Date 11/22/63 1300 (CST)
Prosecter: CDR J.J. Humes, MC, USA (497831)
Assistant: CDR "J" Thornton Boswell, MC, USN, (439878);
LCOL, Pierre A. Finck, MC, USA (04 043 322)
Ht. - 72 1/2 inches Wt. - 170 pounds Eyes - blue Hair - Reddish
Pathological diagnosis: Cause of Death: Gunshot wound, head.
Signature: J.J. Humes, CDS, MC, USN
Military organization: President, United States
Age: 46 Sex: Male Race: Caucasian
Autopsy No. A63-272
Patient's Identification: Kennedy, John F., Naval Medical
According to available information the deceased, President
Kennedy, was riding in an open car in a motorcade during an official
visit to Dallas, Texas on 22 November 1963. The President was
sitting in the right rear seat with Mrs. Kennedy seated on the
seat to his left. Sitting directly in front of the President
John B. Connally of Texas and directly in front of Mrs. Kennedy
Mrs. Connally. The vehicle was moving at a slow rate of speed
an incline into an underpass that leads to a freeway route to
Dallas Trade Mart where the President was to deliver an address.
Three shots were heard and the President fell forward bleeding
the head. (Governor Connally was seriously wounded by the same
gunfire.) According to newspaper reports ("Washington Post"
November 23, 1963) Bob Jackson, a Dallas "Times Herald"
Photographer, said he looked around as he heard the shots and
rifle barrel disappearing into a window on an upper floor of
nearby Texas School Book Depository Building.
Shortly following the wounding of the two men the car was
Parkland Hospital in Dallas. In the emergency room of that hospital
the President was attended by Dr. Malcolm Perry. Telephone
communication with Dr. Perry on November 23, 1963 develops the
following information relative to the observations made by Dr.
and procedures performed there prior to death.
Dr. Perry noted the massive wound of the head and a second
smaller wound of the low anterior neck in approximately the midline.
A tracheostomy was performed by extending the latter wound. At
point bloody air was noted bubbling from the wound and an injury
the right lateral wall of the trachea was observed. Incisions
in the upper anterior chest wall bilaterally to combat possible
subcutaneous emphysema. Intravenous infusions of blood and saline
were begun and oxygen was administered. Despite these measures
cardiac arrest occurred and closed chest cardiac massage failed
re-establish cardiac action. The President was pronounced dead
approximately thirty to forty minutes after receiving his wounds.
The remains were transported via the Presidential plane to
Washington, D.C. and subsequently to the Naval Medical School,
National Naval Medical Center, Bethesda, Maryland for postmortem
General Description of the Body
The body is that of a muscular, well-developed and well nourished
adult Caucasian male measuring 72 1/2 inches and weighing
approximately 170 pounds. There is beginning rigor mortis, minimal
dependent livor mortis of the dorsum, and early algor mortis.
hair is reddish brown and abundant, the eyes are blue, the right
measuring 8 mm. in diameter, the left 4 mm. There is edema and
ecchymosis of the inner canthus region of the left eyelid measuring
approximately 1.5 cm. in greatest diameter. There is edema and
ecchymosis diffusely over the right supra-orbital ridge with
mobility of the underlying bone. (The remainder of the scalp
described with the skull.) There is clotted blood on the external
but otherwise the ears, nares, and mouth are essentially unremarkable.
The teeth are in excellent repair and there is some pallor of
Situated on the upper right posterior thorax just above the
border of the scapula there is a 7 x 4 millimeter oval wound.
wound is measured to be 14 cm. from the tip of the right acromion
process and 14 cm. below the tip of the right mastoid process.
Situated in the low anterior neck at approximately the level
third and fourth tracheal rings is a 6.5 cm. long transverse
with widely gaping irregular edges. (The depth and character
wounds will be further described below.)
Situated on the anterior chest wall in the nipple line are
bilateral 2 cm.
long recent transverse surgical incisions into the subcutaneous
The one on the left is situated 11 cm. cephalad to the nipple
one on the right 8 cm. cephalad to the nipple. There is no hemorrhage
or ecchymosis associated with these wounds. A similar clean wound
measuring 2 cm. in length is situated on the antero-lateral aspect
the left mid arm. Situated on the antero-lateral aspect of each
a recent 2 cm. transverse incision into the subcutaneous tissue.
There is an old well healed 8 cm. McBurney abdominal incision.
Over the lumbar spine in the midline is an old, well healed 15
scar. Situated on the upper antero-lateral aspect of the right
an old, well healed 8 cm. scar.
1. There is a large irregular defect of the scalp and skull
on the right
involving chiefly the parietal bone but extending somewhat into
temporal and occipital regions. In this region there is an actual
absence of scalp and bone producing a defect which measures
approximately 13 cm. in greatest diameter.
From the irregular margins of the above scalp defect tears
stellate fashion into the more or less intact scalp as follows:
a. From the right inferior temporo-parietal margin anterior
to the right
ear to a point slightly above the tragus.
b. From the anterior parietal margin anteriorly on the forehead
approximately 4 cm. above the right orbital ridge.
c. From the left margin of the main defect across the midline
antero-laterally for a distance of approximately 8 cm.
d. From the same starting point as c. 10 cm. postero-laterally.
Situated in the posterior scalp approximately 2.5 cm. laterally
right and slightly above the external occipital protuberance
lacerated wound measuring 15 x 6 mm. In the underlying bone is
corresponding wound through the skull which exhibits beveling
the margins of the bone when viewed from the inner aspect of
Clearly visible in the above described large skull defect
from it is lacerated brain tissue which on close inspection proves
represent the major portion of the right cerebral hemisphere.
point it is noted that the falx cerebri is extensively lacerated
disruption of the superior saggital sinus.
Upon reflecting the scalp multiple complete fracture lines
are seen to
radiate from both the large defect at the vertex and the smaller
at the occiput. These vary greatly in length and direction, the
measuring approximately 19 cm. These result in the production
numerous fragments which vary in size from a few millimeters
cm. in greatest diameter.
The complexity of these fractures and the fragments thus produced
tax satisfactory verbal description and are better appreciated
photographs and roentgenograms which are prepared.
The brain is removed and preserved for further study following
Received as separate specimens from Dallas, Texas are three
fragments of skull bone which in aggregate roughly approximate
dimensions of the large defect described above. At one angle
largest of these fragments is a portion of the perimeter of a
circular wound presumably of exit which exhibits beveling of
outer aspect of the bone and is estimated to measure approximately
2.5 to 3.0 cm. in diameter. Roentgenograms of this fragment reveal
minute particles of metal in the bone at this margin. Roentgenograms
of the skull reveal multiple minute metallic fragments along
corresponding with a line joining the above described small occipital
wound and the right supra-orbital ridge. From the surface of
disrupted right cerebral cortex two small irregularly shaped
fragments of metal are recovered. These measure 7 x 2 mm. and
1 mm. These are placed in the custody of Agents Francis X. O'Neill,
Jr. and James W. Sibert, of the Federal Bureau of Investigation,
executed a receipt therefor (attached).
2. The second wound presumably of entry is that described
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 proved. The wound
presumably of exit was that described by Dr. Malcolm Perry of
Dallas in the low anterior cervical region. When observed by
Perry the wound measured "a few millimeters in diameter",
it was extended as a tracheostomy incision and thus its character
distorted at the time of autopsy. However there is considerable
eccymosis of the strap muscles of the right side of the neck
the fascia about the trachea adjacent to the line of the tracheostomy
wound. The third point of reference in connecting these two wounds
is in the apex (supra-clavicular portion) of the right pleural
this region there is contusion of the parietal pleura and of
apical 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 cm. Both the visceral and parietal pleura
intact overlying these areas of trauma.
The scalp wounds are extended in the coronal plane to examine
cranial content and the customary (Y) shaped incision is used
examine the body cavities.
The bony cage is unremarkable. The thoracic organs are in
normal positions are relationships and there is no increase in
pleural fluid. The above described area of contusion in the apical
portion of the right pleural cavity is noted.
The lungs are of essentially similar appearance the right
320 Gm., the left 290 Gm. The lungs are well aerated with smooth
glistening pleural surfaces and gray-pink color. A 5 cm. diameter
area of purplish red discoloration and increased firmness to
is situated in the apical portion of the right upper lobe. This
corresponds to the similar area described in the overlying parietal
pleura. Incision in this region reveals recent hemorrhage into
The pericardial cavity is smooth walled and contains approximately
10 cc. of straw-colored fluid. The heart is of essentially normal
external contour and weighs 350 Gm. The pulmonary artery is
opened in situ and no abnormalities are noted. The cardiac chambers
contain moderate amounts of postmortem clotted blood. There are
gross abnormalities of the leaflets of any of the cardiac valves.
following are the circumferences of the cardiac valves: aortic
pulmonic 7 cm., tricuspid 12 cm., mitral 11 cm. The myocardium
firm and reddish brown. The left ventricular myocardium averages
1.2 cm. in thickness, the right ventricular myocardium 0.4 cm.
coronary arteries are dissected and are of normal distribution
smooth walled and elastic throughout.
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
described old abdominal incisional scar.
Aside from the above described skull wounds there are no significant
gross skeletal abnormalities.
Black and white and color photographs depicting significant
are exposed but not developed. These photographs were placed
custody of Agent Roy E. Kellerman of the U.S. Secret Service,
executed a receipt therefore (attached).
Roentgenograms are made of the entire body and of the separately
submitted three fragments of skull bone. These are developed
were placed in the custody of Agent Roy H. Kellerman of the U.S.
Secret Service, who executed a receipt therefor (attached).
Based on the above observations it is our opinion that the
died as a result of two perforating gunshot wounds inflicted
velocity projectiles fired by a person or persons unknown. The
projectiles were fired from a point behind and somewhat above
level of the deceased. The observations and available information
not permit a satisfactory estimate as to the sequence of the
The fatal missile entered the skull above and to the right
external occipital protuberance. A portion of the projectile
the cranial cavity in a posterior-anterior direction (see lateral
roentgenograms) depositing minute particles along its path. A
of the projectile made its exit through the parietal bone on
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
saggital sinus, and of the right cerebral hemisphere.
The other missile entered the right superior posterior thorax
the scapula and traversed the soft tissues of the supra-scapular
the supra-clavicular portions of the base of the right side of
This missile produced contusions of the right apical parietal
and of the apical portion of the right upper lobe of the lung.
missile contused the strap muscles of the right side of the neck,
damaged the trachea and made its exit through the anterior surface
the neck. As far as can be ascertained this missile struck no
structures in its path through the body.
In addition, it is our opinion that the wound of the skull
such extensive damage to the brain as to preclude the possibility
the deceased surviving this injury.
A supplementary report will be submitted following more detailed
examination of the brain and of microscopic sections. However,
not anticipated that these examinations will materially alter
J. J. HUMES
CDR, MC, USN (497831)
"J" THORNTON BOSWELL
CDR, MC, USN (489878)
PIERRE A. FINCK
LT COL, MC, USA
Supplementary Report of Autopsy Number A63-272 President
John F. Kennedy
Pathological Examination Report No. A63-272
Gross Description of the Brain
Following formalin fixation the brain weighs 1500 gms. The
cerebral hemisphere is found to be markedly disrupted. There
longitudinal laceration of the right hemisphere which is para-sagittal
in position approximately 2.5 cm. to the right of the of the
which extends from the tip of the occipital lobe posteriorly
to the tip
of the frontal lobe anteriorly. The base of the laceration is
approximately 4.5 cm. below the vertex in the white matter. There
considerable loss of cortical substance above the base of the
laceration, particularly in the parietal lobe. The margins of
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
corpus callosum extending from the genu to the tail. Exposed
latter laceration are the interiors of the right lateral and
When viewed from the vertex the left cerebral hemisphere is
There is marked engorgement of meningeal blood vessels of the
temporal and frontal regions with considerable associated
sub-arachnoid hemorrhage. The gyri and sulci over the left
hemisphere are of essentially normal size and distribution. Those
the right are too fragmented and distorted for satisfactory description.
When viewed from the basilar aspect the disruption of the
cortex is again obvious. There is a longitudinal laceration of
mid-brain through the floor of the third ventricle just behind
chiasm and the mammillary bodies. This laceration partially
communicates with an oblique 1.5 cm. tear through the left cerebral
peduncle. There are irregular superficial lacerations over the
aspects of the left temporal and frontal lobes.
In the interest of preserving the specimen coronal sections
made. The following sections are taken for microscopic examination:
a. From the margin of the laceration in the right parietal
b. From the margin of the laceration in the corpus callosum.
c. From the anterior portion of the laceration in the right
d. From the contused left fronto-parietal cortex.
e. From the line of transection of the spinal cord.
f. From the right cerebellar cortex.
g. From the superficial laceration of the basilar aspect of
During the course of this examination seven (7) black and
six (6) color 4x5 inch negatives are exposed but not developed
cassettes containing these negatives have been delivered by hand
Rear Admiral George W. Burkley, MC, USN, White House
Multiple sections from representative areas as noted above
examined. All sections are essentially similar and show extensive
disruption of brain tissue with associated hemorrhage. In none
sections examined are there significant abnormalities other than
directly related to the recent trauma.
Sections show a moderate amount of sub-epicardial fat. The
arteries, myocardial fibers, and endocardium are unremarkable.
Sections through the grossly described area of contusion in
upper lobe exhibit disruption of alveolar walls and recent hemorrhage
into alveoli. Sections are otherwise essentially unremarkable.
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
biopsy pattern" of sudden death.
Sections show no significant abnormalities.
Sections show no significant abnormalities aside from dilatation
engorgement of blood vessels of all calibers.
Sections through the wounds in the occipital and upper right
posterior thoracic regions are essentially similar. In each there
of continuity of the epidermis with coagulation necrosis of the
at the wound margins. The scalp wound exhibits several small
fragments of bone at its margins in the subcutaneous tissue.
This supplementary report covers in more detail the extensive
of cerebral trauma in this case. However neither this portion
examination nor the microscopic examinations alter the previously
submitted report or add significant details to the cause of death.
J. J. HUMES
CDR, MC, USN, 497831
Date: 6 December 1963
From: Commanding Officer, U. S. Naval Medical School
To: The White House Physician
Via: Commanding Officer, National Naval Medical Center
Subj: Supplementary report of Naval Medical School autopsy
A63-272, John F. Kennedy; forwarding of
1. All copies of the above subject final supplementary report
J. H. STOVER, JR.
6 December 1963
From: Commanding Officer, National Naval Medical Center
To: The White House Physician