dr. Perry further indicated in this interview that there was "essentially very little bleeding." (30) Asked if he believed that a major arterial injury had been inflicted, particularly to the adjacent common carotid artery, he said that:

    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)

  90. Description of the autopsy procedure makes no reference to removal or dissection of the neck organs nor of examination of the arteries of the neck. Dr. Finck testified on February 24, 1969:

    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.

  91. When asked, "But you were told not to go into the area of the neck, is that your testimony.?", his answer was, "From what I recall, yes, but I don't remember by whom." Queried further, "Did you attempt to probe this wound in the back of the neck?", his answer was "I did" Counsel, on learning of his difficulty in attempting to probe the missile pathway, asked: "Isn't this good enough reason to you as a pathologist to go further and dissect this area in an attempt to ascertain whether or not there is a passageway here as a result of a bullet?" Dr. Finck's answer was, "I did not consider a dissection of the path."(32)

    Entrance (inshoot) wound of the back of the head

    1) Clothing

  92. The bullet perforated no clothing prior to its penetration into the skin of the posterior scalp.

    2) Photographs

  93. The panel examined photographs of the back of the head, including: Black and white negatives and prints Nos. 15 and 16; color transparencies Nos. 42 and 43; and correspondingly numbered color prints of the back of the head. These were studied with both the naked eye and 10X magnification. The photographs again all appear to have been taken from approximately the same position, and stereoscopic visualization of the two 4 by 5 inch color transparencies enables three dimensional perception. In the center of the photographs is a vertical centimeter ruler, which, by stereoscopic visualization, is demonstrated to be slightly closer to the camera than the adjacent skin surface. The upper portion of the ruler, which is in sharpest focus, is adjacent to a slightly oval scalp defect located in the "cowlick" area of the scalp just above or superior to a line drawn between the superior or upper margins of the area. (See fig. 13, a drawing of the back of the President's head.) This defect is partially covered by hair and dried blood. This wound is located considerably above the occipital protuberance, slightly to the right of the midline, and approximately 13 centimeters above the most prominent neck crease. It has a maximum vertical diameter in the photograph of approximately 1.5 to 2 centimeters, and maximum transverse diameter of approximately 0.9 centimeter.

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

  94. Accurate reconstruction of the exact dimensions of the wound is difficult because the ruler and wound are in different planes of focus. The long axis of the wound more closely approximates a vertical angle than that depicted within the "Autopsy Descriptive Sheet? (See fig. 6.) The inferior margin of this wound, from 3 to 10 o'clock, is surrounded by a crescent-shaped reddish-black area of denudation, again presenting the appearance of an abrasion collar, resulting from the rubbing of the skin by the bullet at the time of penetration. From 12 to 3 o'clock, there is a suggestion of undermining, that is, tunneling of the tissue between the skin surface and the skull. Three small linear lacerations or tears of the skin, measuring less than 0.2 centimeter, in length, extend radially from the margins of the defect at 11 o'clock, 12 o'clock, and 3 o'clock. (See fig. 14:, a close-up photograph of this wound.)

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

  95. An irregular, somewhat rectangular white object is also seen in these photographs, near the lower margin at the scalp hair at a point which most of the panel considers to be consistent with a localization slightly to the right of, and most likely below, the occipital protuberance. The panel agrees that the object is dried brain tissue.

  96. Examination of the enhanced photographs prepared from the by 5 inch color transparency of the photograph of the back of the head (print No. 4g) reveals more sharply contrasted detail of the wound described in the upper occipital region and the dried brain tissue in the lower occipital region. stereoscopic visualization of this fragment indicates that it is adherent to and on the surface of the hair. computer-assisted image enhancement of this photograph reveals a dark oval shadow within the margins of the scalp perforation in the cowlick area which may be the perforation of the underlying skull. The hole in the scalp lines up with the hole in the skull. The X-rays also locate the skull defect at this point.

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

  97. Examination of the dried brain tissue in the lower occipital region by computer-assisted image enhancement also c]early demonstrates that it is on the surface of the hair. Such enhancement further provides some three-dimensional characterization. (See fig. 15, a close-up photograph of the dried brain tissue.) All members of the panel agree that the upper scalp wound, the location of which is identified by X-rays as approximately 10 centimeters (as measured on the X-ray) above the external occipital protuberance, is a typical entrance wound. All concur in its striking similarity to the entrance wound in the upper back. All agree that the white material is a piece of brain tissue and that it has no relationship to the location of the entrance wound, despite the interpretations of the autopsy pathologists in their Warren Commission testimony and interviews.

  98. stereoscopic visualization of the inside of the cranial cavity at its depth, after removal of the brain, reveals a semicircular beveled defect of the inner table in the posterior parietal area to the right of the midline, from which fracture lines radiate corresponding to the entrance perforation indicated in the skull X-rays.

    3) X-rays

  99. Skull X-ray No. 2, a lateral view of the head, reveals rather marked disruption of the smooth contour of the skull on the right side in the. temporal-parietal region, with multiple fractures through other portions of the skull. There is sharp disruption of the normal smooth contour of the skull 10 centimeters (as measured in the X-ray) above the external occipital protuberance, with suggested beveling of the inner table and with fracture lines radiating superiorly and inferiorly. (See fig. 16, showing the beveling process.) At this point there is an irregular, radiopaque, sharply outlined bullet fragment. The skull defect, apart from its location, corresponds with the description within the autopsy report, in which it characterized as follows:

    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.

  100. The location of the missile fragment and transverse fractures of the occipital region of the skull is also apparent in the anterior posterior X-ray view of the skull (No. 1). It shows the missile fragment to be slightly to the right of the midline and in approximately the same vertical plane as in the above-described lateral view. (See figs. 17 and 18, photographs of X-rays Nos. 1 and 2 respectively.)

    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.

  101. Computer-assisted image enhancement of this film more sharply delineates the fracture lines and bone fragments, as well as the missile fragment in the occipital region. The defect in the skull and the inward beveling thereof provide definite evidence of an entrance wound of the head at a point corresponding to that noted by the panel in the upper back of the scalp, rather than "slightly above" the external occipital protuberance as indicated in the autopsy report, or in the lower part of the head near the hairline, as stated by the autopsy pathologists in their interviews with the panel. (See figs. 19 and 20, and computer-assisted enhancements of X-rays 1 and 2 respectively. See also fig. 21, a photograph of a premortem X-ray of the skull of the President, against which :to compare the damage shown in autopsy X-rays Nos. 1 and 2.)

    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

  102. The autopsy report localizes and characterizes the posterior head wound as follows:

    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.

  103. Dr. Finck, in his correspondence to Brigadier General Blumberg, made this observation concerning the entrance wound:

    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.

  104. The panel was concerned about the apparent disparity between the localization of the wound in the photographs and X-rays and in the autopsy report, and sought to clarify this discrepancy by interviewing the three pathologists, Drs. Humes, Boswell, and Finck, and the radiologist, Dr. Ebersole. Each was asked individually to localize the wound of entrance within any one of several of the above-referenced photographs after reviewing the photographs, X-rays and autopsy report. In each instance, they identified the approximate location of the entrance wound on a human skull and within the photographs being in a position perceived by the panel to be below that described in the autopsy report. (See figs. 22 and 23, photographs of a human skull.) They also said it coincided with the rectangular white material interpreted by the panel as brain tissue present on top of the hair near the hairline. Each physician persisted in this localization, notwithstanding the apparent discrepancy between that localization and the wound characterized by the panel members as a typical entrance wound in the more superior "cowlick" area.

    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.)

  105. Drs. Ebersole, Finck, and Boswell offered no explanation for the upper wound, while Dr. Humes first suggested that it might represent an extension of a more anterior scalp laceration, incident to the exit wound, in spite of the fact that within the photograph the margins of the wound appear to be intact around the entire circumference. Dr. Finck believed strongly that the observations of the autopsy pathologist were more valid than those of individuals who might subsequently examine photographs.

  106. The panel continued to be concerned about the persistent disparity between its findings and those of the autopsy pathologists and the rigid tenacity with which the prosecutors maintained that the entrance wound was at or near the external occipital protuberance. Subsequently, however, in his testimony before the select committee, Dr. Humes agreed that the defect was in fact in the "cowlick" area and not in the area of the brain tissue.

  107. The photographs of the brain, described later, also support the panel's conclusions.

  108. One panel member, Dr. Rose, wishes to emphasize the view of the majority of the panel (all except Dr. Wecht) that the absence of injury on the inferior surface of the brain offers incontrovertible evidence that the wound in the President's head is not in the location described in the autopsy report.

  109. All members of the panel except Dr. Wecht concur that there one and only one wound of entrance in the head and that it is located in the "cowlick" area of the back of the head, and that the white substance referred to by the original prosecutors is a fragment of brain tissue. Dr. Wecht agrees that there is an entrance wound in the "cowlick" area and that the white substance is brain tissue, but he cannot exclude the possibility that it might overlie a very small skin and bone perforation of either entrance or exit. (See fig. 13, a drawing of the back of the President's head, with the wound as previously identified by the panel. It shows the adherent white brain tissue and the localization of the entrance wound as described within the body of the pathologists' autopsy report and during recent interviews. See also fig. 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.)

    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

  110. The panel examined photographs of the face and head of President Kennedy, taken from the front and to the right including black and white prints No. 5 and 6 and color transparencies and prints Nos. 26, 27, and 28. These reveal a series of lacerations, described within the autopsy report as extending from an area in the right parietal region, anteriorly to the right frontal region, to a point 1 to 2 centimeters below the hairline; inferiorly and to the right, almost to the upper border of the tragus of the ear; and posteriorly toward the occipital region and to the left across the midline. There is a large skin flap in the right frontal region anteriorly and laterally, with two fragments an anterior compound fracture of the calvarium of the skull deflected outward and toward the right ear.

  111. The photographs also show brain substance within the margins of the skin and skull defect, similar to the white material adherent to the hair in the right occipital-parietal region described above.

  112. The panel also examined photographs taken from a position superior to the midportion of the President's head, including black and white prints Nos. 7, 8, 9, and 10 and color transparencies prints Nos. 32, 33, 34, 35, 36, and 37. These reveal many of the features described in the preceding series of photos, including brain substance in the right temporo-parietal region. A fragment of bone extends from the right fronto-temporal region.

  113. Black and white photograph No. 17 and color transparency and print No. 44 are closeups of the margins of the fracture line the right frontoparietal region after reflection of the scalp. On the margins of this fracture line is a semicircular defect which appears to be beveled outward, although the photograph is not in sharp focus. computer-assisted image enhancement of this photograph revealed the defect more clearly. (See fig. 25, a closeup photograph of the semicircular exit defect on the margin of the fracture line in the right parietal region.

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

  114. Anthropologist Dr. Angel's evaluation of the "Harper bone fragment" (see below) indicates that it may include, a portion of the sagittal suture which is probably in apposition (corresponds) to this exit defect.

    2) X-rays

  115. Left and right lateral skull X-rays Nos. 2 and 3, partly described above, when subjected to computer-assisted image enhancement, more clearly revealed the extent of the fractures of the temporo-parietal region and their extensions into the frontal and occipital portions of the skull bilaterally. The displacement of the residual fracture fragments in the right temporo-parietal region, with consequent overriding of several margins of the residual bony defect. is also apparent. (See fig. 20.)

  116. Three additional X-rays, Nos. 4, 5, and 6, show three irregularly shaped pieces of skull recovered from within the President's limousine. The largest piece is almost triangular, with a serrated, or zigzag, edge on the longest straight margin, which the panel interprets as to be a portion of the right coronal suture. This edge meets a much sharper straight edge which represents an obvious fracture margin. At the junction of these two margins is a semicircular defect, described in the autopsy report as showing outward beveling, with small particles of radiopaque materials. These the panel considers to be missile fragments. (See fig. 26, an X-ray of the three bone fragments.)

    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

  117. The autopsy report characterized the exit defect as follows:

    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)

  118. This description does little except locate the general area of convergence of the scalp lacerations. It is probably misleading in the sense that it describes "an actual absence of scalp and bone." The scalp was probably virtually all present, but torn and displaced; probably only the separately recovered bone fragments (described below) were absent. The description of the bone fails to recognize either the semicircular defect or any beveling in the bone fragments still attached to the head.

  119. The note prepared by Dr. Finck for presentation to Brigadier General Blumberg, dated February 1, 1965, states, with respect to the exit wound:

    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"

  120. The "Harper bone fragment" is a fragment of bone found near the scene of the assassination at 5:30 p.m. on November 23, 1963, by Billy A. Harper, then a premedical student. He was taking photographs of the assassination scene and, on finding the fragment, took it to his uncle, Jack C. Harper, M.D., who, in cooperation with A.B. Cairns, M.D., chief athologist at the Methodist Hospital in Dallas. had photographs taken on November 25, 1963, by M. Wayne Balleter. chief medical photographer at that hospital. Two 35 millimeter color transparencies of the convex and concave surfaces of the fragment, with an inch ruler in place, were picked up from Mrs. Jack C. Harper on July 10, 1964, by Special Agent Robert P. Gemberling of the FBI. The panel examined both these photographs and 8- by 10-inch black and white and color prints prepared from them.

  121. J. Lawrence Angel, in a written memorandum addressed to the panel, dated October 24, 1977, characterized this fragment as follows (see addendum E for full text):

    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

  122. Paper cutouts were prepared to approximate the shape and size of the bone fragments demonstrated in X-rays Nos. 4, 5, and 6 and the photograph of the "Harper bone fragment." The panel attempted to locate the correct position of these fragments and them using the paper cutouts, to place these bone fragments on a human skull for the purposes of reconstruction. The largest of the X-ray fragments-that on which outer beveling and tiny metal fragments are evident--completes a portion of the exit perforation, with the suture line fitting into the coronal suture; the Harper bone fragment completes the circular perforation in the suture line immediately superior to the temporal bone. No other exit or entrance perforation is identified. (See fig. 29, a scale drawing of the frontal and right, side of a human skull, which shows the displaced bone fragments and the extensive fragmentation of the skull.) The sagittal suture follows the midline in the anterior-posterior direction, and is joined at approximately right angles by the coronal suture in front, which extends downward to the right and left sides, approximately midway between the outside margin of the orbit. and the outer ear canal. (See also fig. 30, another scale drawing, showing the path of the bullet through the head, and fig. 31, a drawing of a profile view of President Kennedy, showing the internal anatomic structure and the location of the entrance and exit wounds to the head (the entrance wound is only partially visible).

    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).

  123. The size of the exit defect is most accurately estimated from the X-rays of the largest separately received bone fragment, in which a segment of the circumference of the defect is demonstrated at one corner. Geometrically, by drawing a chord segment between the two extremities of this portion of the circumference and reconstructing a perpendicular radius, the central extremity of which is equidistant from all portions of this curve, the diameter of the defect is estimated to be 2.5 centimeters. This is consistent with the size of the defect as seen in the photographs, but cannot be determined more precisely because no ruler was present in the same plane.

  124. According to Dr. Angel's report:

    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.

  125. The panel considered and rejected the possibility that if there were a residual defect, it might conceivably have been the location for an additional entrance wound. It did so because there was no radiographic evidence of such a missile within the skull, nor any observation or description of the effects of such a missile either on the skin, on the skull bones or within the brain.

  126. One panel member, Dr. Wecht, suggests there is a remote possibility that a "soft-nosed" or frangible bullet could have struck the right side of the President's head in the exit defect leaving no visible evidence of a separate entrance wound. Further, according to Dr. Wecht in his dissent (which follows this report):

    [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)

  127. All other members of the panel believe that such speculation about the timing and placement of separate wounds is without merit, and, further, they know of no soft-nosed or frangible missile that would disintegrate so completely on striking a surface as soft as the brain. There is no evidence of any such disintegration in the X-rays.

    Course of the missile through the head

    1) Photographs

  128. The panel examined photographs (including Nos. 17, 18, 44, and 45) they were taken from the front right side of the body, with the scalp reflected down and away from the fractured skull bones and with the brain removed. The lens was focused on the interior-posterior deepest portion of the wound, apparently in an attempt to depict the interior of the bullet perforation of the posterior region of the skull. In the photograph prepared from color transparency No. 45, the exterior bone fragment with the semicircular defect is more in focus than the base of the skull in the depth of the picture which is out of focus. In the photographs prepared from positive color transparency No. 45, the exterior fragment is out of focus but the depth of the photograph is in sharper focus. The photographs, also studied using the computer-assisted enhancement technique, show a possible portion of the beveled inner table corresponding to the semicircular margin of the entrance wound at the back of the head in the right posterior parietal bone. Color transparencies and prints Nos. 46,47, 48, and 49 and black and white prints Nos. 19, 21, and 22 reveal the inferior aspect of the brain, with extensive fragmentation and laceration of the right inferior cerebral hemisphere, some loss of cerebral substance on the inferior surface of the left temporal lobe, and scattered areas of subarachnoid hemorrhage in the underlying cortex The right sylvian fissure shows dark red-brown to black discoloration suggestive of blood clot. The surface of the midtemporal region is lacerated and depressed. The cerebral peduncles( ) are likewise lacerated. The panel notes that the posterior-inferior portion of the cerebellum virtually intact. It certainly does not demonstrate the degree of laceration, fragmentation, or contusion (as appears subsequently on the superior aspect of the brain) that would be expected in this location if the bullet wound of entrance were as described in the autopsy report. There is no damage in the area of the brain corresponding to the piece of brain tissue on the hair which the autopsy pathologists told the panel was the entrance wound.

  129. The panel examined the photographs of the superior aspect of the brain, including color transparencies and prints No. 50, No. 51 and No. 52 and black and white prints No. 20, No. 23, No. 24 and No. 25. The left cerebral hemisphere is covered by intact arachnoid beneath which dark brown to black subarachnoid hemorrhage is most prominent over the frontal and parietal gyri and within the adjacent sulci. On the right cerebral hemisphere is an anterior-posterior cylindrical groove in which the brain substance is fragmented or absent. This groove extends from the back of the brain to the right frontal area of the brain and contains within the depths of its central portion a greybrown rectangular area. The majority of the panel considers this to be a blood vessel in the sylvian fissure.

  130. The majority of the panel members agrees that examination of the brain itself even now would substantiate this opinion. One member, Dr. Wecht, can justify no such opinion without first examining the brain itself.

  131. Laceration of the corpus callosum within the deep margins of the wound of the right cortex is also evident (see fig. 32, a drawing of the superior surface of the brain).

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

    2) X-rays

  132. The panel examined X-ray films of the anterior-posterior view of the skull (No. 1) and left (No. 2), and right (No. 3) lateral views of the skull with the naked eye and with 10 x magnification. Film No. reveals the defect referred to above in the posterior parietal region. in it location corresponding to the previously described skin defect in the "cowlick" area of the scalp. Embedded in the skull in the lower margin of this defect is a radiopaque shadow which, in the opinion of the panel, is a fragment of the missile. This shadow is 10 centimeters above the external occipital protuberance and 2.5 centimeters to the right of the midline in this film. One surface of this fragment, visualized in film No. 1, is round. The maximum diameter of the fragment measures 0.65 centimeter.

  133. Within the right side of the head are randomly distributed, irregularly shaped, radiopaque shadows which are missile fragments. These shadows, measuring from 0.2 to 0.6 centimeter in diameter, extend from the back to the front; the largest one is present beneath the skin in front. Another group of smaller,, more uniform, shadows, 0.1 centimeter less in diameter, so-called missile dust, forms a cylindrical pattern, with the axis directed anterior-posterior, approximately paralleling the sagittal plane, and extending toward the large bony defect in the right temporal-parietal region on the right side of the head. The long axis of this grouping, if extended backward, approaches the entrance defect and missile fragment in the right side of the back of the head.

  134. The panel considered the location and grouping of the smaller missile fragments seen in films Nos. 2 and 3 and suggests that the extensive fragmentation and disruption of the skull bones, and the movement of the body after death, could have caused movement of the missile fragments in movable portions of skin, bone, and brain. The panel also noted the absence of any metal fragment within the left cerebral hemisphere, as demonstrated in film No. 1, although a number of extensive fractures involving the upper portion and base of the right skull extend across the midline.

  135. The panel also noted several artificially caused defects on these films. Two round, puckered areas on film No. 1 were apparently due to examination under a high intensity light that was too close. Dr. Ebersole advised the panel that he placed the converging pencil lines on film No. 2 after the autopsy, pursuant to an official White House, request to obtain certain anthropometric measurements for a sculptor. None of these defects interfered with accurate interpretation of these films.

  136. In March 1978, Dr. McDonnel of Los Angeles, examined the skull films for the panel and reported:

    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)

  137. Dr. McDonnel further examined these films using computer assisted enhancements of the anterior-posterior (fig. 19) and left lateral (fig. 20) views and submitted a more detailed report on August 4, 1978. Such separation of the galea from the outer skull bones often occurs as a result of the dislocation of adjacent bone fragments and is seen in an explosive-type injury to the skull. The location of the metallic fragment inside the galea , medial to the defect in the skull representing the initial penetration, suggests that this separation commenced on initial impact, allowing the tiny above-described missile fragment to be displaced medially within this space created by explosion (between the skull and its overlying galea). Dr. McDonnel also indicted that such dislocation of this and other missile fragments might have occurred as a consequence of manipulation of the head prior to, during or following transit, but prior to the X-ray examination of the skull, although such medial dislocation would not be expected as a consequence of gravity alone.

  138. Dr. Chase, during his examination, noted the presence of extensive comminuted fractures of the calvarium. He said that the extensive damage apparent from the X-ray precluded interpretation of exactly what happened to the top of the skull, based on radiographic examination alone. He indicated that he saw no evidence of any posterior missile perforation apart from one in the posterior parietal area. Stated more explicitly, there was no perforation in the area of the external occipital protuberance. He further indicated that the degree of damage to the skull and the fact that there was "little residual material" (relatively small amount of bullet fragments present) led him to believe that the missile was jacketed. He said further that there was no evidence in the X-rays of a shot coming from the front or of more than one bullet striking the skull. Dr. Chase indicated that for there to be a second entrance perforation, there would have to be another exit point in the skull or a bullet that was left behind, neither of which is present.

  139. Dr. Davis described the entrance wound visible in the X-rays as follows:

    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)

  140. The panel understands the vertical distance mentioned above to mean 9 or 10 centimeters above the horizontal plane through the external occipital protuberance.

    3) Autopsy report

  141. The autopsy report describes the track of the missile through the head as follows:

    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)

  142. The panel acknowledges the difficulty of and necessity for describing the fractures and suggests that the autopsy examination at the very least should have noted evidence in the skull and scalp that would assist in localizing the exit wound. An appropriate examination would have included replacement of the bone fragments in approximate anatomic position and then description of the missile track from the entrance to the exit wound.

  143. The autopsy report states that: "The brain is removed and preserved for further study following formalin fixation." (45) The brain, which had been fixed in formalin, the chemical preservative normally used to prevent deterioration, was further examined. The results are described in the "Supplementary Report of Autopsy No. A63-272, President John F. Kennedy" (Commission Exhibit No. 391). This document observes:

    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)

  144. The panel notes that the brain was not coronally sectioned, a standard pathological practice which permits examination of the inside of the brain. Rather, as evidenced in the autopsy report, supplemental report and Dr. Humes' testimony before the Warren Commission,(47) the brain was preserved intact without a complete examination. Only very limited microscopic sections were taken. The panel stresses that coronal sectioning is the most acceptable and accurate method of determining precisely the effects of a missile on the brain, as well as the angle of a bullet track in the head. The failure to section the brain also precluded collection of interior samples for microscopic study.

  145. The panel members do not concur with the rationale for having limited the examination in this way. The brain should have been scientifically examined, with sectioning and description of the interior injuries. Only those portions necessary to document the findings need have been retained as evidence for potential court proceedings or for other purposes.

  146. The autopsy report lists the outer brain areas from which sections were taken for microscopic examination:

  147. These sections are described as follows:

    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)

  148. The summary within the autopsy report contains this statement concerning the missile pathway:

    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)

  149. The summary concludes:

    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.

  150. The panel concurs with this opinion.

  151. Dr. Finck, in his personal note to Brigadier General Blumberg dated February 1, 1965, added this additional information on the observation of the head wound:

    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

  152. With the exception of Dr. Wecht, as noted earlier, the panel, having viewed all of the photographs, X-rays and other documentary information concerning the autopsy on President Kennedy, concurs that there is evidence of two, and only two, gunshot wounds, and that they both entered from behind. The panel notes that the autopsy pathologist did not know that the tracheotomy incision had been made through a bullet wound in the front of the neck until sometime after the autopsy and removal of the body from Bethesda Naval Hospital. They did indicate the other wounds on the body which resulted from surgical treatment. These were recorded in the autopsy report prepared by Drs. Humes, Finck and Boswell as follows:

    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)

  153. The panel also took note of a summary of the findings, prepared by the three original pathologists, at the time of their review of the photographs and X-rays on November 1, 1966, and signed on January 26, 1967. The following is from that document:

    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)

  154. The panel concurs with these observations.

    2) Examination of the Abdominal Organs

  155. The panel took note of the observations recorded within the autopsy report prepared by the three pathologists in which the gross description is limited to the following statement:

    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)

  156. Microscopic examination of the abdominal organs was limited to the liver, spleen, and kidneys, described as follows:

    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)

  157. The panel is concerned that the Autopsy Protocol and Supplemental Report do not include reference to, nor description of, the President's other organs, including the adrenal glands. The panel took note of several publications in the medical literature relevant to his adrenal glands:

    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.

  158. The 1967 article persuasively presents correlation for the dates listed in the 1955 and 1957 articles, when then-Senator John Kennedy underwent spine surgery, specifically lumbar fusion, at a New York hospital, and describes the successful medical management of his hypoadrenalism (Addison's disease). Although Senator Kennedy's name is not mentioned in these reports, the majority of the panel is convinced that he could still definitely be identified, substantially earlier contentions that he did suffer from hypoadrenalism. That he suffered from this condition is further supported by the fact that the President's physician provided the attending surgeons at Parkland Hospital with steroids. The gunshot injuries clearly were fatal, however, and would have been fatal independent of the condition of his adrenal glands. Pathologists in courts of law are usually asked to provide evidence concerning the condition of organs other than those directly concerned with the immediate cause of death.

  159. All of the panel members are of the opinion that a medicolegal autopsy report should be complete, whether or not it is ultimately available to the public. In support of this position, the panel suggests that, were the injuries inflicted upon the President of such a nature that a preexisting disease might alter the prognosis, observations about such a condition would be essential to evaluating properly the interrelationship of the preexisting natural disease and the terminal injuries. The panel believes the autopsy should be complete, even though in many jurisdictions in the United States all of the information derived as a result of examination at public expense pursuant to statute may be made public on presentation of a request with reasonable cause.

    3) Organs and histologic sections

  160. All members of the panel acknowledge that, as a rule, when reviewing another pathologist's work, they should have access to all pertinent materials, including written reports, histologic slides, and any tissues or other evidence which was retained. In this instance, since no descriptions, photographs, or microscopic slides were available to document the condition of the inside of the brain, and since injuries to the brain were critical in evaluation aspects of the President's death, the panel urged to committee to search for the missing histologic slides, tissues, and the brain itself. The majority of the panel (all except Dr. Wecht) believes that a most reasonable and diligent search was undertaken at considerable expense and effort by the committee and that the missing materials are not available. The majority of the panel further believes that the documentation that is available--photographs of the body and the uncut brain, X-rays, and autopsy and physician reports--are sufficient to permit accurate evaluation of the gunshot injury to the head and brain, and that proper examination of the brain itself would only further confirm the panel's conclusion that one, and only one, bullet struck the President's head from behind. The panel believes that all of the histologic sections should also be reviewed, but that such review would not alter its conclusions, which are based on the extensive gross injuries described and documented and on the microscopic report available.


  161. Governor Connelly sustained an entrance wound in the right lateral back, with a corresponding exit wound on the right front chest below the right nipple; a reentry wound on the dorsum (back or top) of the right wrist, with a corresponding outshoot wound on the volar (palmar or lower surface) of the right wrist; and a superficial entrance wound in the left thigh. Documentation of these wounds is as follows:

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

    1) Clothing--suit jacket (back)

  162. The suit is of lightweight, black, closely woven fabric; the jacket is three-buttoned, single-breasted, size 42 tall. There is an irregularly shaped oval defect perforating all layers of the jacket on the right back, with its midpoint 19.5 centimeters to the right of the midline and 13.6 centimeters below the upper shoulder-seam, measuring approximately 1.7 by 1.2 centimeters. (See fig. 33, a photograph of the back of, Governor Connally's jacket.) Further characterization of this and other defects in Governor Connally's clothing was not undertaken prior to the garments being cleaned. (The Connally clothing was cleaned, presumably to make it more presentable, before any members of the original investigative team determined that scientific examination might be of value.) There was never any attempt to preserve the chain of custody of this evidence, an essential procedure if it were to be used in a subsequent criminal proceeding.

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

  163. This situation is explained in correspondence from Hoover to Rankin, dated April 16, 1964:

    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)

  164. The panel suggested that appropriate areas of Governor Connally's clothing, including the area of the jacket around the back entrance defect and corresponding exit and reentry defects elsewhere on the clothing, be subjected to two types of analysis: Soft X-ray and energy dispersive X-ray examination. The purpose would be primarily to .determine if any missile particles remained on the clothing, to analyze and define the elemental nature of such fragments, and, finally, to determine if any correlation might be made between the elements found and the missile's behavior after striking Governor Connally.

  165. The analysis was conducted at the Southwest Institute for Forensic Sciences in Dallas, Tex. (a copy of the complete report is found in addendum F). It contains the following discussion on the defects in Governor Connally's clothing:

    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)

  166. The shirt is long-sleeved, French-cuffed, white dress, size 16-35. A defect in the back measuring up to 0.8 centimeter in vertical diameter and 1.3 centimeters in transverse diameter is in a position corresponding to the defect in the jacket, with its upper margin 12 centimeters below the shoulder seam and 5 centimeters medial to the right shoulder seam (See fig. 34, a photograph of the back of Governor Connally's shirt)

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

    3) Surgical report and interview with the surgeon

  167. Dr. Robert Shaw's operative record characterizes the riot wound of entrance as follows:

    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)

  168. A report on a committee interview with Dr. Shaw included the following:

    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)

  169. Shaw also said in the interview that this wound was shaped as if the bullet had entered at a slight declination. Shaw probed through this wound with his finger and felt the Penrose drain that he had placed in the latissimus dorsi muscle.

  170. In measuring the diagram, made by Dr. Shaw at the time of the staff interview in order to illustrate better the size of the entrance and exist wounds, it is interesting that the entrance wound measurements taken from this diagram are 1.5 by 0.8 centimeters, with the long dimension in the longitudinal plane of the body (the long axis), and that the exit wound is approximately 5 centimeters in greatest dimension. (See fig. 35, a drawing prepared during the interview in which Dr. Shaw attempted to convey the actual size and location of both the entrance wound in the right posterior thorax and the corresponding exit in the right anterior thorax.)

    FIGURE 35--Reproduction of a drawing prepared during a staff interview with Dr. Robert R. Shaw, in which Dr. Shaw attempted to convey the actual size and location of both the entrance hole in the posterior thorax and the corresponding exit in the right anterior thorax.

  171. In September 1978, Dr. Baden conducted a physical examination on Governor Connally to see the scars resulting from his wounds (see addendum G for the complete report on this examination). Dr. Baden localized these wounds as follows:

    [A]t the site of gunshot perforation of the right upper back there is now a 11/8 inches long horizontal pale, well healed scar that is up to three-eighths inch wide centrally, with a lateral border slightly lower than the roedial border (about 5 inches). The medial margin is one-half inch superior to and five-eighths inch medial to the apex of the right posterior axilla. The lateral border is 6 inches to the right of the midline of the back and 4 3/4 inches below the shoulder line. (60)

  172. The panel believes that the ovoid characterization of this wound requires interpretation. The examination of the clothing, had it been conducted immediately after the wounding, might have been of assistance. One possible interpretation is that the avoid entrance wound, as described, could have resulted from the missile striking the skin surface on a tangential plane, causing an abrasion most pronounced on the margin adjacent to the acute angle of the trajectory that would create the illusion that the wound was more ovoid than it actually. was. The undermining of the contralateral margin, when the wound itself is looked into, would accentuate the out-of-round character of the wound itself. Dr. Shaw, in his original description and subsequent interview, did not note any significant undermining or abrasion by the missile which would have been produced by a non tumbling, tangential impact.

  173. Another possible interpretation of this ovoid wound is that the missile itself, just, prior to striking the body, was out of alignment with its trajectory (due to striking an intervening object). That is to say, it had tumbled slightly before entering the body, thereby creating an elongated defect.

  174. The panel, in its evaluation, also considers it important that the shape of the defect in the clothing would have been a more uniformly round hole if the bullet had struck on a tangential plane with the missile aligned with its trajectory. The panel (except for Dr. Wecht) concludes, therefore, that the wound in Governor Connally was probably inflicted by a missile which was not aligned with its trajectory but had yawed or tumbled prior to entry into the Governor. This conclusion incorporates consideration of the testimony of relatively inexperienced, somewhat hurried observers, not fully aware of the subsequent implications of their findings.

    Exit (outshoot) wound of the right anterior chest

    1) Clothing--Suit jacket (front)

  175. There is an irregularly round defect, measuring 1 by 1 centimeters in maximum diameter, penetrating all layers of the coat on its right front side. The midpoint of the defect in the jacket is 34.5 centimeters below the upper border of the collar, 49 centimeters above the lower margin of the coat, and 15 centimeters to the right of the midline. (See tiff. 36, a photograph of the front of Governor Connally's coat, illustrating the location of the anterior exit bullet hole.)

    FIGURE 36.--Photograph of the front of Governor Connally's suit jacket, showing the location of the anterior exit bullet hole.

    2) Clothing--Shirt (front)

  176. There is a slit-like defect in the front of the shirt, measuring 3.8 centimeters in length and varying from 0.1 10 0.2 centimeter in width. The midpoint of the defect is 15.7 centimeters to the right of the midline and 27.9 centimeters below the shoulder seam. The long axis extends inferiorly and medially at an angle of approximately 60(deg)from the vertical axis of the shirt. This joins medially a vertical linear tear measuring 3.1 by 0.1 to 0.2 centimeters and is paralleled by another vertical linear tear measuring 4.8 by 0.1 to 0.2 centimeters.

    The difficulties of further characterizing these defects by laboratory examination were described earlier in the letter from Hoover to Rankin and in the report describing the nondestructive analyses (soft X-ray and energy dispersive X-ray) results obtained after examination of the clothing. (See fig. 37, a photograph of the front of Governor Connally's shirt, illustrating the location of the anterior, exit bullet hole.)

    FIGURE 37.--Photograph of the front of Governor Connally's shirt, showing the location of the anterior exit bullet hole.

    3) Surgical report and interview with the surgeon

  177. Dr. Shaw's operative record characterizes the exit wound as follows:

    [The missile] emerged below the right nipple [T]he wound of exit was a ragged wound approximately 5 centimeters in its longest diameter. (61)

  178. Subsequently within his report, Dr. Shaw described his operative procedure: "An elliptical incision was made around the wound of exit removing the torn edges of the skin and the damaged subcutaneous tissue." In a committee interview, Dr. Shaw further localized and characterized the exit wound in a drawing in which he attempted to reproduce the actual size of the exit defect (see fig. 35).

  179. In Dr. Baden's report of his recent examination of Governor Connally, he localizes the residue of this wound as follows:

    The exit wound scar is in the right front chest 1 inch below the central nipple line and has been incorporated in a surgical scar that is 9 1/2 inches long that extends from 3 inches to the right of the midline, 1 inch beneath the nipple line, and proceeds superiorly to the right upper posterior axillary area.(62)

    Course of the missile through the back (thorax)

    1) X-rays

  180. Dr. J. Reynolds' X-ray report includes the following which is relevant to the missile's path through the thorax:

    anterior-posterior film of the chest was obtained on November 22, 1963. There is marked soft tissue swelling of the lateral aspect of the right thorax and free air is seen in the soft tissues at this site and in the region of the axilla. The right fifth rib is fractured in several places. The right lung base shows a dense confluent infiltration presumed to be the result of pulmonary contusion. No free pleural fluid or pneumothorax is identified at this time but the shadow of safety pin is superimposed on the right hemithorax, perhaps marking the site of a chest tube. (63)

    (See fig. 38, a reproduction of the anterior-posterior X-ray film the chest of Governor Connelly, illustrating the multiple fractures the right fifth rib and the contusion of the right lung.)

  181. The report states further:

    A subsequent film on November 23, 1963 was taken in posterior-anterior projection. Again, it shows that the right base is obscured by a homogeneous density which probably represents pulmonary contusion. The heart and mediastinum the study of the previous day. (64)

    FIGURE 38.--Photograph of the anterior-posterior X-Ray film of the chest of Governor Connally, showing the multiple fractures of the right fifth rib and the contusion of the right lung.

    2) Surgical report and interview with the surgeons

  182. Dr. Shaw's operative record characterizes the pathway of the missile and its effects as follows:

    The incision was then carried in a downward curve up toward the right axilla so as to not have the skin incision over the actual path of the missile through the chest wall. This incision was carried down through the subcutaneous tissue to expose the serratus anterior muscle and the anterior border of the latissimus dorsi muscle. The fragmented and damaged portions of the serratus anterior muscle were excised. Small rib fragments that were adhering to the periosteal tags were carefully removed preserving as much periosteum as possible. The fourth intercostal muscle bundle and fifth intercostal muscle bundle were not appreciably damaged. The ragged ends of the damaged fifth rib were cleaned out with the rongeur. The pleura had been torn open by the secondary missiles created by the fragmented fifth rib. The wound was opened widely and exposure was obtained with a self retaining retractor. The right plural [pleural] cavity was then carefully inspected. Approximately 200 cubic centimeters of clot and liquid blood was removed from the plural [pleural] cavity. The middle lobe had a linear rent starting at its peripheral edge going down toward its hilum and separating the lobe into two segments. There was an open bronchus in the depth of this wound. Since the vascularity and the bronchial connections to the lobe were intact, it was decided to repair the lobe rather than to remove it. This laceration had undoubtedly been caused by a rib fragment There was no evidence of injury of the mediastinum and its contents The upper lobe was found to be uninjured It was found that the latissimus dorsi muscle although lacerated was not badly damaged(65)

  183. Dr. Shaw's recent committee interview report contains this recharacterization of the findings of his procedure:

    There was a smaller tunneling wound in the back/chest. The bullet struck the fifth rib in a tangential way pushing it out, causing a fracture at a point farther up the rib (like a tree limb breaking from pressure exerted near its end). Bullet and rib fragments exited out the front of the Governor causing the larger exit hole. Shaw said the lower two-thirds of the Governor's lower lung lobe was like liver, full of blood and holes caused by secondary (bone) missile fragments. There was a rent in the latissimu dorsi(66)

  184. Dr. Petty, also present at Dr. Shaw's interview, summarized Dr. Shaw's observations concerning the course of the missile:

    There was a tunnel made by the missile in passing through the chest wall. The bullet struck the fifth rib in a tangential manner and shattered approximately 10 centimeters of the posterior and lateral aspect of the fifth rib. The setratus anterior muscle was torn and the fifth and sixth intercoastal muscles were intact and the periosteum of the rib was nearly intact. Shaw removed more of the fifth rib to enter the chest wall. There was damage of the middle lobe of the right lung due to the impact upon the chest. It actually was ripped into two segments and there was a leak in the bronchus. The lower two thirds of the lower lobe of the right lung looked just like liver, "just a bag of blood." Shaw repaired the right middle lobe. It inflated well. There was no need to touch the lower lobe of the right lung except for 1 centimeter long rent in it. This was over sewn. (67)

  185. In his summary of the interview, Dr. Petty suggested that the missile tunneled around the chest wall and did not proceed in a straight line from entrance to exit.

  186. The majority of the panel members, however, disagree. They would have expected a comparable missile, which was slowed only by passage through the President's neck and by striking only a relatively thin and readily shattered rib, to pass from entrance to exit in a fairly straight line and to perforate the lung. They are not certain that the surgeon could have known whether the injury to the lung was caused by the missile or by rib fragments only. They cannot conclude solely from the findings on the internal injuries whether the missile which injured Governor Connally had struck an intervening target. They note, however, that the findings are entirely consistent with such a path. The relatively large back entrance perforation is indicative of the missile having first struck an intermediate target, and the relative lack of damage to the bullet is believed by some panel members and Larry M. Sturdivan, the wound ballistics expert, to indicate that the missile had passed through other tissue, slowing it down, before it hit the Governor, striking his rib and wrist.

  187. Dr. Baden's report comments on the angle of the trajectory:

    Positioning the Governor while erect in the anatomic posture shows the missile track to proceed from back to front. downwards at approximately a 10 degree angle, for a distance of 12 1/2 inches through the body. (68)

    Reentry wound into the dorsum (top or back) of the right wrist

    1) Clothing--Suit jacket

  188. There is an irregular defect through all layers of the medial edge of the right sleeve of the coat, located 1.9 centimeters from the roedial sleeve seam posteriorly; it measures 1.6 by 0.9 centimeters and involves both anterior and posterior (front and back) surfaces, representing the defect of both entry and exist in the coat sleeve.

    2) Clothing--shirt

  189. There is a defect which passes through both layers of the French cuff of the right shirt sleeve. The defect on the outer layer of the cuff measures 1.6 by 0.9 centimeters, that on the inner layer of the cuff 1.8 by 0.5 centimeters. These two defects approximate each other and are 10.0 centimeters from the cuff margin and 10.6 centimeters roedial to its anterior corner.

    3) Medical record review

  190. Dr. Charles Gregory's operative record describes the, wound of entry on the Governor's wrist:

    The wound of entry on the dorsal aspect of the right wrist over the junction of the right distal fourth of the radius and shaft was approximately 2 centimeters in length and rather oblique with the loss of tissue with some considerable contusion at the margins of it. (69)

  191. This enlarged entrance perforation is suggestive of a reentrance wound. Dr. Vernie A. Stembridge's surgical pathology report includes
    characterization of the wound to the dorsal surface of the wrist:

    Specimen (A) consists of an ellipse of skin which is white and hairy measuring 30 millimeters by 10 millimeters by 6 millimeters. In the middle of the epidermal portion of the specimen is a ragged laceration extending into the dermis and measuring 10 millimeters by 2 millimeters by 2 millimeters. A small amount of hemorrhage is present in the subcutaneous tissue and dermis. Microscopic examination of skin from the right wrist reveals a focal absence of epithelium with hemorrhage and disruption of the underlying dermis and soft tissue. (70)

  192. The panel considers this histologic description to be consistent with the defect being an entrance wound.

    Exit wound on the volar (lower) surface of the right wrist

    1) Clothing--Suit jacket (see above)

    2) Clothing--Shirt

  193. The defect passes through both layers of the French cuff of the right shirt sleeve on the under surface. It measures 1.9 by 1.3 centimeters in the outer layer and 2 by 1.5 centimeters in the inner layer. It is 2.8 centimeters from the cuff margin and 11.3 centimeters medial to its posterior corner.

    3) Medical record review

  194. Dr. Gregory's operative record characterizes the exit wound on Governor Connally's wrist as follows: "There was a wound of exit along the volar surface of the wrist about 2 centimeters above the flexion crease of the wrist and in the midline." (71)

    Course of the missile through the right wrist >

    1)Medical record review

  195. Dr. Gregory's operative record describes the course of the missile through the wrist:

    It was noted that the tendon of the abductor palmaris brevis was transected, only two small fragments of bone were removed, one approximately 1 centimeter in length and consisted of lateral cortex which lay free in the wound and had no soft tissue connections, another much smaller fragment perhaps 3 millimeters in length was subsequently removed. Small bits of metal were encountered at various levels throughout the wound and wherever they were identified and could be picked up were picked up and have been submitted to the pathology department for identification and examination. Throughout the wound and especially in the superficial layers and to some extent in the tendon and tendon sheaths on the radial side of the arm are small fine bits of cloth consistent with fine bits of Mohair. It is our understanding that the patient. was wearing a Mohair suit at the time of the injury and this accounts for the deposition of such organic, material within the wound.(72)

  196. Dr. Stembridge's report characterizes the tissue removed from the right wrist:

    Specimen (C) is labeled bone and debridement from right wrist and consists of several small pieces of tissue. Two small fragments each 3 mm. in greatest dimension appeared to be pieces of cotton and/or wool. Two other small pieces, the largest of which measured 8 millimeters by 3 millimeters by 2 millimeters and the smallest of which measured 3 millimeters by 3 millimeters by 2 millimeters appear to be soft tissue. The other portion of the specimen consists of three irregular fragments of bone, the largest of which measures 1 centimeter by 5 millimeters by 3 millimeters and is composed of both cortical and cancellous bone and the other two measuring 6 millimeters by 2 millimeters by less than 1 millimeter and appearing to be composed of cortical bone only. The soft tissue fragments are submitted for microscopic examination. Microscopic examination of debridement, from the right wrist reveals multiple fragments of bone, and small amounts of fibrofatty connective tissue. Embedded within the fibrofatty tissue is a small segment of fragmented peripheral nerve. (73)

    The panel concludes that its findings further indicated that the missile had passed through Governor Connally's suit jacket and wrist and had remained intact.

  197. Dr. Baden, in his recent examination of Governor Connally, localizes the residue of these wounds:

    Examination of the right wrist shows the gunshot wound of entrance to be incorporated into a well healed surgical dorsally and extending to the wrist; there are well healed fine surgical scars on the ventral aspect (undersurface) of the wrist, horizontally and longitudinally.(74)

    2) X-Rays

  198. Dr. J. Reynolds X-ray report describes the wound in the wrist:

    Films of the wrist were obtained on November 22, 1963, and they show a comminuted fracture of the distal portion of the radial shaft. In this area, in the volar aspect of the distal forearm, a few small metal fragments are seen in the. soft tissue. The alignment of the bone at the fracture appears good. (75)

    (See figs. 39, 40, and 41 and reproductions of the X-rays.)

    FIGURE 39.--Photograph of an X-ray of the wrist, showing the extent of the fracture and missile fragmentation.
    FIGURE 40.--Photograph of an X-ray of the wrist, showing the extent of the fracture and missile fragmentation.
    FIGURE 41.--Photograph of a LogEtronic enhancement of a wrist X-ray, showing more clearly the extent of the fractures and missile fragmentation.

    3) Disposition of the missile fragments from the wrist

  199. An FBI report by Special Agent 5. Doyle Williams, dated November 30, 1963, describes the disposition of the missile fragments, about which there are some confusion:

    Doctor Charles Francis Gregory, Parkland Hospital, stated he and Doctor Tom Shires and other staff physicians performed surgery on Governor Jim Connally on November 22, 1963. He states surgery performed by him was done on the Governor's right arm, and that he removed from the arm a small fragment of metal. He stated the metal fragment was placed into a transparent container for preservation, and that during the operation, he recalled no other pieces or bits of metal being removed from the Governor's body. Doctor Gregory was asked whether or not he removed or saw another doctor remove a small fragment of metal from the left thigh of Governor Connally, and he states that although X-rays indicated the possibility of a small fragment of metal embedded in the left thigh that no surgery was performed to remove same. Doctor Gregory stated Surgery Supervisor Audrey Bell took custody of the fragment of metal removed from the Governor's arm, and that the ultimate disposition of the metal which was considered to be of possible evidentiary value, could best be explained by Miss Bell. He stated he did not on his own knowledge know, however, but he had been advised [that] Miss Bell obtained a receipt from State Trooper Bob Nolan [a State of Texas highway patrol officer] and transferred the metal fragment to him in accordance with instructions from the Governor's office at Parkland Hospital. (76)

    In another FBI report, dated November 23, 1963, Special Agent Williams said:

    Bobby M. Nolan, Texas highway patrolman, Tyler district, was interviewed relative to a bullet fragment removed from the left thigh of Governor Connally, which was turned over to him at Parkland Hospital in Dallas for delivery to the FBI. Nolan stated his instructions were apparently not clear at the outset and that following contact with his superior officers while at the Dallas Police Department, he turned the bullet fragment over to Captain Will Fritz [Dallas Police Department.] at approximately 7:50 p.m. He stated he had no further information concerning the matter and that his only participation in this series of events was the acceptance of the fragment and delivery of same to Captain Fritz. (77)

  200. All the panel members except Dr. Wecht agree, after a review of the notes of Drs. Gregory and Shires on the operation, that the missile fragment that Officer Nolan attributed to the thigh was probably the fragment recovered from the right wrist. This fragment is labeled "(29 metal fragment from arm of Governor ,John Connally" in FBI report "DL 89-48" and in correspondence addressed to Dallas Police Chief Jesse E. Curry.

  201. All the panel members except Dr. Wecht would have expected a comparable rifle missile perforating the wrist, without, being slowed by striking an intervening target, to have produced significantly greater soft tissue and bone injury and a smaller skin entrance perforation. They also agree that the method of labeling and handling this evidence was so poor that there might have been difficulty in having it admitted as evidence in a criminal proceeding.

    Reentry wound in the left thigh


  202. There is a defect of the left pant leg 61.5 centimeters below the top of the trousers and 6.4 centimeters medial (inward) to the crease of the pants; it measures 0.7 by 0.9 centimeter and is rectangular in shape. (See fig. 42, a photograph of the defect in Governor Connally's trousers.)

    2) Medical record review and interview of the surgeon's

  203. Dr. Shires' operative record characterizes the thigh wound as follows:

    FIGURE 42.-Photograph of the suit trousers of Governor Connally, showing the location of the missile defect.

    There was a 1 centimeter punctuate missile wound over the juncture of the middle and lower third, roedial aspect, of the left thigh. X-rays of the thigh and leg revealed a bullet fragment which was embedded in the body of the femur in the distal third. The missile wound was seen to course through the subcutaneous fat and into the vastus medialist. The direction of the missile wound was judged not to. be in the course of the femoral vessel, since the wound was distal and anterior to Hunter's canal. (78)

  204. Dr. Stembridge's report characterizes the tissue removed from the left thigh as follows:

    Specimen (B) is labeled skin from left thigh and consists of an ellipse of white skin measuring 22 by 8 by 7 millimeters. In the center of the ellipse is a 6 by 4 by 3 millimeter oval laceration extending down into the subcutaneous tissue from the epidermis. Microscopic examination of the tissue from the left thigh reveals an area from the epithelial puncture with complete disruption of the underlying dermis and soft tissue producing necrosis. PP/md Pathologic diagnosis: "Tissue from left thigh: Recent hemorrhage (history of gunshot wound.)" (79)

  205. The report on the committee interview with Dr. Shires states that his examination of the thigh was: "largely an exploration to insure there was no vessel damage." [T]he only significant wound in the thigh was a missile track. He says he merely did a debridement. When asked if the thigh wound could have been caused by a secondary fragment, Dr. Shires said, you " can't tell anything from the size or shape of the wounds as to whether or not it is an entrance or exit wound." He said that when dealing with fragments, there are too many unknown variables and that it is hard to differentiate fact from fiction. [He also said] the wound was small and that the thigh had very little damage and did contain a metal fragment. Dr. Shires was asked about his Warren Commission testimony that noted a peculiarity in the nature of the wound; namely, that the tissue damage seemed more significant than the size of the fragment present. He said that it is difficult to determine how the fragment entered. He said, " all you can say is that a tangential wound occurred." He said that there was a large range of possibilities for what happened.

    Significantly, Dr. Shires said the main issue he was seeking to resolve by the examination of the thigh was whether the missile could have hit a major vessel. He said it did not, and that he did not physically pursue the fragment that was there because it was " not medically significant." Dr. Shires said he was able to determine that the fragment was in the thigh bone from his examination of the original Connally X-rays. (80)

  206. After reviewing the three original thigh X-rays and the enhancement (LogEtronics) of these X-rays, Dr. Shires indicated:

    [I]t doesn't make any difference whether the metal fragment is in the femur or just under the skin with regard to the issue of whether there was a full bullet striking the thigh or a fragment of a bullet. He said the wounds were probably caused by a tangential hit. He said a tangential wound could have sent the fragment anywhere into the thigh. Dr. Shires noted that on the enhancement of the thigh (LogEtronics) the item in the bone looks more like an artifact than when he examined the original. He was open minded about the possibility that the fragment could have been just under the skin, but preferred to reiterate his initial impression that the fragment was in the thigh bone. Dr. Shires said that while they explored the entire track of the missile, they were not " exploring it as a track .,, rather they were " exploring the wound looking for a big missile injury." Dr. Shires found little hemorrhage, though he thought it was likely that a high velocity missile did not pass through the skin causing the wound.(81)

    (See figs. 43 and 44, enhanced X-rays of Governor Connally's thigh.)

    3) X-rays

  207. Dr. Reynolds' report on Governor Connally's X-rays describes the X-ray of the left femur and left lower leg:

    Film of the shaft of the left femur and of the left lower leg reveals no fracture in this area. A tiny metallic fragment is seen in the lower medial aspect of the thigh, in the subcutaneous fat. (82)

    FIGURE 43. Photograph of a LogEtronic enhancement of a thigh X-ray, showing the location of the missile fragment in the subcutaneous fat.
    FIGURE 44.--Photograph of a LogEtronic enhancement of a thigh X-ray, showing the location of the missile fragment in the subcutaneous fat.

  208. On November 29, 1963, Dr. Reynolds prepared a supplementary X-ray report which further characterizes the shadows within the thigh:

    AP (anterior-posterior) and lateral films of the digital portion of the left thigh were obtained and include the distal portion of the shaft and the region of the knee. One film is in the AP projection and the other the lateral projection with the direction of the beam from roedial to lateral and the film lying adjacent to the lateral aspect of the thigh. fractures are seen. A few punctuate and linear densities are seen on the film but these are inconsistent, and appear on one and not the other and therefore interpreted as artifacts. There is, however, one density which remains constant on both films and appears to lie beneath the skin of the region of the subcutaneous fat in the roedial aspect of the thigh. By measurement on the films, without correction for target film distance and object film distance, this small density lies 15.2 centimeters above the distal end of the medial femoral condyle on the AP film and, on this film, lies 8 millimeters beneath the external surface of the skin. It is 6.25 centimeters medial to the femoral shaft. On the lateral film, the center of this small metallic density lies 15 centimeters above the distal end of the roedial femoral condyle. It lies 4.9 centimeters posterior to the skin of the anterior surface of the thigh and it is superimposed on the shaft of the femur. In relation to the femur, the density is superimposed on a point 1.5 centimeters posterior to the exterior of the anterior cortex. The shape of this density is irregular but is roughly oval. Precise measurements are difficult but it is estimated that the greatest length in the AP projection is about 3.5 millimeters and the greatest width about 1.3 millimeters. Measurements of the densities in the lateral projection reveal the greatest length to be about 2 millimeters and the greatest width to be about 1.5 millimeters. The long axis of the metallic object is oriented generally along the axis of the femur. (83)

  209. The panel concurs with Dr. Reynolds' opinion that the 2-millimeter density is a missile fragment that was just under the skin and was not deep within the thigh in the femur bone, as described in the Warren Commission Report. The panel believes the density in the femur bone was erroneously described and is an artifact in the X-ray film and not a bullet fragment.

  210. The panel members, except Dr. Wecht, agree that in their experience a comparable rifle missile that did not strike an intervening target would produce greater soft tissue and bone injury and would penetrate much deeper into the thigh and probably pass through it.

    4) Nondestructive analysis of tissues from the right wrist and left thigh and of slides prepared from them

  211. Panel member Dr. Petty obtained the paraffin blocks containing residual tissue excised from the wrist and thigh of Governor Connelly from Vernie A. Stembridge, M.D., the original examining surgical pathologist. Dr. Petty subjected the tissue to nondestructive analysis at the Southwestern Institute of Forensic Sciences in Dallas, using techniques which employ X-ray back scatter with scanning electron microscopy and energy dispersive X-ray. The report of this examination states:

    The three microscopic slides were examined and no evidence of metallic fragments was noted either by direct observation or by seeing evidences of tearing of the tissues which might have occurred as a result of the nicking of the microtome knife due to contact with metallic fragments that would occur during preparation of the microscopic slides. The paraffin blocks containing the tissues from the debridement were then subjected to energy dispersive X-ray analysis. No evidence of copper, lead, zinc, or nickel was found. After preparation the paraffin blocks containing the tissues removed at the time of debridement and still renaming following the preparation of microscopic slides were subjected to analysis using a scanning electron microscope fitted with a low angle detector for X-ray back scatter. No copper, lead, zinc, or nickel was found by means of this analysis. (84)

    (See addendum H for the complete report.)

  212. The panel conclude that no metal fragments were present in the available tissues removed from the injured wrist and thigh for possible further analysis and comparison.


  213. To understand better the significance of the panels' observations and the bases for its conclusions, it is useful to review some of the terminology and basic concepts of wound ballistics and to indicate the limitations that certain variables impose on interpreting the findings. Some of these factors were considered and recorded in a reasonably accurate manner during the original autopsy and subsequent experimentation; others were not.

  214. The forensic pathologist is trained to observe the morphologic (structural) or physical effects of a missile or missiles on a body and to interpret these effects in order to provide an investigator with as much information as possible, as detailed in section V of this report, including: the distance or range of the weapon from the body; relationship of the weapon and trajectory of the missile to the body; approximate mass and velocity of the missile (which together characterize its kinetic energy); and the amount of this kinetic energy transferred from the missile to the body after striking together with the results of such impact on, or perforation of the tissues damaged and the body as a whole. These observations will be discussed separately, with particular emphasis on their relationship to specific evidentiary items examined.

    - Range of the weapon from the target

  215. A missile must have sufficient velocity (speed) to cause a particular wound. The velocity depends on the type of ammunition employed, including the type of powder and powder charge. Velocity drops off as the distance between the weapon and the target increases.

  216. The missile is not the only object that emanates from the firearm. Expanding gas produced by the burning of the powder, which actually pushes the missile out of the bore of the firearm, bursts forth from the, muzzle with great velocity, causing the audible report associated with discharge. Powder grains are also blown out of the muzzle; these may be partially burned or completely unburned. Thus, gas, powder and missile are all actually forced out of the bore of the weapon in any discharge of a firearm.

  217. The incandescent nature of the gas also causes flame and heat to emanate from the muzzle. In addition, small fragments of the missile itself and its coating are forced from the muzzle, together with any fragments of material that may have been in the bore of the weapon.

  218. The forensic pathologist estimates the range of fire :red other particulars concerning injury from a firearm by examining the pattern of deposit of these substances about the bullet's point of impact on either the body or the clothing. Distance may be determined by comparing the pattern of these deposits with patterns produced by the same weapon fired with similar ammunition under similar environmental conditions at selected distances, with the weapon in a comparable position relative to the surface. Terms such is "contact", "close range" and "intermediate range" are used to characterize the shooting; characteristic details can vary from weapon to weapon and with various types of ammunition.

  219. When a weapon is fired close against the skin's surface, virtually all the substances, including those from the muzzle blast itself, penetrate the skin to the underlying tissues, where they may be detected by physical or chemical means. In addition to these deposits, the missile itself is often coated with a lubricant in which microscopic and macroscopic particles of primer or powder charge residue may be mixed, which, barring an intermediate target between the weapon and the body, are usually deposited at the margins of the perforation of the clothing or the skin. This residue is termed "bullet wipe" by the forensic pathologist.

  220. If all the above-mentioned residues are missing except "bullet wipe," the gunshot wound is characterized as a "distant" wound, meaning that the muzzle of the weapon was discharged at a distance from which it would cause no residue to be deposited on the target. Such a wound consists of a missile perforation about which there might be a deposit of bullet wipe on the clothing and/or in the superficial margins of the wound; this is in addition to the abrasion collar, described earlier, produced when the entering bullet rubs against the margins of the indented skin.

  221. Wound ballistics research has shown that a missile velocity of 125 to 170 feet per second is necessary for penetration of the human skin when using steel spheres varying from one-sixteenth to one quarter inch in diameter. Clothing also impairs perforation, but it usually less efficient than skin in hindering penetration, depending on its nature. The size of the defect in the skin varies considerably depending on the size and velocity of the missile. Skin is extremely elastic; it often stretches considerably to allow missile penetration and then returns to its normal shape thereafter, leaving a defect smaller than the missile itself. Close proximity of the weapon to the skin or bone beneath the skin and the angle of impact may enlarge the entrance perforation.

  222. The characteristics of the abrasion collar surrounding the entrance perforation reflect the direction of the bullet at the instant of impact with the skin and the angle of the trajectory prior to contact with the skin, as well as the shape of the missile itself. If the trajectory is perpendicular to the surface of the skin, the hole is usually round and the abrasion collar correspondingly symmetrical around it. (See fig. 45, a picture of an abrasion collar when the missile was perpendicular to the target.) If the angle of the trajectory of the missile to the skin surface is other than perpendicular, the abrasion collar may be asymmetrical, that is, more prominent on the surface with the most acute angle between the skin and the bullet, and less apparent on the opposite surface, where there may be undermining of the tissues. (See fig. 46, showing an abrasion collar produced by a missile striking at an acute area.)

    FIGURE 45.--Drawing of a typical entry wound, displaying a symmetrical abrasion collar resulting from a distant rifle shot with a trajectory at right angles to the skin surface.
    FIGURE 46.--Drawing of a typical entry wound, displaying an asymmetrical abrasion collar resulting from a distant rifle shot with a trajectory at an acute angle to the skin surface.

  223. If a missile strikes an intervening target, its normal yaw may be exaggerated, or it may begin to tumble. The entry wound in subsequent target might reflect this distortion in trajectory by anything from a very slight asymmetry to an ovoid or virtually rectangular reentry wound. The latter would be the case if the missile were to strike sideways and is somewhat similar to what was described in some of the initial medical reports on the wound in the posterior thorax of Governor Connally. (See fig. 47, a drawing showing yawing or tumbling.) Such a subsequent entry wound might show no wipe residue in the skin because of the missile's prior passage through skin and tissue. Some small fragments of the metal from the missile's surface might break off as the missile strikes, however, and adhere to the margins of the defects in either the clothing or skin.

    FIGURE 47.--Drawing of an entry wound caused by a tumbling or yawing missile.

  224. A missile's path may also be deflected from a true straight line by striking an intervening target, with the extent of deflection usually based on the mass of the intervening object. Slight deflection could result from striking a twig or small branch of a tree. The panel members fully considered the potential effects of intervening targets on yaw and deflection of the missiles and their possible significance to bullet paths and injury patterns.

    - Relationship of the weapon and missile trajectory to the target

  225. The accuracy of a weapon is provided by the spin imparted by the rifling within the weapon and, to a lesser degree, the shape of the projectile. An elongated, symmetrically shaped missile is a more accurate than an irregular or spherical one. Other considerations in accuracy are distance to the target, effect of gravity on the missile while in flight, and effects of air resistance. Air resistance varies considerably with the speed of the missile. A very high velocity missile, after leaving the weapon, losses its speed at a much greater rate than does a low or intermediate velocity missile.

  226. A missile's pathway from the weapon to the target is known as its trajectory. A bullet should travel only a short distance after leaving the barrel before it stabilizes, minimizing the tendency to yaw. During the first hundred yards or so, the bullet yaws periodically, with its tip oscillating slightly from the line of flight. While in flight, the bullet's movement, although much quicker because of its high rate of spin, mimics that of a spinning top. At one instant the bullet is point on, at the next its axis is at a slight angle to the line of flight. These motions are periodic. This angle of yaw increases to a certain degree and then progressively decreases until it is again zero, whereupon another similar gyration commences. During flight the degree of yaw is normally comparatively slight, usually less than 3(deg)in properly designed bullets of the type used in this homicide, except when near to the terminal, or maximum, range from the weapon. The tendency to yaw increases in proportion to the density of the medium through which the missile passes relative to air; in tissues it may be increased many times more than in air (approximately 800), resulting in rapid, complex bullet motions.

  227. The yaw of a bullet passing through a body may be rather extreme from point to point. Nevertheless, in the experience of panel members, if the missile enters the body without tumbling or appreciable yaw, its pathway or track is essentially a straight line as long as it does not strike a significant bony surface. To reconstruct this linear path, the tissues may be placed in the same anatomic relationship to each other as they were at the time of missile perforation. Consequently, in the absence of an intervening target, the missile's trajectory from point of origin to the body represents a backward extension of the bullet's pathway within the body. Bone or other extremely dense tissue, such as cartilage, in the immediate pathway of the missile might alter the angle of the track through the body after the characteristic skin perforation. This alteration is distinguishable from that produced by yaw, which, at a particular point in the passage through the body, might cause the missile to be out of line with its pathway, although the pathway itself remains straight.

  228. The panel believes that the difficulty which Drs. Humes, Finck, and Boswell experienced in trying to place a soft probe through the bullet pathway in President Kennedy's neck probably resulted from their failure or inability to manipulate this portion of the body into the same position it was in when the missile penetrated. Rigor mortis may have hindered this manipulation. Such placement would have enabled reconstruction of the relationships of the neck and shoulder when the missile struck. It is customary, however, to dissect missile tracks to determine damage and pathway. Probing a track blindly may produce false tracks and misinformation.

  229. The panel is concerned as to the degree of accuracy attainable in determining the missile trajectory based on backward extension of a bullet track from within the body, Particularly if precision within the range of a few degrees is required. An intermediate or high velocity bullet creates a temporary bullet track relatively larger than that of the bullet itself. This precludes reconstruction within the required degree of accuracy.

  230. Another factor hampering precise determination of the bullet track by the backward extension method is imprecision in knowing the relative position of various portions of the body at the instant of missile penetration. For example, the placing of President Kennedy's arm in the position it was in at the instant the missile struck the back might not be important because the relatively medial location of the entrance wound probably would minimize significant interference by the shoulder movement. The exit wound in the neck, on the other hand, might move to either side as much as several centimeters if his head or neck were to be rotated normally.

  231. The alignment of missile tracks that passed through several parts of the same body enables recreation of the relationships of these structures at the moment when struck. This allowed Governor Connally's posture at the time he was struck to be recreated.

  232. The determination of the point of origin of a missile by backward extension from a bullet track through a body must take into account not only the above variable factors, but also requires knowing, reasonably precisely, the exact position of that portion of the body penetrated at the instant it was struck. Any motion of the body, no matter how slight, would alter the extended trajectory of the missile from the bullet track in the body considerably and thereby change the point of origin. The longer the distance of the trajectory, the greater the magnification of even the smallest error in determining body position or path in the body.

  233. In the panel members' experience, if a missile, having struck an intervening target, is tumbling significantly at the time it strikes a target, the missile's course through the second target is much more unpredictable, both as a result of its exaggerated yawing at the point of impact and its loss of kinetic energy prior to striking the second target. Thus, the track through the Governor is less reliable for use in determining origin than that through the President, if the bullet struck the President first.

  234. The panel members agree that in their experience, if a missile strikes an object capable of creating a shearing force, such as the skull, the bullet's pathway in the body might be significantly different from the line of its trajectory prior to impact. The missile fragment lodged within the margin of the entrance skull defect is evidence of obvious shearing force with lateral torque. The only conclusion that the panel members can reach as a group is that all of the missile's mass, small and large fragments alike, would have moved forward from the point of impact with such a bony surface. The degree of lateral movement of the pathway would be influenced by the surface's convexity, amount of kinetic energy propelling the missile forward, and nature of the tissue through which the missile fragments were traveling.

  235. In the present case, the anterior-posterior and lateral X-rays of the skull indicate that the vast majority of the missile fragments moved in a cylindrical, slightly coned, pathway, in the same direction as the bullet's path prior to its striking the skull.

    - Wounding capability of the missile

  236. A missile's wounding capability is a consequence of the transfer of kinetic energy from the missile to the body. A missile's kinetic energy is the same as that of any moving object: KE=mv2/2g, where m is the weight in English pounds and v is the striking velocity. in feet per second. The results in conventional foot-pounds are derived by dividing by 2 times the acceleration due to gravity (32.2 feet per second per second). From this formula it can be deduced that the missile's kinetic energy varies as the square of its velocity. Thus, doubling the velocity increases the kinetic energy by a factor of 4, while doubling the mass serves only to double the kinetic energy.

  237. A missile passing through a body produces, around the wound track, a hemorrhagic area composed of the tissues which have been torn by the direct impact of the bullet. The missile creates a permanent cavity, the size of which is generally proportional to the missile's total loss of kinetic energy while in the wound. As the bullet passes through the tissue, considerable radial motion is imparted to the tissue elements and a large temporary cavity is formed. When the wound track is dissected, extensive bleeding and tissue injury may be found extending for a considerable distance away from the track produced by high velocity bullets. After sectioning the tissues, this hemorrhagic area is often well-defined; its extent is proportional to the missile's loss of kinetic energy while in the wound. High speed X-rays and motion pictures have also demonstrated the formation of this temporary cavity, with a volume that may be as much as 27 times that of the permanent cavity.

  238. The panel agrees that the tissue disruption due to the temporary cavity created by passage of a high or intermediate velocity missile might have produced fractures of the transverse processes of one or several of the lower cervical and/or upper thoracic vertebrae in President Kennedy's neck, as indicated by the postmortem X-rays. There are significant muscle masses attached to the vertebrae which would receive tremendous shock, even if several inches distant from such a missile. A direct. grazing missile impact may have occurred, but it would not have been necessary to cause the damage visible in the X-rays.

  239. The missile's rate of energy loss in the wound and the consequent transfer of this energy to the body is dependent on several factors, including the amount of initial energy and the degree of retardation of the missile within the body. This retardation varies according to the missile's shape, the density of the tissues through which it is passing, and its degree of yaw while passing through the target. A soft-pointed hunting bullet loses a greater portion of kinetic energy than a full, metal-jacketed military bullet, the ammunition used in this instance. In the case of a full-jacketed, non deforming bullet, yaw is the most significant retarding factor as the bullet travels through the tissue. This yaw, as previously indicated, varies along the bullet's path, producing maximum energy loss at points where it is greatest and minimum energy loss where it is absent. A small entry hole through the skin, extensive internal damage, and a relatively small exit hole indicate that the bullet had minimum yaw at the moments of entrance and exit, with a release of energy, possibly due to yawing, in between.

  240. The changes in density from air to skin, muscle, and bone may produce marked variations in yaw. A bullet that is positioned appropriately relative to its trajectory on penetrating the skin may be tipped to 100(deg) within 3 inches of penetration, thus dramatically reducing speed, with a corresponding increase in energy transfer and tissue destruction. Subsequently its posture may again change, so that its long axis is in the line of flight and considerably less energy is lost and consequent tissue damage is minimized.

  241. The majority of the panel members, on the basis of the nature and extent of the Governor's chest injury alone, could not determine whether the missile that struck Governor Connally in the back had already passed through President Kennedy. They could, however, from the nature of the entrance wound in Governor Connally's back, the nature of the damage to his wrist, and the limited penetration of his thigh, determine that the bullet which struck those areas had lost sufficient kinetic energy prior to inflicting these wounds to permit the conclusion that one bullet caused all of the wounds to the Governor. The panel cannot rule out the possibility, if confined only to the surgical evidence, that the wound to Governor Connelly's wrist was caused by a large fragment of the bullet which struck the President's head.

  242. The majority of the panel members, after fully evaluating the objections of Dr. Wecht, believes that the medical evidence of a diminishing degree of injury to the chest, wrist and thigh, the ability to align these body parts to conform to a single bullet track, provide strong support for the conclusion that all of the Governor's injuries were caused by one missile.

    - Effect of a missile on the body

  243. The effects of a missile striking a portion of the body will conform to the basic laws of motion, readily understood and often observed in everyday occurrences such as the collision of a moving with a stationary billiard ball. If the two balls are of equal mass and the energy of the first is transmitted on impact to the second, the first ball will stop completely, while the second will be propelled at a velocity comparable to the striking velocity of the first. If the second ball is twice the mass of the first and the transmitted kinetic energy is comparable to that of the first, it will be propelled forward at only half the velocity. Much of the kinetic energy transferred by the first ball is due to its velocity, since its mass, relative to that of the second ball, is insignificant. Nevertheless, the sum of mass and velocity will result in significant imparted velocity to the motionless target.

  244. This situation can be best observed using non jacketed missiles designed to impart maximum transfer of kinetic energy to the target during and after striking, thereby maximizing the missile's "knockdown" capability and minimizing the possibility of exit from the target and the striking of a second target. A jacketed missile transfers significant, but considerably less, kinetic energy to the target. Instead, the energy transfer propels the target body or a portion of it in the same direction as the missile. The vector of propulsion might affect the body in its entirety if the victim were standing, or might affect only the upper portion of the body if the victim were seated depending on the site of impact. The movement of the body, or of a large portion of it, will be minimal because of the bullet's small mass, not withstanding its high velocity. If the bullet strikes the head, an object of relatively low mass in comparison with the entire body, the movement of the head in the direction of missile travel may be considerable. Rotational movement of the head, or of a lightweight portion of the body may also occur.

  245. By comparing the bullet tracks, a forensic pathologist may be able to determine if the wounds were inflicted on a body in an unsupported position that would permit movement, ,red, if s% in what order the wounds might have occurred. In cases where the body was supported position that would preclude motion, such as lying against a firm surface, a transfer of kinetic energy from the missile to the body will result but not cause motion. Transmission of such energy to the body will be manifest by injury to areas in contact with the supporting surfaces.

  246. Accurate determination of the bullet pathway and careful observation of the missile wounds themselves are useful in determining whether several wounds to different portions of a body were caused by the same missile. By placing a rigid probe through the bullet tracks after careful dissection and inspection and after evaluation of deflections possibly caused by striking bone and other tissues, and then attempting to align the tracks by moving the body, a conclusion may be reached as to whether multiple perforations were caused by a single missile.

  247. Bullet reentry wounds are often of a different configuration than initial entry wounds as a consequence of the missile's deformation during penetration and the tumbling effects produced. When various portions of the body are in contact during multiple perforations, one surface may serve to shore another from which a missile exits, so that the exit wound, even from an intermediate or high velocity missile, may exhibit little of the damage and tearing usually seen in exit perforations. Reentry wounds may also show adjacent injuries incident to secondary missiles from the primary injury. The primary wound or the reentry wound may contain fragments of clothing such as was present in the wound in Governor Connelly's wrist.

    - Effect of the body on a missile

  248. The panel members individually have had considerable experience with how the various portions of the body affect missiles passing into or through them. Individually and collectively, they have seen the effects on missiles varying from .22 caliber long rifle bullets to those similar in size and velocity to the missiles used in this homicide---6.5 millimeters or 0.26 inch--and larger. In some cases the missiles had perforated similar portions of bodies--as in the upper back wound of President Kennedy, and thereafter penetrated significantly harder surfaces. These could not be distinguished from missiles fired through soft tissue alone. A bullet striking soft tissue decelerates so that if it then strikes a hard surface such as bone, it is appreciably less deformed than if it struck the hard surface directly. Dr. Wecht alone had had experiences contrary to this.

  249. Most panel members also agree that entrance penetrations of the skull by jacketed missiles, with the resultant shearing forces produced by impact with the sharp, rigid bone margins, often result in significant distortion of the missile, while perforation of the thorax or abdomen usually results in little or no deformation of the missile, except in those instances in which {he missile hits a vertebra. Several members of the panel have investigated deaths in which missile impact resulted in deformation similar to the flattening noted in Warren Commission exhibit CE 399, and instances in which there was loss of the central core mass of a jacketed bullet as a result of deformation of the intact jacket and squeezing of the lead core backwards (a toothpaste effect) .....

  250. The panel members agree that, in cases where Jacketed missiles strike bony surfaces such as the skull, long bones or vertebra, a portion or all of the jacket might separate at the point of initial missile deformation, with the central, heavy lead core continuing in a path usually in the same direction as that of the missile trajectory prior to entry into the target. It is not unusual for a portion of a missile to separate into additional fragments upon exiting from the skull or other part of the body and entering a second structure.

  251. Another consideration about missile wounds that has been emphasized by others(85) is the relatively short time that a missile is actually moving through tissue, usually less than a thousandth of a second. A bullet of 150-F rains weight, passing through 8 inches of tissue, entering at 2,000 feet per second (approximately the velocity of the 6.5 millimeter Mannlicher-Carcano bullet) and exiting at 1,000 feet per second will pass through the body in 0.00045 second and impart to the tissue 998 foot-pounds of energy, the work equivalent of more than 4,100 horse power. This energy transfer produces a temporary cavity as described earlier, which actually develops after the bullet has passed through the tissue. Accordingly, a bullet can pass through a head and be about 100 feet further along before a photograph reveals the explosive destruction of the head. This also explains the presence of entry and exit bullet. holes in bones and tissue even though the skull is extensively fragmented or blown apart by the subsequent formation of the temporary cavity. The velocity of the outward-moving tissue particles may be only 125 feet per second, far less than the 1,000 to 2,000 feet per second velocity of the bullet projectile. Thus, when the Zapruder film reveals the explosion of the skull, the bullet had already passed through.

  252. Finally, the panel members also discussed their experiences with the explosive effects of shotgun and, to a lesser extent, military rifle wounds to enclosed portions of the body such as the head. Rarely has any member observed photographs documenting the reactions of victims' bodies to being shot, although crime scene reconstruction has often enabled panel members to establish body position prior to the shooting. The panel members have critically evaluated the observations of Alvarez (86) and the physical principles he considers in explaining the President's head movements in the Zapruder film. The panel members took note of the differences between the missile and targets (melons) in Alvarez's work and the missile and targets in this homicide. The work of Lattimer and associates,(87) which addressed some of these differences by using a weapon and missiles similar to those used in the Kennedy assassination and which attempted to duplicate the injury pattern on skulls, was also critically reviewed, as were studies by Dr. John Nichols. (88)

  253. The panel members agree that the exit wound of a missile seriously deformed by initial penetration of the skull might be considerably larger than the entrance defect and that the forces related to yaw and the large temporary cavity created by the missile would usually be transmitted fairly equally throughout a closed space such as the skull. The larger exit defect in the front of the skull would theoretically permit greater exodus of tissue under pressure, and a resulting backward movement of the head could occur.

  254. The panel is aware of the time interval between the backward motion of the President's head and the earlier, slight forward motion, possibly caused by the initial missile impact and transfer of energy to the head as recorded in frames 313-314 of the Zapruder film. The panel further recognizes the possibility of the body stiffening, with an upward and backward lunge, which might have resulted from a massive downward rush of neurologic stimuli to all efferent nerves (those which stimulate muscles). The disparity in mass and strength between those muscles supporting the body on the back (dorsal surface) of the spine and those muscles on the front (ventral) surface could account, at least partially, far this type of motion, although it would be reasonable to expect that all muscles would be similarly stimulated.

  255. The panel suggests that the lacerations of a specific portion of the brain--the cerebral peduncles as described in the autopsy report(89)--could be a cause of decerebrate rigidity, which could contribute to the President's backward motion. Such decerebrate rigidity as Sherrington (90) described usually does not commence for several minutes after separation of the upper brain centers from the brain stem and spinal cord. It is, however, most intense in those muscles which normally counteract the effects of gravity.

  256. The panel is also aware of possible effects on motion that could be caused by the moving car within which the President sat.

  257. The panel concludes that the backward movement of the head following its forward movement occurred after the missile had already exited from the body and had created a large exit defect in the skull, and that it was most probably due to a reverse jet effect, or a neuromuscular reaction, or a combination of the two. The short interval between the two motions supports this explanation.

  258. One panel member, Dr. Wecht, suspects that the backward head motion might be explained by a soft-nosed bullet that struck the right side of the President's head simultaneously with the shot from the rear and disintegrated on impact without exiting the skull on the other side. The remaining panel members take exception to such speculation, since they are unaware of any missile with such capabilities. Further, the X-rays taken prior to the autopsy show no evidence of a second missile, nor do the photographs of the head and brain show evidence of any injury to the left side.


  259. Pathology is that specialty of medicine concerned with the investigation and evaluation of disease and other abnormalities in the human body. Forensic pathology is that area of pathology concerned with the legal aspects of death and injury, and the ability to present and evaluate the manifestations of death in courts of law and legal proceedings. Forensic pathologists are routinely asked to evaluate or develop hypotheses that involve pathological abnormalities and to suggest circumstances that could have produced them. Although it is often hoped that such evaluations can be made with absolute certainty, forensic pathologists can rarely state unequivocally that a given situation is explainable by one and only one hypothesis.

  260. More commonly the forensic pathologist makes a conclusion that has a reasonable degree of medical certainty or states that the evidence is or is not consistent with any given hypothesis. In some cases, more than one hypothesis may explain the evidence.

    - Number, location, and nature of President Kennedy's wounds

  261. The majority of the forensic pathology panel (in each cast all members except Dr. Wecht) conclude that President Kennedy was struck by only two bullets, fired from some distance to the rear of his limousine. One bullet struck the President in the right upper midback and exited the front of the throat. This occurred prior to or during the segment in the Zapruder film of the assassination when the President is obscured from view by the Stemmons Freeway sign. This wound might have proven fatal.

  262. The second bullet struck the President in the upper back of the head and exited somewhat forward and to the right through the top, causing a massive defect in the skull. This second wound was fatal in and of itself. The wound in the upper right midback measures approximately 0.9 by 0.9 centimeter in maximum diameter and was located approximately 5 centimeters below the shoulder and 5 centimeters to the right of the midline of the back. The wound cannot be located more precisely from the available evidence because the autopsy pathologists failed to measure it with reference to standard fixed body landmarks and did not dissect the missile track.

  263. A red-brown to black area of skin surrounds the wound, forming what is called an abrasion collar. It was caused by the bullet's scraping the margins of the skin on penetration and is characteristic of a gunshot wound of entrance. The abrasion collar is larger at the lower margin of the wound, evidence that the bullet's trajectory at the instant of penetration was slightly upward in relation to the body.

  264. The majority of the panel concludes that the bullet that struck the President in the back exited in the front of the neck at approximately the third tracheal cartilage. The exit wound was almost obscured by a tracheotomy performed on the President at Parkland Hospital, but could still be observed afterward at the lower margin of the tracheotomy incision. This wound is located approximately at the point where the bullet would be expected to exit, given the nature of the entrance wound in the upper right back and the damage to the transverse process of the lower cervical and first thoracic vertebras, which are situated on a line between the entrance and exit points.

  265. The panel believes that Parkland doctors mistakenly identified the defect in the neck as an entrance wound because of its small size, which is characteristic of an entrance wound but occurs not uncommonly in exit wounds caused by high velocity missiles that have passed through soft tissue. It is also possible that this exit wound may have been small because the tissues through which the missile exited were supported by clothing, inhibiting the normally extensive distortion or tearing often characteristic of an exit wound. In addition, the Parkland doctors had not looked at the President's back and did not realize there was another perforation.

  266. Compounding the oversight of the Parkland doctors was the lack of communication between them and the pathologists performing the autopsy at Bethesda Naval Hospital who did not realize that the tracheotomy had been made through a bullet wound. The autopsy pathologists only saw the back wound. On learning the day after the autopsy that the incision had been made through an existing wound, the pathologists concluded that the missile which entered the upper back exited through the neck defect.

    - Location of the head wound

  267. The panel concludes unanimously that the head entrance wound was located approximately 10 centimeters above the external occipital protuberance and slightly to the right of the midline, near the upper convexity of the back of the head at the "cowlick" portion of the President's hair part. The external surface of the skin around the wound was very similar to that of the back wound.

  268. The autopsy pathologists did not describe this location in their report or in their testimony before the Warren Commission. It does correspond, however, to the location described by two separate teams of medical experts convened by Attorney General Ramsey Clark and the Rockefeller Commission, respectively, as well as by other independent medical examiners. Further, while testifying before this committee, Dr. Humes, the chief autopsy pathologist, changed his earlier testimony and supported the panel's conclusion as to the location of the wound.

  269. The panel notes that the skull X-rays, photographs of the head and photographs of the brain substantiate this location. The scalp wound, as it appears in the photographs, has many of the features described in the autopsy report, including size, an abrasion cuff which is more prominent on the lower margin than the upper, and linear tears extending radially from the upper margins of the wound. The scalp wound overlays skull damage characteristic of an entrance wound (inward beveling), also described in the autopsy report.

    - Nature and trajectory of the missile striking the head

  270. The majority of the panel concludes that only one missile caused the damage to the head. The nature of the damage is consistent with that caused by a jacketed missile. The X-ray evidence indicates that the missile fragmented on impact, produced a number of outwardly radiating fractures, and proceeded in an essentially straight and forward path and to the right, paralleling the upper surface of the head. This type of missile fragmentation is consistent with a jacketed missile. The main core mass probably existed in a single fragment that remained intact until striking the automobile, causing it to fragment into several pieces. The small missile fragment present at the margin of the entrance wound was probably a portion of the missile jacket and indicates that the skull might have slightly deflected the course of the missile and its fragments through the head.

  271. The bullet exited in the top front area of the skull (right frontoparietal portion) adjacent to the coronal suture. There is a considerable loss of bone in the area where the bullet exited, with multiple fractures extending from the defect. In the photographs, part of the perimeter of the 2.5 centimeters, beveled exit hole is visible along the margin of the defect and is somewhat larger than the diameter of the bullet itself. On the basis of these photographs and simulated skull reconstruction, the panel was able to determine the location of the point of exit within a reasonable margin of error.

    - Deficiencies in the autopsy

  272. The panel unanimously concluded that the deficiencies of the autopsy contributed to the uncertainty over the locations of the entrance and exit wounds in the head. The pathologists did not describe the wounds with reference to fixed body landmarks, nor did they examine the brain adequately. The panel itself was unable to examine the brain because it is among certain autopsy materials which are unaccounted for. The majority of the panel is satisfied that the select committee made a diligent though unsuccessful, effort to locate these missing materials. The majority of the panel believes that examination of the materials would fully support its conclusions.

  273. The panel discussed the methods for and difficulty of determining the trajectory and origin of the missiles. It notes that inherent in the procedures is a margin of error because of (1) the difficulty of establishing the precise angles of the missile tracks through the President's head and body, and (2) the difficulty of knowing the exact time of impact and the exact position of the body at the time of impact. These problems are greater for the bullet passing through the President's back and neck because it is less clear exactly when it struck the President. The impact to the head appears clearly in the Zapruder film, and its timing has therefore been determined with a high degree of accuracy.

  274. As the panel noted, the locations of both sets of entrance and exit wounds are approximations and are less precise than can often be made. The autopsy pathologists used non fixed body landmarks such as the mastoid process to locate the wounds. The location of these landmarks will change with movement of the body; hence, the measurements to the wounds will vary depending on the position of the body when the measurement is taken.

  275. The position of the body itself when the bullets struck also affects the relationship of the entrance and exit wounds and the trajectory of the missiles. For example, if the President were moving his head to the left or right, the location of the entrance would relative to the landmarks used as reference points by the autopsy pathologists would vary. Similarly, the relationship of the exit wound to the entrance wound and the angle of the missile trajectory prior to striking the body would differ substantially.

  276. Finally, the autopsy doctors failed to dissect the upper back missile track. The panel is, therefore, unable to determine conclusively whether the missile's path was in a straight line from entrance to exit and whether this injury would necessarily have been fatal.

  277. The panel considered the value of disinterring the President's body to locate more precisely the various wounds and their relationships to one another and the pathways of the missiles. The majority concludes that an examination of the body would fully support its conclusions and thus would not further its investigative goals. Consequently, the majority of the panel decided against recommending disinterment.

    - Second head wound

  278. When questioned by panel members, the autopsy pathologists stated that the piece of brain tissue on the lower rear of the head just above the hairline covered the entrance wound they described in their report. The majority of the panel concludes, however, that the brain tissue actually lies on top of the hair and does not obscure a wound of any kind. If the brain tissue were obscuring a wound, the X-rays of the underlying skull would show evidence of wound damage, as would the photographs of the brain. There is no such evidence.

  279. Dr. Wecht raises the possibility of a tiny wound of entrance or exit being present beneath the white piece of brain that would not necessarily show up in the X-rays or the photographs of the brain. Dr. Wecht is also unwilling to rule out the possibility of another wound having occurred almost simultaneously with the area of the defect in the right front of the head without examining the brain.

  280. The other panel members believe that a near simultaneous wound from another shot, occurring at the instant when the skin and underlying bone are separated as a result of the known shot, is unfounded speculation. We believe strongly that another missile did not enter the right front of the head within the area of the large defect. We find no evidence supporting this speculation in the photographs of the head or brain, or in any of the X-rays of either adjacent bone fragment or the left side of the head where, in such an event, one might expect such a missile to lodge. No other missile was found, and the majority knows of no bullet that would completely disintegrate on hitting the soft tissue of the brain, as Dr. Wecht suggests.

  281. The majority also points out the following excerpt from Dr. Wecht's testimony in public hearings before the select committee on September 7, 1978. He said that there is "very meager" evidence to support his minority view, that there is an "extremely remote" possibility that the President was shot in the head by a second bullet from the side or front. Later in his testimony he reiterated his position:

    Mr. PURDY. Dr. Wecht, does the present state of available evidence permit the conclusion that to a reasonable degree of medical certainty there was not a shot from the side which struck the President?
    Dr. WECHT. Yes, with reasonable medical certainty I would have to say that the evidence is not there. I have already said it is a remote possibility and I certainly cannot equate that with reasonable medical certainty.(91)

  282. The issue of a second bullet striking the head from the front or side originates in part from the pronounced backward and leftward motion of the President's head and shoulders after being shot, as seen in the Zapruder film. To some, this motion appears explainable only by a shot coming from the front or side.

  283. The majority of the panel believes that there is a possibility that this movement may have been caused by neurologic response to the massive brain damage caused by the bullet, or by a propulsive effect resulting from the matter that exited through the large defect under great pressure, or a combination of both. Whatever the cause of the President's movement, the majority of the panel concludes that only one bullet struck the President's head and that it entered at the rear and exited from the right front.

    - Governor Connally's wounds

  284. The majority of the panel concludes that the evidence on the nature of the wounds suffered by Governor Connally to his torso, wrist and thigh provides strong support for the conclusion that the wounds were caused by one bullet. The ovoid shape of the entrance wound on Governor Connally's back, described by one of the doctors at Parkland Hospital who treated the Governor, was most probably caused by a yaw or tumble in the flight of the bullet, which was deviating from its normal flight characteristics and path because of passing through President Kennedy. The majority does not feel, however, that the evidence is sufficient to eliminate entirely the possibility that the wobble was caused by a different intervening object.

  285. The medical evidence alone does not provide the panel with sufficient information to state with absolute certainty that the bullet that struck Governor Connally was the same one which had previously struck President Kennedy in the upper right back, exiting through his neck. The majority believes, however, that the medical evidence is consistent with this hypothesis and much less consistent with other hypotheses. Further, the panel considered other nonmedical evidence that strongly indicates that a single bullet injured both men. This evidence includes: The position of the two men, as shown in the Zapruder film; the fact that the two men can be aligned consistent with the trajectory of one bullet; photographs of the seat locations in the limousine; the actual distortion of the so-called "pristine bullet"; the failure to recover any other bullet from the limousine or body; ballistics studies of the ammunition involved; and the results of neutron activation analysis of the bullet fragments conducted by Vincent P. Guinn, Ph.D. (These factors are discussed in the reports of other expert panels convened by the select committee.)

  286. The panel notes the interval between the observable reactions of the President and the Governor at the time of their injuries, as seen in the Zapruder film. Some observers have contended that the interval is too long to permit the conclusion that a single bullet struck both men.

  287. The majority of the panel believes that the interval is consistent with the single-bullet theory. At issue is the time delay between bullet impact and the observable reactions of each man to his injury, which in turn is determined by many factors, including whether or not their reactions were voluntary or involuntary. If involuntary, they would have occurred almost simultaneously with the injuries. If voluntary, there is often a slight delay in reacting.

  288. The first visual evidence that the President was struck was the movement of his hands to a position in front of his neck and his facial expressions. The majority of the panel construes these movements to have been voluntary, although it recognizes that they could have been involuntary had the bullet caused sufficient shock to his spine and spinal cord. The majority cannot say definitely, based on the available evidence, whether this more serious injury occurred and precisely when the President was struck.

  289. Similarly, the panel cannot determine precisely when Governor Connally was struck from either the medical evidence or his reactions as seen in the film: the puffing of his cheeks and the dropping of his shoulders. The majority believes that the nature of his injuries could have resulted in a voluntary motion, which would mean a delayed reaction. Thus, the majority believes that there could have been sufficient delay in Governor Connelly's reaction to account for the interval seen in the film and to permit the conclusion that a single bullet injured both men, notwithstanding its inability to determine whether President Kennedy's reaction was voluntary or involuntary.

  290. Panel members have differing views as to how soon Governor Connally would be expected to drop the hat he was holding in his right hand following the injury to his right wrist, but generally agree that there is little empirical data on which to determine with confidence what specific reaction should be expected from this type of wound.

    - Autopsy procedures

  291. As noted earlier, the panel unanimously concludes that the autopsy was faulty for a number of important reasons, some of which contributed to the speculation and controversy concerning the medical evidence. The panel believes that many of the difficulties are a result of inexperience with or neglect of the standard procedures which should be followed in forensic autopsies. The purpose of the medicolegal autopsy, as described in detail elsewhere in this report, is to answer anticipated or actual questions about the manner of death and to document the findings and answers in such a way that independent examiners may review the findings and procedures and reach their own conclusions.

  292. The panel urges unanimously that procedures such as those outlined elsewhere in this report be adopted as a model to be followed in the event of the suspicious death or obvious homicide of high Government officials.



  293. The members of the forensic pathology panel were asked to comment on the post mortem examination conducted by the pathologists, Dr. Humes, Boswell, and Finck, including the procedure and the rport prepared afterwards.

  294. According to a summary report prepared by Drs. Humes, Boswell, and Finck pursuant to requests by the Department of Justice following a meeting on January 20, 1967, at the office of Dr. Robert II. Bahmer, Archivist of the United States, (92) then-Commander Humes was directed to perform the autopsy by the Surgeon General of the U.S. Navy because of the decision to bring the body of the late President to the Naval Medical Center in Bethesda, Md., where Dr. Humes was Director of Laboratories. According to the summary, the Surgeon General of the Navy advised Dr. Humes "to determine the nature of the President's injuries and the cause of his death. (93)

  295. The same record indicates that the autopsy began at approximately 8 p.m. on Friday, November 22, 1963, and was concluded at approximately 11 p.m. The autopsy report, written by Dr. Humes with the assistance of Drs. Boswell and Finck, was prepared the morning of November '23 and delivered by Dr. Humes to Admiral Burkley, the President's physician, on November 24 at about 6:30 p.m.

  296. The Navy "Clinical Record Authorization for Post Mortem Examination, U.S. Naval Hospital, Bethesda, Md.," dated November 22, 1963, indicates the following:

    You are hereby authorized to perform a complete post mortem examination on the remains of John F. Kennedy. Authority is also granted for the preservation and study of any and all tissues which shall be removed. This authority shall be limited only by the conditions expressly stated below: [no restrictions are indicated]
    Signature:[Mrs.] John F. Kennedy [typed];
    Address: White House, Washington, D.C.;
    Authority to consent:wife [no signature is present].
    The performance of the autopsy specified above is approved: R.O. Canada, Captain MC USN; Title: Commanding Officer; Date:22 November 1963 [no signature in this location either].(94)
    Signature of witness: Robert Kennedy.

    On the bottom of this document is a block designated "Patient's Identification (for typed or written entries give: name--last, first, middle; grade; date; hospital or medical facility) is the signature "G G Burkley, Physician to the President."(95)

  297. The autopsy doctors had the following qualifications, as detailed in their report on their 1967 review of the autopsy photographs and X-rays:

    In charge was James J. Humes, M.D., at the time commander, Medical Corps, U.S. Navy, and Director of Laboratories, Naval Medical School. He was certified in 1955 by the American Board of Pathology in anatomic and chemical pathology. Assisting him were J. Thornton Boswell, M.D., and Pierre A. Finck, M.D. Dr. Boswell at that time was a commander in the Medical Corps, U.S. Navy, and Chief of Pathology, Naval Medical School. He was certified in 1957 by the American Board of Pathology in anatomic and clinical pathology. Dr. Finck, a lieutenant colonel, Medical Corps, U.S. Army, was then chief of the Military Environmental Pathology Division and Chief of the Wound Ballistics Pathology Branch, Armed Forces Institute of Pathology, Walter Reed Medical Center. He was certified in 1956 by the American Board of Pathology in anatomic pathology and in 1961 in forensic pathology. (96)

  298. In his testimony before the Warren Commission, Dr. Humes characterized his experience as follows:

    My type of practice which fortunately has been in peacetime endeavor to a great extent, has been more extensive in the field of natural disease than violence. However, on several occasions in various places where I have been employed, have had to deal with violent death, accidents, suicides, and so forth. Also, I have had training at the Armed Forces Institute of Pathology, I have completed a course in forensic pathology there as part of my training in the overall field of pathology. (97)

  299. When asked what his specific function was in connection with the autopsy, Dr. Humes responded as follows:

    As the senior pathologist assigned to the Naval Medical Center, I was called to the center by my superiors and informed that the President's body would be brought to our laboratories for an examination, and I was charged with the responsibility of conducting and supervising this examination; told to also call upon anyone whom I wished as an assistant in this matter that I deemed necessary to be present. (98)

  300. Dr. Humes said he selected Dr. Boswell as one of his assistants and, later, Lt. Col. Pierre Finck, who was made available to him by Brigadier General Blumberg, the commanding officer of the Armed Forces Institute of Pathology, because "I felt it advisable and it would be of help to me to have the services of an expert in the field of wound ballistics and for that reason I requested Colonel Finck to appear." (99)

  301. Many of the difficulties that arose in relation to the post mor- tem examination or autopsy developed in part because of the basic differences between an autopsy conducted in a hospital pursuant to the wishes of the next of kin and one conducted under the aegis of a medicolegal investigative system, pursuant to statute, for official purposes. The investigation of a death that is known or suspected to be unnatural is a multidisciplinary effort, requiring cooperation amongst a number of scientific disciplines and ongoing communication between those disciplines from the initiation of the investigation until its completion. The medicolegal autopsy is only one stage of this investigation, albeit an important one. To be performed properly, it requires that the prosecutor evaluate information obtained from those aware of the circumstances of the death and that the prosecutor anticipate and address questions which might arise subsequently.

  302. In a suspicious death, the body is initially the property of the State (state's evidence), and the autopsy is usually, if not invariably, conducted in accordance with statute, in anticipation that the evidence gathered as a result of the procedure may be introduced into a civil or criminal proceeding. Such an examination is conducted without the consent of surviving members of the family who, on completion of the examination, assume custody of the body and make final disposition.

  303. Traditionally, the hospital pathologist conducts the examination in a hospital setting, invariably pursuant to the wishes of the family. Such an examination is concerned primarily. with pathologic appraisal of the clinical diagnosis for which the physician was attending the patient, with evaluation of the treatment afforded the patient, and, in a more general sense, with the education of the medical community concerning the interrelationship between morphologically recognizable disease and the manifestation of this disease in the patient while alive. Such a procedure is also conducted in order to understand the development (pathogenesis) of the one or several diseases that the deceased person may have had, commencing with the identification of the causative (etiologic) agent or process responsible for initiating the disease, and continuing through the primary and subsequent secondary changes in the body. incident to this disease. This usually culminates with an understanding as to which disease processes were immediately responsible for the patient's death. Correlation of the clinical presentation of the patient while alive with the disease processes identified at the autopsy is the responsibility of the traditionally trained hospital pathologist, who usually commences this procedure with a thorough review of the medical history of the deceased and with consultation with the attending physicians m an attempt to define the "problems" or questions to be answered during this type of procedure.

  304. The medicolegal autopsy, on the other hand, addresses itself to a number of different problems, although it has a number of features in common with the traditional hospital autopsy discussed above. The forensic pathologist conducting this examination has an educational background that initially is the same as the hospital pathologist's and includes a thorough understanding of natural disease processes, the manifestation of these diseases within the body and the correlation of these changes with clinical findings in the living person. He must also, however, fully understand the manifestations and ramifications of so-called "unnatural disease," that is, disease deriving from the effects of violence of all types, as well as other exogenous, unnatural agents on the body. The examination conducted by the hospital pathologist is designed to establish "clinical pathological correlation"--the relating of the medical illness to the findings of the autopsy. The forensic pathology examination is conducted after understanding the questions which have arisen in the course of the investigation prior to the autopsy and with anticipation of questions that might arise during or after the procedure. Such questions must be specifically addressed in the subsequent report.

  305. Such an investigation and examination should be conducted so that the observations and findings are objectively documented, before conclusions or opinions deriving from them are reached. Such documentation entails carefnl scrutiny, appropriate measurements, photography and use of any other means to make the observations and findings of the initial procedure available to professionals in the same or related fields whose expertise might be sought for further evaluation, or for review by other physicians in the event of criminal or civil litigation. Therefore, the medicolegal autopsy is conducted not only as a problem-oriented procedure that addresses itself to questions raised or anticipated. but also as a procedure that attempts to document the answers to these questions in such a way that other independent experts may review the findings and reach their own conclusions. The procedure is conducted in a systematic sequence, and a number of examinations by several different disciplines may be conducted concurrently.

  306. The general steps of any medicolegal investigation might be summarized as follows:

  307. 1) Careful scrutiny of the scene of death, with collection and preservation of evidence gathered, whether or not it is immediately apparent that it has a bearing on the evaluation of death. Such an investigation naturally includes careful documentation, not only by photography, but also by detailed report, from which a subsequent evaluator may be able to reconstruct independently the circumstances of death. If there is any possibility that the victim may survive, the body is moved from the crime scene prior to this examination by the investigator. Even then the subsequent investigation and documentation should be as thorough as is reasonable.

  308. 2) The medicolegal autopsy. This procedure begins after members of the team responsible for the onscene investigation have been consulted. The examiner should be fatal/jar with the evidence derived from it and from all of the other individuals who may have had contact with the body of the victim subsequent to injury, with detailed collection of information concerning artifacts which may have been introduced onto or into the body incident to therapeutic management. The medicolegal autopsy in every instance should address itself to establishing the cause of death beyond a reasonable doubt and the elimination of other competing causes of death, these being criteria for presentation of such evidence in a criminal proceeding. The medicolegal autopsy is intended to be a complete examination which minimizes speculation.

  309. In a gunshot homicide, there are other specific questions, in addition to the above, which the examiner should address, including:
    1. The identification, characterization, and localization of all wounds of missile entrance (inshoot), and the identification, characterization, and localization of all wounds of exit (outshoot).
    2. The correlation of individual entrance and exit wounds, examination of the internal bullet track, the structures penetrated or perforated, and the extent of resulting injury.
    3. The evaluation, if possible, of the lethality of individual wounds, the expected survival period, and the capability and extent of physical activity after injury.
    4. The evaluation, if possible, of the sequence of individual wounds from observations on and in the body.
    5. The determination of the cause of death and the exclusion of other antecedent and competing conditions.

    The medicolegal examination

    1. Physical facilities

  310. The pathologist conducting the procedure should have access to facilities that will allow all team members to proceed in an orderly systematic fashion, without undue pressures, to complete the examination successfully and collect all of the necessary evidence in an expeditious manner. Included among equipment which should be available arc examining and washing facilities and instruments, equipment for color, and black and white photography, X-ray equipment, and recording equipment to enable onsite observation and description of the findings.

    2. Personnel

  311. Among the members of the team who should be available for consultation in examination of a gunshot victim are:

  312. Considering the purposes and significance of a medicolegal autopsy, it is necessary that every attempt be made to have appropriate professional staff and physical facilities available, recogonizing that such resources to vary from community to community. This is especially true when a medicolegal autopsy is conducted on the President of the United States. The examination must be conducted without compromising professional or physical resources, even if there were contrary pressures in the interests of time or for some other expediency. The decision to perform an autopsy should take into consideration the wishes of the family, and the necessity and requirements of the procedure should be explained to the family as sensitively as possible, but the forensic pathologist must retain final decisionmaking authority and responsibility as to whether an autopsy should be performed and its scope.

    3. Details of the procedure

  313. The individual steps that should be followed in the course of such procedures and the reasons for these steps include the following:

    Specific considerations pertaining to the John F. Kennedy autopsy

  314. The panel evaluated some of the major difficulties encountered during and after the Kennedy autopsy and the reasons for these difficulties, in addition to those which might have been encountered had a defendant allegedly responsible for this crime been placed on trial within the jurisdiction where the crime occurred.

    1. Jurisdiction

  315. Chapter 49 in the Code of Criminal Procedure in the State of Texas details the responsible authorities and procedures for "Inquests upon dead bodies." Article 49.01, entitled "When Held" states: "It is the duty of the justice of the peace to hold inquests,' with or without a jury, within his county in the following cases " Paragraph two lists these cases, among others:'"When any person is killed, or from any cause, dies an unnatural death, except under sentence of the law or dies in the absence of one or more good witnesses." Paragraph four includes: "When the circumstances of the death of any person are such as to lead to suspicion that he came to his death by unlawful means." The same section also contains this statement:'"The inquests authorized and required by this article shall be held by the justice of the peace of the precinct in which the death occurred."

  316. Article 49.03 entitled "Autopsies and Tests," states the following concerning an inquest held to ascertain the cause of such death:

    The justice of the peace shall in all cases call in the county health officer, or if there be none or if his services are not then obtainable, then a duly licensed and practicing physician, and shall procure their opinions and advice on whether or not to order an autopsy to determine the cause of death. If, upon his own determination he deems an autopsy necessary, the justice of the peace shall, by proper order, request the county health officer, or if there be none or if it be impracticable to secure his services, then some duly licensed practicing physician who is trained in pathology to make an autopsy in order to determine the cause of death, and whether death was from natural causes or resulted from violence, and the nature and character of either of them.

  317. The record of inquest details that the formal inquest on John Fitzgerald Kennedy was held on November 22, 1963, at 1 p.m., at Parkland Memorial Hospital in Dallas, Tex., and that the date of death was November 22, 1963, at Parkland Hospital.

    The "Nature of Information given J.P." was "Death as a result of two gunshot wounds of head and neck."

    The document states that the information was provided by Dr. Malcolm Perry, M.D., Parkland Memorial Hospital, Dallas, Tex.

    It also contains Justice :

    I, Theran Ward, justice of the peace, precinct No. 2, Dallas County, Tex., after viewing the dead body of John Fitzgerald Kennedy and hearing the evidence, find that he came to his death as a result of multiple gunshot wounds of the head and neck. With this, my hand, officially, this the loth [sic] day of November A.D. 1963, Theran Ward, justice of the peace, precinct No. 2, Dallas County, Tex.

  318. Thus, the Texas statute in effect at that time placed the responsibility for determination of the cause of death with a layman, the justice of the peace, who might consult the county health officer and might order an autopsy by a qualified pathologist, if deemed necessary, "to determine the cause of death."

  319. Other than the official record of inquest, which states specifically that Ward did, in fact, view the remains of President Kennedy, there is no record of a formal inquest or other procedure to gather evidence from the body within the territorial jurisdiction of death. Nor does the record indicate whether Ward was consulted prior to removal of the body from Dallas County, Tex, for which the President's personal physician, Admiral Burkley, was responsible. If such was the case, the authority to approve an autopsy subject to the wishes of the next of kin in Bethesda was a legal order, and evidence obtained as a result of that procedure undoubtedly would have been admissible in a subsequent criminal procedure. If he was not consulted and chose to make an issue of his responsibilities and their abrogation by authority other than himself, and had criminal litigation ensued, a duly constituted court in the State of Texas might have found legal problems to be associated with the criminal proceeding.

  320. The record of inquest signed by Ward was dated November 10, antedating the assassination of the President, by some 12 days. The panel concludes that the document is in error and that the correct date of issue most probably was December 10, some 18 days after assassination of the President.

  321. The official certificate of death, signed by Ward on December 6, 1963, records the "Findings by the Justice" as follows:

    I, Theran Ward, a justice of the peace, in and for Dallas County, Tex. after viewing the dead body of John Fitzgerald Kennedy and hearing the evidence find that he came to his death as a result of two gunshot wounds (1) near the center of the body and just above the right shoulder, and (2) 1 inch to the right center of the back of the head. Witness my hand, officially, this the sixth day of December A.D. 1963, Theran Ward, justice of the peace, precinct No.3, Dallas County, Tex.

    On the same document is the official recording:

    I, Theran Ward, a justice of the peace, in and for Dallas County, Tex., do hereby certify that said inquest was held before me, on the day mentioned, and the proceedings in said inquest, as described above are correct. (s) Theran Ward, justice of the peace, precinct No. 3.

    2. Pathologists conducting the autopsy

  322. As his Warren Commission testimony indicates, Commander Humes was selected to perform the post mortem examination because he was the senior pathologist at the U.S. Navy Medical Center in Bethesda, where the President's body was taken at Mrs. John F. Kennedy's request.

    His testimony further indicates that Commander Humes was directed to seek assistance from any individual of his choosing, recognizing the distinct difference between the background and training of an individual regularly employed in Iraspiral practice and one trained in forensic pathology.

    As Commander Humes stated to the Warren Commission, his training in forensic pathology was limited to a course "at the Armed Forces Institute of Pathology'," and his experience was limited to "several occasions in various places where I have been employed (where) I have had to deal with violent death, accidents, suicides, and so forth."

  323. The panel concludes that the assistance of experienced pathologists engaged in the full-time practice of forensic pathology, not merely in a consulting or review capacity (such as was the experience of Lieutenant Colonel Finck). would have materially assisted in the proper performance of this autopsy.

    3. Secrecy during and following the autopsy

  324. A memorandum directed to Commander Humes and his associates by Capt. John H. Stover, dated November 25, 1963, officially reminded the physicians of his earlier verbal admonition that they not discuss any of the procedure or findings with anyone unless with his specific authorization. Lieutenant Colonel Finck, in his letter to J.M. Blumberg dated Feb. 1, 1965, recalled this admonition:

    After the completion of the post mortera examination, the Surgeon General of the Navy told us not to discuss the autopsy with anyone, even among prosectors or with the investigators involved.

    This directive prohibiting communication, even with "the investigators involved," would certainly impede a proper medicolegal investigation and timely preparation of an accurate report.

    4. Completeness of the autopsy

  325. As stated earlier, a complete medicolegal autopsy is necessary not only to determine the exact cause of death and to gather other evidence that might be of value in identifying the manner of death, but also to rule out other or contributing causes. Commander Humes has indicated on record and before this panel that he was not advised of any restrictions on the performance of a complete autopsy. Dr. Finck indicated the contrary during a trial in New Orleans, La., on February 24, 1969. This was the trial of the State of Louisiana v. Clay that resulted from the investigation of New Orleans District Attorney Jim Garrison into the possibility that Clay Shaw and others conspired to kill President Kennedy. In connnection with the medical inquiry in this trial, Finck had been called to testify and was asked, "Why did you not dissect the track of the bullet wound that you have described today and that you saw at the time of the autopsy at the time that you examined the body? Why? I asked you to answer that question." Dr. Finck replied:"As I recall I was told not to, but I don't remember by whom?" Question:"Could it. have been one of the admirals or one of the generals in the room?" Answer: "I don't recall." Question:"Do you have any particular reason why you can't recall at this time ?" Answer :"Because we were told to examine the head and chest cavity, and that doesn't include the removal of the organs of the neck."

  326. Dr. Finck. in his letter further detailed his understanding of the restrictions:

    After the publication of the Warren report, numerous physicians criticized the autopsy protocol that did not describe the adrenal glands of Kennedy who suffered from adrenal insufficiency. The prosectors complied with the autopsy permit and its restrictions. I was told that the Kennedy family first authorized autopsy of the head only and then extended the. permission to the chest. Organs of the neck were not removed, because of the same restrictions. I feel that the prosectors accomplished their mission that was to determine the direction of the shots and the cause of death.

  327. He further noted the restrictions of the procedure as he understood them:"The organs of the neck were not removed: The President's family insisted to have only the head examined. Later, the permission was extended to the chest."

    He also states:

    On Sunday, November 24, 1963, I went to the naval hospital to help Commander Humes who had written an autopsy report. Humes, Boswell, and Finck, the three prosectors, signed the autopsy report in the office of Admiral Galloway. (I had suggested several corrections in the autopsy report,. While we were checking the autopsy report in the admiral's office, the television announced the murder of Oswald by Ruby.)In my discussion with Commander Humes, I stated that we should not check the block "complete autopsy" in the autopsy report form. In compliance with the wishes of the Kennedy family, the prosectors had confined their examination to the head and chest. Humes declared that the block "complete autopsy" should be checked.

  328. Lieutenant Colonel Finck also indicated:

    I was denied the opportunity to examine the clothing of Kennedy. One officer who outranked me told me that my request was only of academic interest. The same officer did not agree to state within the autopsy report that the autopsy was not complete, as I had suggested to indicate. I saw the clothing of Kennedy, for the first time on March 16, 1964, at the Warren Commission, before my testimony, more than 3 months after the autopsy.

  329. Commander Humes indicated to the panel that during the autopsy Admiral Galloway ordered that the procedure be a complete examination. As indicated in section III of the panel's report, the autopsy report acknowledged removal and description of thoracic and abdominal organs, but not of neck organs. Likewise, the forensic pathologist on the team, Dr. Finck, the individual who might have observed changes on the clothing which would characterize entrance and exit wounds, did not have access to this evidence, apparently because the senior pathologist, Dr. Humes, did not have the experience or education to be aware of the value of such an examination.

  330. As indicated elsewhere in this report, the panel members also took note of the failure to include the description of certain organs, including the adrenal glands, within the body of the autopsy report. The panel members are divided in their opinion as to the propriety of this omission in a public report, but all agree with the need to maintain permanent records of such observations in the event that there is need to provide them in subsequent criminal litigation.

  331. The panel also took note of the unavailability of the histopathologic sections and the brain, which had not hitherto been sectioned. The panel aknowledges the need for such evidence in subsequent criminal litigation and the adverse effect that failure to retain such evidence might have on the proper outcome of such litigation.

  332. The panel likewise took note of the failure to record properly the findings during the procedure, particularly the measurements of the location of the entrance wound in the head, or even to retain the original notes from which the final report was prepared for reasons stated by Dr. Humes before the Warren Commission. The panel believes that the inability to examine such documentation in the event of legal dispute could adversely affect the outcome of subsequent criminal litigation.

  333. Finally, prosectors should have reviewed the preliminary report in conjunction with the photographs taken during the course this procedure and prepared a more complete diagram which included critical measurements not otherwise recorded. By doing so they might have avoided a very obvious error in the location of the wound of entry in John F. Kennedy's head, as documented elsewhere in this report.

    5. Examination procedure

  334. The more serious procedural errors of the post mortem examination include the following:

  335. a. The body was moved out of the geographical area statutorily responsible for investigation of the death and autopsy.

    b. The pathologist(s) charged with performing the autopsy had insufficient training and experience to evaluate a death from gunshot wounds. They did not confer with the physicians who had treated the President at Parkland Hospital before commencing their examination and did not therefore realize that a bullet perforation in the neck had been altered by a tracheotomy procedure until after the body had been removed.

  336. c. The pathologists did not or could not control the circumstances at work unimpeded by visitors.

  337. d. Proper photographs were not taken.

  338. e. The President's clothing was not examined by the pathologists.

  339. f. The autopsy procedure was incomplete:

    1. The external examination did not take thorough note of all the wounds: The anterior neck exit wound was not noticed, the head entrance wound was not accurately located with reference to fixed anatomic reference points, and the head was not reconstructed in order to determine the precise location of the head exit wound.
    2. The bullet track in the back and neck was not dissected, so extent of injury to the neck structures was not evaluated and course through the body not fully appreciated.
    3. The angles of the bullet tracks through the body were not measured relative to the body axis.
    4. The brain was not properly examined and sectioned.

  340. g. The autopsy report was incomplete, prepared without reference to the photographs, and was inaccurate in a number of areas:

    1. The entrance head wound location was incorrectly described.
    2. The entrance and exit wounds on the back and front neck were not localized with reference to fixed body landmarks and to each other so as to permit reconstruction of trajectories.
    3. There was no description of the neck areas which were not dissected. Instead, the pathologists referred to the observations of the treating physician at Parkland (hearsay) and did not mention that they failed to detect the presence of the missile exit in the anterior neck.
    4. There was no description of the adrenal glands or of other organs.

  341. Resources available to conduct medicolegal autopsies vary tremendously in different sections of the country, with accompanying variation in the degree of sophistication of the examination and related ancillary procedures, such as odontology, toxicology, et. cetera. The resources available for this autopsy, however, were extensive.

  342. The above list of deficiencies in the autopsy reflects only those gross errors which would have been avoided in most metropolitan medicolegal jurisdictions and which probably would have been avoided in this instance if a forensic pathologist with day-to-day experience in the investigation and examination of such deaths had been present at the autopsy.

  343. Despite the deficiencies of the postmortem examination of the President, the panel found that sufficient documentation was available for it to arrive at correct and valid conclusions, as stated in this report, as to the cause of death of President Kennedy and the precise injuries the President suffered.


  344. The panel has taken note of chapter 18 of the United States Code annotated, entitled "Presidential Assassination, Kidnaping, and Assault," enacted in 1965, which states:

    SEC. 1751. Presidential assassination, kidnaping, and assault; penalties:

  345. Chapter 18, entitled "Congressional Assassination, Kidnaping, and Assault," also enacted since the Presidential assassination, states. Sec. 351. Congressional assassination, kidnaping, and assault penalties--

  346. The panel considered these statutes and the metlind whereby medicolegal autopsy would be conducted as a consequence of these statutes. Currently under a contingency plan developed by the Federal Bureau of Investigation in cooperation with the Armed Forces Institute of Pathology, the institute would cooperate in the selection of qualified individuals to assist, in the examination.

  347. The panel is compelled to offer the following alternative, more viable procedures for consideration by the select committee.

  348. On the death of any of the officials designated in the two statutes, where it has apparently been caused or aggravated by any criminal act specified in this section, a complete and thorough post mortem examination and autopsy shall be performed on the dead body. No person, member of any government agency or otherwise shall forbid or interfere in any way with the performance of such an autopsy.

  349. Three or more physicians, each licensed to practice medicine in at least one state of the United States or, in lieu thereof, holding a commission in one of the armed services of the United States, shall perform this autopsy. Each of the physicians shall have been certified by the American Board of Pathology in the medical specialty of forensic pathology. In the event that the death has occurred within the jurisdiction of a medical examiner or coroner of any State or political subdivsion thereof, the medical examiner or coroner may attend the autopsy, and in the event that he or she is a licensed doctor of medicine certified hy the American Board of Pathology as specified above, will be designated to participate in the performance of the autopsy.

  350. The Attorney General of the United States shall designate the forensic pathologists who will perform the autopsy, on the advice and recommendation of the Director of the Armed Forces Institute of Pathology.

  351. Another alternative is to have all U.S. attorneys establish prior working relationships or standardized procedures with a medical examiner or coroner from their jurisdictions so that, if a death occurs in their jurisdiction, this person automatically participates in the autopsy. The medical examiner or coroner must be certified by the American Board of Pathology in the specialty of forensic pathology. The U.S. attorney and the previously designated medical examiner or coroner in the jurisdiction where death occurs will then designate the remaining forensic pathologists. In the event the death occurs outside the jurisdiction of any U.S. attorney, the Attorney General will then choose the forensic pathologists.

  352. One of the three or more physicians designated to perform the autopsy will be designated as the team leader and will be responsible for the preparation of the final report, with the concurrence of a majority of those participating in the autopsy. If the medical examiner or coroner in the community where the death occurred meets the designated qualifications, he will be the team leader. In the event that a material divergence of opinion arises between team members pertaining to an interpretation of a salient finding of the autopsy or subsequent laboratory testing of fluids or tissues from the body, a minority report me be prepared.

  353. Laboratories designated by the team leader will examine and document all material evidence unless such evidence is of the type that is customarily examined by crime laboratories, in which case the designated investigator from the FBI will designate the laboratory and will see that the evidence is properly transferred, with documentation. No photograph taken of the body or its accouterments, or of any evidence removed from the body, will be destroyed; all should be retained as evidence regardless of quality. All laboratory test results, all photographs, and all other evidence material to the determination of the events associated with the injury to the victim will be made available to the forensic pathology team as frequently as may be requested by its leader during the preparation of its reports. The forensic pathologist may also consult with laboratories and individuals apart from the FBI.

  354. On completion of all criminal court proceedings arising out of the prosecution of the person or persons responsible for the death under investigation, all physical evidence, including photographs, that can be preserved will remain the property of the United States of America and be preserved in the custody of the Archivist of the United States at the National Archives.

  355. The panel suggests that these procedures might be considered as the implementing rules or regulations to support section 1751 of title 18, but believes that they might also be incorporated into para- graph (h) of the existing legislation. This would preclude the develop- ment of a situation similar to that which existed at the time of the assassination of President Kennedy. Military medicine still does not acknowledge the need for a full-time mediocolegal investigative system within its programs, but depends on pathologists, many of whom are not specifically trained in forensic pathology, to act as consultants to investigators, performing autopsies on request. These examinations are often performed without adequate interaction between the investigator and the pathologists, who frequently has not had appropriate training. As review of the findings of such investigations and examinations by the forensic pathology branch of the Armed Forces Institute is usually delayed, it is often too late to correct inadequacies of the investigation or examination which may result in inadequate documentation and interpretation of evidence in subsequent criminal or civil litigation.


  356. The single-bullet theory (SBT) is unequivocally repudiated by an objective, thorough evaluation and analysis of all the medical, scientific, and physical data in the assassination of President John F. Kennedy (JFK).

  357. Despite the semantical sophistry and intellectual gymnastics of the forensic pathology panel report. (FPPR), it is clear that the SBT can no longer be maintained as an explanation for the bullet wounds in JFK's back and neck, and all the bullet wounds in Gov. John B. Connally (JBC). The angles at which these two men were hit do not permit a straight line trajectory (or near straight line trajectory) of Commission exhibit 399 (the so-called magic bullet) to be established. Indeed, quite the opposite is true. In order to accept the SBT, it is necessary to have the bullet move at different vertical and horizontal angles, a path of flight that has never been experienced or suggested for any bullet known to mankind. I am submitting a sketch, marked Wecht exhibit 11, to demonstrate this point in graphic fashion.

  358. An examination of the physical relationship between JFK and JBC immediately prior to and immediately following the moment that their wounds are alleged to have been inflicted by Commission exhibit 399 (as required by the SBT) provides unquestionable evidence that the bullet could not have moved in the direction claimed by the FPPR. I am submitting several photographs, marked Wecht exhibits 1 through 6, which demonstrate this relationship.

  359. Wecht exhibit 6 shows JBC firmly clutching his hat. This is approximately 1 1/2 seconds after he is alleged to have been shot through the chest, right wrist, and into his left thigh. Indeed, the FPPR states that they were surprised that although he bad suffered the injury to his wrist, lie did not drop his hat. The panel should not only be surprised, but incredulous. If they were not so slavishly dedicated to defending the Warren Commission report (WCR), and the previous opinions submitted by two of the panel members, Dr. James Weston and Dr. Werner Spitz, they would have interpreted this picture correctly and accepted it for what it obviously and clearly demonstrates--namely, that JBC was not struck in the chest, wrist, or thigh by CE 399, and the SBT is, therefore, indefensible.

  360. I do not accept the conclusion of the FPPR that the configuration of the gunshot wound on JBC's back indicates that the bullet that struck him at that location had to have been tumbling, and that such tumbling was most probably caused by the bullet (CE 399) having first gone through JFK's back and neck. There is strong evidence to indicate that the elongation of the wound on JBC's back was in the horizontal plane, and not in the vertical plane, which would be
    *References to or quotes from the Forensic Pathology Report refer to drafts of the report.

    consistent with the shot having struck JBC on a tangential angle from the right rear. Furthermore, if, in fact, the bullet that struck JBC was tumbling, such tumbling could just as easily have been caused by the bullet nipping a small tree branch or leaves during the course of its preimpact trajectory.

  361. With regard to this portion of the discussion. I should like to note for the record that the FPP and HSCA stair placed much emphasis on and gave a great deal of credence to so-called ballistics studies performed by Dr. John Lattimer, a urologist with no training, experience, or expertise whatsoever in forensic pathology. At the same time, the FPP and HSCA paid no attention whatsoever 10 the ballistics studies performed by Dr. John Nichols, a board-certified pathologist and full-time professor of pathology on the faculty of the University of Kansas School of Medicine. This is additional evidence of clearcut bias on the part of both the HSCA staff and the FPP.

  362. Examination of CE 399, correlated with various studies previously performed with identical ammunition fired from a Mannlicher Careano rifle, definitely proves that, this bullet could not have inflicted all the damage attributed to it under the SBT to JFK and JBC. Specifically, there is no way that this bullet could have caused all the bone damage to JBC's right fifth rib and right, radius, without having sustained more physical deformity.

  363. I am submitting pictures of CE 399 (Wecht, exhibits 7, 8 and 9) to show that the only deformity of this bullet was minimal indentation at the base, with absolutely no damage to the nose of the bullet and no defects in the copper jacket.

  364. I am also submitting another picture (Wecht exhibit 10), which is a composite photograph of identical ammunition fired under the auspices of the Warren Commission in 1964:. These other bullets were fired into cotton wadding, a goat carcass (breaking one rib of the goat), and the wrist of a human cadaver (breaking the distal end of the radius), respectively. They all showed more deformity than CE 399, especially the bullet that was fired through a human wrist. And yet, we are asked to accept the fact that CE 399 broke both a rib and a radius in JBC, and emerged intact. and only minimally deformed at the base. This finding alone destroys the SBT in an objective, scientific manner.

  365. Despite repented requests by me that further studies be performed on animal carcasses and human cadavers with 6.5-millimeter ammunition (copper jacket lead core), the FPP members refused to go along with this very reasonable and logical request. It is clear to me that their reluctance was based upon their knowledge that such studies would further destroy the SBT.

  366. Similarly, I repeatedly requested that our panel he given access to JFK's brain, so that it could be properly examined some members of the FPP did give affirmative lip service to this request, it was quite clear from their deliberations in the FPPR that they did not choose to emphasize and pursue properly this scientifically logical and reasonable demand.

  367. In this regard, with reference to both of my requests concerning test-Grings through animal carcasses and human cadavers and an attempt to locate and gain access to JFK's brain. I should like to note that there was also great reticence on the part of Prof. G. Robert Blakey, chief counsel and director of the House Select Committee on Assassinations (HSCA), to undertake these pursuits. As a matter of fact, Professor Blakey did not seem the least bit interested in undertaking such studies. I wish to emphasize the fact that such controlled test-firings were performed at the request, of the Warren Commission in 1964, and undoubtedly could have been repeated at this time with a reasonable expenditure of time, effort, and money.

  368. The FPPR states that: The panel considered the question that the residual defect might conceivably have been the location for an additional inshoot wound, but noted that there was no radiographic evidence of such a missile within the skull, nor any observation or description of the effects of such a missile on the slain flaps, within the brain, or interior of the skull.

  369. In my opinion, the medical evidence and other physical evidence and investigative data in this case do not rule out the possibility of an additional gunshot wound of JFK's head. This shot could have been fired in synchronization with the other shot that struck JFK in the back of the head, and would most probably have been fired from the right side (in relationship to the Presidential limousine).

  370. A soft-nose bullet, or some other type of relatively frangible ammunition, that would have disintegrated upon impact, could have struck the right side of JFK's head in the parietal region. Inasmuch as there is a large defect of JFK's skull in this area, it is not possible to rule out, the existence of a separate entrance wound at the site. Since 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. Also, there would not be a separate exit wound if this kind of ammunition had been used.

  371. Again, it must be reemphasized that examination of JFK's brain is a critical element of this assassination investigation. It is truly incredible that appropriate dissection and examination of JFK's brain was not performed by the pathologists who did this autopsy on November 22, 1963, or at the time of their supplemental examination of the brain 2 weeks later on December 6, 1963. It is equally incredible, and most unfortunate, that the members of the FPP and HSCA staff have cursorily dismissed my frequent requests that JFK's brain be recovered and properly examined at this time. Their perfunctory dismissal of this obviously important and medically critical aspect of the investigation demonstrates without question their preconceived bias am] professionally injudicious attitude vis-a-vis this case.

  372. The FPPR engages in a lengthy discussion to explain the basis for their conclusion that "Solely on the basis of others" descriptions of the wounds in Governor Connally's wrist and thigh, the panel could not rule out the possibility that these were caused by a fragment of the bullet striking the President's head, although the panel felt that the ability to align the wounds in the chest, wrist, and thigh, offered strong presumptive evidence that they were caused by one missile." I wish to take strong exception to this conclusion and express my unequivocal disclaimer to this so-called "presumptive evidence."

  373. The FPPR goes to great lenths to explain why it is not possible to draw straight lines through JFK and JBC in an attempt either to corroborate or disprove the SBT. Then, with incredible, intellectual inconsistency, the report nevertheless goes on to conclude that the SBT is physically possible and plansible. This blatant disregard of medical and scientific evidence and deliberate distortion and misrepresentation of analytical studies demonstrate more vividly than anything else the bias of my colleagues on the FPP.

  374. As further evidence of my allegation that the FPP began its deliberations with a preconceived bias vis-a-vis the WCR. I should like to point out in its report (first page of part 1), the statement that following its very first meeting at the National Archives on September 18, 1977, "it was disclosed that subpanel l was in unanimous agreement with respect to the interpretation of the evidence." (Subpanel 1 consisted of a]] the FPP members except Spitz, Wecht and Weston.) And vet. when subpanel l met with subpanel 2 (Spitz. Wecht, and Weston), I pointed out many problems and emphasized various specific issues, other members of the overall FPP also expressed strong differences of opinion. This clearly demonstrates the strong, premature desire, on the part of the FPP to rush headlong into another superficial whitewash of the WCR.

  375. I also wish to point out for the record that a meeting was between subpanel 1 of the FPP and Drs. Humes and Boswell in Washington. D.C., during the time of their first meeting in September no question in my mind that this meeting was arranged by the HSCA staff and members of the FPP at that time in order to exclude me from participating in the discussion and interrogation of Humes and Boswell (two of the three pathologists who performed the autopsy on JFK on November 22, 1963).

  376. The FPPR does not adequately and definitively address itself the numerous procedural and substantive deficiencies of the original autopsy and related medical-scientific investigative studies. The FPPR states that "Rather than proceed step by step with a critical review of the autopsy conducted by these individials who were acting in response to official military orders under duress, with time and other constraints, the panel felt it wise to delineate some of the basic differences between a 'hospital autopsy' and a forensic autopsy performed a necessary step in an official medicolegal investigation of death?

  377. I would like to have it noted as a matter of the official record that I never agreed to such an approach. I feel that a constructive, detailed, critical analysis of the JFK autopsy should most definitely be incorporated as a vital part of the FPPR. In fact, this objective was specifically set forth as one of the four charges addressed to the FPP at the outset of the deliberations in September 1977 (see p. 2 of the FPPR). The panel was "to conduct a detailed objective critique of the professional manner in which the autopsy of President Kennedy was conducted."

  378. Once again, the FPP demonstrates more concern about the feelings sensitivities and reputations of its personal friends and professional colleagues than it does about uncovering the ultimate truth involving the assassination of President John F. Kennedy. My exclusion from the above-mentioned meeting serves as further evidence of the bias that existed on the part of Professor Blakey and the FPP toward me personally.

  379. At this time, I have not seen the final proposal prepared by Dr. Weston, but I know from the previous drafts that he was requesting photographs and data from members of the FPP that would corroborate various points that Dr. Weston felt should be emphasized in the FPPR. I cannot accept any such photographs and interpretations without having full details of those respective cases from the jurisdictions of the FPP members who have submitted such materials. In light of the bias and scientific inconsistency that these panel members have demonstrated in various facets of their overall involvement in this undertaking, I am not prepared blindly and naively to accept their representations of what a particular photograph is supposed to demonstrate and prove.

  380. There are numerous other items in the FPPR which are equally incorrect, inconsistent or susceptible to interpretations substantially different from the conclusions drawn by the FPPR. Regrettably, because of the August 11 deadline that has been imposed by Professor Blakey, I simply have not had sufficient time to mention and discuss each of these items in this Addendum report. In this regard, I wish to point out that I consider the time restriction imposed by Professor Blakey to have been extremely short and most unreasonable in light of the great amount of time that was given to Dr. Weston to prepare the FPPR.

  381. Also, I wish to point out for the record that I believe it was quite inappropriate and injudicious to have had the FPPR prepared by Dr. James Weston, in light of his previous involvement in a review of the WCR and his publicly acknowledged and officially recorded stance vis-a-vis the WCR. Once again, the fact that Professor Blakey and his staff either assigned, or permitted this assignment to be made to Dr. Weston is clear evidence of their blatant disregard for an objective, impartial approach to all the evidence in this case.

  382. Furthermore, at this time, I am not aware of the findings, interpretations and conclusions of other specialty panels that had been created by the HSCA to review the evidence in the JFK assassination. I do not understand how the FPP can prepare a final report without knowing what the final deliberations are of these other specialty panels. This is not the way forensic pathologists function, and I am truly amazed that they would have engaged in such an unprofessional approach in a matter of this magnitude.

    H. WECHT, M.D. J.D., Coroner of Allegheny/County.

    FIGURES used in the dissenting view to the Forensic Pathology Panel Report, submitted by Cyril H. Wecht, M.D., J.D.

    Wecht exhibits 1,2, 3,4 5,6. Photographs demonstrating the physical relationship between President Kennedy and Governor Connally.
    Wecht exhibits 7, 8, and 9 Photographs demonstrating the degree of deformity of bullet CE 399.
    Wecht exhibit 10. Photograph displaying ammunition identical to CE 399, fired under the auspices of the Warren Commission in 1964.
    Wecht exhibit 11. Photograph of a sketch illustrating the positions of the occupants in the presidential limousine.


  383. The panel majority has considered all the issues raised by the panel minority of one. The conclusions of the panel majority remain unchanged in the absence of additional bona fide evidence.


Abrasion collar: The dark circle around the margins of a bullet perforation of entrance, caused by the rubbing of a bullet against the skin as it stretches and penetrates it at the moment of impact.

Acromion process: The lateral end of the spine of the scapula (shoulder blade) which forms the top. outside, back portion of the shoulder. Anatomic position: The position of the body at attention, with the face forward, the arms at the side, and the palms of the hand facing forward.

Anterior-posterior: Refers to X-rays taken with the beam proceeding from the front of the body (anterior) to the back (posterior), with the back part of the body against the X-ray plate (posterior-anterior view of the chest indicates that the chest is against the X-ray plate and the beam enters from the back).

Apical or supraclavicular portion of the pleural cavity: The uppermost part of the pleural cavity (lung cavity) adjacent to the neck and above the collarbone.

Arachnoid: A thin, transparent, delicate membrane that covers the brain.

Axilla: The armpit.

Basilar aspect: The underside of the brain.

Beveling: Beveling in bone resembles the beveling observed when a BB or small caliber missile strikes a plate glass window. (See fig. 16, depicting beveling.) Pathologists use this information to characterize the direction of travel of a missile through bony surfaces, since the margins of the defect on the bony surface where the bullet enters the bone are sharply outlined and may approximate the dimensions of the missile itself, while the margins where the bullet exits from the opposite bony surface are large, more irregular, and cratered. Missile fragments or bullets exiting from the skull produce a similar pattern in reverse direction, that is, the point where the bullet first strikes the skull on the inside of the exit point is smaller and the beveling extends to a larger, more irregular defect on the outer surface of the bone.

Calvarium: The top of the skull; the skullcap.

Cecum: The beginning of the large intestine or colon.

Cerebellum: The part of the brain immediately behind and below the cerebrum and situated in the lower back part of the skull.

Cervical: Refers to the area of the neck.

Comminuted fracture: A fracture in which the bone is broken into a number of fragments.

Computer-assisted image enhancement: A procedure in which graphic images are recorded on a television camera and then, with the assistance of Operator or by preprogramed instructions to the computer, color or light variations which are barely perceptible or are even imperceptible to the human eye are magnified so that they are more easily seen. The procedure assigns numbers indicating the level of intensity of the three primary colors in many tiny spots comprising the televised image. These numbers are stored systematically on the computer, thus "digitizing" the image. The programer uses various mathematical manipulations of these numbers to render the enhancement.

Contusion: Bruise (results from trauma and bleeding from injured small blood vessels).

Computer-assisted image enhancement of X-rays a process somewhat different from that of photographic enhancement. In this technique, the initial steps of image digitalization are similar, but the mathematical programing serves to reduce the fuzzy, ill-defined shadows on the X-ray to rather concise lines, simulating line drawings prepared from X-rays.

Coronal sectioning: A technique for sectioning the brain, similar to slicing a loaf of bread. The brain is cut parallel to the coronal suture line of the skull, which extends from the front of one ear to the front of the other ear. Coronal suture: See "suture lines."

Corpus Callosum: The part of the brain that connects the cerebral hemispheres.

cortex: The outer part of an organ such as the brain or adrenal glands. Decerebrate rigidity: Rigidness of the body or a part of the body which is caused by a muscle spasm of the entire body below the neck resulting from interference in the transmission of stimuli from the higher centers of the brain which maintain balance and muscle tone to the spinal cord.

Definition: In optics, the power of a lens to give a distinct image.

dermis: The innermore layers of the skin.

Dorsal aspect: Refers to the posterior or back surface of the body or a part of the body as opposed to the ventral aspect, or anterior or front surface.

Ecchymosis: hemorrhage or bleeding into tissues; often referred to as black and blue marks.

energy dispersive X-ray examination: A techniquewhich measures the radiation characteristic of different (chemical) elements when excited by an X-ray source. It allows one element to be distinguished from another, such as lead, copper, or zinc.

Epidermis: The thin, outermost layer of the skin.

Epithelium: A purely cellular layer covering the surface of the skin. Ethmoid: Resembling a sieve.

External occipital protuberance: The prominence in the middle of the back of the skull.

Falx cerebri: A thin, fibrous membrane that extends between the cerebral hemispheres.

Fascia: A fibrous, connective tissue membrane.

Forensic odontologist: One who applies the technique of dentistry for medical legal purposes to assist in identification of individuals by dental comparisons and examination of bite mark evidence.

Frangible bullet: A bullet composed of metal fragments designed to splinter on impact: often used in shooting galleries to prevent the ricocheting of bullets.

Frankfortplane: A standard reference point. It is a horizontal plane of the head passes through the most inferior portion Of the left orbit and the superior margin of the left external auditory foramen (ear canal). Fronto-parietal: Refers to the front and upper aspects of the head and skull.

Fronto-temporal: Refers to the front and side aspects of the head and skull.

Galea: A thick, fibrous membrane between the scalp and the skull bones.

Gross description: Description of the body or body organs made with the naked eye and without the aid of a microscope.

Gyri: The rounded elevation of the outside of the cerebral hemisphere of the brain; the depressions are called sulci.

hemithorax: One-half of the chest.

Hemorrhage: Bleeding.

In-life: Taken while the person was living.

Interstitial emphysema: Abnormal accumulation of air within tissues.

Latissimus dorsi muscle: The broadest muscle of the back

Lobe: A rounded, projecting part.

Mastoid process: The lowest projection of temporal bone immediately behind the ear.

Medial femoral condyle: In the middle of the rounded articular surface at the extremity of the bone.

mediastinum: The middle part or aspect of the chest.

"Missile dust": Refers to the X-ray appearance of tiny metal fragments deposited in the tissues along the course of a missile track.

Necrosis: The death of tissues.

Obelion: A point on the sagittal suture between the parietal foramina (small holes located approximately 0.5 to 1 centimeter lateral to the sagittal suture) approximately 5 centimeters above its posterior margin where it terminates. in the lambdoidal suture, the semicircular suture extending around the occipital or back portion of the head and separating the parietal bones from the occipital bone.

Occipital protuberance: See external occipital protuberance.

Occipital region: The back part of the head.

Occipital-parietal: The upper, back part of the head and skull.

Orbit: The body socket which contains the eye.

Paraffin blocks: Wax blocks containing small pieces of tissue used in the preparation of slides for microscopic examination. It enables the cutting of the very thin sections necessary for microscopic study.

Parietal: Upper part of the skull or head.

Periosteum: Thin, fibrous membrane covering the bone.

Photographic enhancement: A process for improving the quality of an image for example, with a computer by converting picture elements intodigital numbers that are systematically modified and converted back into picture elements.

Pleural cavity: The space in the chest containing the lungs.

Pleural fluid: Fluid present in the pleural cavity.

Pneumothorax: Air or gas in the pleural cavity.

Positive pressure insufflation: The Propulsion of air through a tube into the trachea and the lungs by a mechanical device during emergency treatment.

Pulmonary contusion: contusion or bruising of the lung.

Pulmonary parenchyma: The substance of the lungs.

Radiolucency: Appearing as an empty space on an X-ray.

Reverse jet effect: The movement of an object in a direction opposite of the release of energy.

Rifling: Refers to the grooves in the barrel of a gun or rifle designed to impart rotation to a missile and make flight more accurate.

Roentgenogram: X-ray.

Sagittal plane: The plane through or parallel to the sagittal suture line of the skull which is at the top of the head between the parietal bone and extends from front to back in an anterior-posterior direction.

Sagittal suture: See suture.

Scanning electron microscopy: A technique in which a beam of focused electrons moves across an object. The secondary electrons produced by the object and the electrons scattered by the object are collected to form a three-dimensional image in a cathode-ray tube.

Scapula: Shoulder blades.

Secondary missiles: Objects which have become missiles as a consequence of being struck by the primary missile, which is usually a bullet. These missiles may inch the fragments of bone.

Sella turcica: Literally, "turkish saddle"; the depression in the sphenoid bone of the skull that contains the pituitary glands.

serratus anterior muscle: A thin muscle between the ribs and scapula and the upper portion and sides of the chest.

Soft-nosed bullet: A bullet with a lead or unjacketed nose.

Soft X-ray examination: A technique which employs X-rays at low levels to reveal materials not seen by normal X-ray techniques.

Spectrographic analysis: Technique in which a spectrograh is used to subject charged and accelerated ions to a magnetic field to detect differing molecular structures. This allows identification of various substances.

Sphenoid sinus: The air spaces in the sphenoid bone of the skull; they serve as accessory air spaces for the nose.

Stephanion: The junction of the coronal suture at its lateral extremity with the temporal line (the upper margin of the temporalis muscle insertion).

Stereoscopic visualization: Technique which involves the use of a stereoscope, an optical instrument with two eyeglasses, to assist the observer in combining the ixnages of two pictures taken from points of view a small distance apart and thus to get the effect of solidity or depth.

Subarachnoid: Underneath the arachnoid membrane.

Sulci: See gyri.

Supraclavicular: The area above the collar bone (clavicular) at the root of the (neck. Suprasternal notch: The V-shaped indentation at the upper border of the stern) or breast bone at the base of the neck, in the midline.

Suture lines: The junctures in the skull between the various flat bones where growth occurs until the individual reaches maturity, when they close or fuse, thereby making the skull virtually one large bone. Even after closure, there are slightly indented residual lines, usually arranged in a somewhat zigzag pattern. Each of these suture lines has been named.

Sylvian fissure: The deepest and most prominent lateral cerebral fissure of the brain.

Temporo-parietal: Refers to the side and upper aspects of the head and skull.

Thoracolumbar: Refers to the chest and lower part, of the vertebral column.

Thorax: Chest.

Tragus: The cartilaginous protusion in the front part of outer ear.

Transparency: An image (usually positive) intended to be observed by light that passes through the image and base, as on a viewer or by projection.

Tumbling: The rotation of a bullet over its longitudinal axis: sometimes resulting in the bullet "tumbling" end over end.

Turcica: See sella turcica.

Vascular foramina: Opening in bone through which blood vessels travel. Vastus medialis: A prominent muscle in the front of the upper leg.

Ventricles: In reference to the brain, the normal cavities within the brain containing cerebro-spinal fluid.

Vertex: The crown or topmost part of the head.

Visceral pleura: A thin semitransparent membrane covering the outer surface of the lung and separated from the "parietal pleura" which lines the inside of the chest cavity. where the lung is suspended only by its attachment or hilium in the midportion of its medial surface.

Refers to the palm of the hand or the sole of the foot.

X-ray back scatter: A technique used to determine the presence of metal in tissue.

Yaw: The deviation of a bullet from its longitudinal axis during its line of flight, resulting from the spin imparted to the bullet by rifling and imperfection in the bullet due to construction or deformation in the bore or other imperfections in the gun, and also caused by resistance of air or tissues.