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JFK's "SHALLOW" BACK WOUND REVISITED (FOR THE UMPTEENTH TIME)


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Okay, let's get back to looking for evidence of a tension pneumothorax in JFK's right lung by examining the testimonies of Drs. Carrico and Perry.

In my previous long post regarding Carrico's testimony, I showed that, after JFK was intubated with an endotracheal tube and hooked up to positive pressure ventilation via a respirator, Carrico listened to the air going into JFK's lungs and found that "Breath sounds were diminished, especially on the right....". The standard LN argument is that Carrico clumsily over inserted the endotracheal tube into JFK's left bronchus, but this was impossible, as air was leaking from the throat wound, and the only way this was possible was if Carrico accidentally placed the cuff ABOVE the wound in the trachea. With the cuff so high on the trachea, the tip of the endotracheal tube could be nowhere near the bronchi. Wit air leaking from the tracheal wound, there would be diminished breath sounds bi-laterally, but this does not explain the right breath sounds being more diminished. Conclusion: tension pneumothorax in JFK's right lung.

Just about the time Carrico was observing diminished breath sounds and air leaking out of the throat wound, Dr. Perry entered Trauma Room One and assumed control of JFK's airway. I would imagine there was a brief discussion between Carrico and Perry, with Carrico swearing he had placed the endotracheal tube cuff below the tracheal wound. It would have been very easy to tell Carrico to simply re-insert the endotracheal tube (again using the laryngoscope) and try to get the cuff below the tracheal wound on the second attempt. However, Perry seemed to be a quick thinker, and it likely occurred to him that the cuff of the e. tube was in its proper place below the tracheal wound, and the real reason that air was being lost out through the throat wound was that JFK's trachea was more damaged (and lower down) than Carrico had first surmised.

Time was extremely limited for JFK, and rather than waste time reinserting the e. tube, just to find that was not the problem, Perry elected to perform a tracheotomy on JFK's trachea. There were good reasons for doing so.

1. By exposing JFK's trachea, Perry could check for further damage, such as ruptured blood vessels or a second or third tear in the trachea below the one seen by Carrico.

2. The tip of the tracheostomy tube does not extend as far below its inflatable cuff as does the cuff on the endotracheal tube, allowing the tracheostomy cuff to be placed deeper in the trachea without overinserting the tip into one of the bronchi. If there was only one tear in the trachea (as there actually was), placing the tracheostomy through an incision made through this tear would guarantee the inflatable cuff would be below the tear.

When Perry made the incision in JFK's throat, exposing his trachea, he made one VERY important observation that pretty much means JFK had to have had a tension pneumothorax in his right lung:

"Mr. SPECTER - Dr. Perry, you mentioned an injury to the trachea.

Will you describe that as precisely as you can, please?
Dr. PERRY - Yes. Once the transverse incision through the skin and subcutaneous tissues was made, it was necessary to separate the strap muscles covering the anterior muscles of the windpipe and thyroid. At that point the trachea was noted to be deviated slightly to the left and I found it necessary to sever the exterior strap muscles on the other side to reach the trachea.
I noticed a small ragged laceration of the trachea on the anterior lateral right side. I could see the endotracheal tube which had been placed by Dr. Carrico in the wound, but there was evidence of air and blood around the tube because I noted the cuff was just above the injury to the trachea."

The most important words in the above excerpt are

"At that point the trachea was noted to be deviated slightly to the left..."

Remember, in an earlier post, how I told you a tension pneumothorax in the right lung will cause a large volume of air to accumulate on the right side of the chest? And remember how I told you this building volume of air will put pressure on the heart, left lung and major blood vessels connected to the heart, to the point the function of these things will be impaired enough to kill the patient? Well, I neglected to tell you one small thing. Not only will a right tension pneumothorax exert pressure on the heart and left lung, it will also shift everything in the chest over to the left. As the trachea is in the chest, just below the larynx, it too gets shifted away from the affected side.

The universal sign of a tension pneumothorax, and this is taught to everyone from surgeons and nurses to the lowliest ambulance driver or first aid attendant, is deviation of the trachea AWAY from the side of the chest affected by the tension pneumothorax. There is NOTHING else a deviated trachea could be. The Lone Nutters will try to explain this away by claiming the wound on the right side of the trachea caused swelling on the right side of the trachea, and this pushed the trachea to the left, but this is absolute nonsense. If there was a hard bony structure up against the right side of the trachea, this might be possible. However, the trachea is out in the open, and this did not happen.

If there had been even ONE surgeon on the Warren Commission, and he was not bought or scared off, he would have pursued this obvious comment by Perry (along with several others) and there is a very good chance the Single Bullet Theory might never have come about. However, as we all know, no surgeons were asked to sit on the WC. Much better to have the fired head of the CIA.

So, Perry makes the incision in JFK's throat, and confirms that Carrico had placed the e. tube cuff too high, and that the e. tube was NOT overinserted into JFK's left bronchus.

"I noticed a small ragged laceration of the trachea on the anterior lateral right side. I could see the endotracheal tube which had been placed by Dr. Carrico in the wound, but there was evidence of air and blood around the tube because I noted the cuff was just above the injury to the trachea."

No doubt about it now. The greatly diminished breath sounds in JFK's right lung were from the built up air pressure of the right tension pneumothorax not allowing air into the right lung.

Perry describes what he did next:

"At that point I was down in the trachea. Once the trachea had been exposed I took the knife and incised the windpipe at the point of the bullet injury. And asked that the endotracheal tube previously placed by Dr. Carrico be withdrawn slightly so I could insert a tracheotomy tube at this level. This was effected and attached to an anesthesia machine which had been brought down by Dr. Jenkins and Dr. Giesecke for better control of circulation.

I noticed there was free air and blood in the right mediastinum and although I could not see any evidence, myself any evidence, of it in the pleura of the lung the presence of this blood in this area could be indicative of the underlying condition.
I asked someone to put in a chest tube to allow sealed drainage of any blood or air which might be accumulated in the right hemothorax.
This occurred while I was doing the tracheotomy. I did not know at the time when I inserted the tube but I was informed subsequently that Dr. Paul Peters, assistant professor of urology, and Dr. Charles Baxter, previously noted in this record, inserted the chest tube and attached it to underwater seal or drainage of the right pneumothorax.

"I noticed there was free air and blood in the right mediastinum....."

I don't imagine these words mean a thing to anyone reading this but, if you were an ER doctor, this would be one of the most important statements in Perry's entire testimony. The importance of this statement is revealed by what Perry stated he did following this observation, which we will examine shortly.

To understand the importance of this statement, let's take another look at this diagram:

anatomy-of-the-respiratory-system-44-638

As can be seen, the pleural cavities are like two s contains the heartealed bags on either side of the chest and they are separated by a space called the "mediastinum". The mediastinum contains the heart and aorta, major veins (superior and inferior vena cava) pulmonary arteries and veins as well as the trachea. Within the mediastinum, the trachea splits into the two bronchi. Now, look closely at the inner walls of the pleural cavities, where they border the mediastinum, and you will see two openings known as the "hilum of the lung". This is the ONLY opening in the pleural cavity, and through this poorly sealed opening must pass the bronchi and pulmonary arteries and veins.

If the right lung were collapsed, and air pressure was building in the right pleural cavity, due to the use of the respirator, air would begin escaping between the inner side of the hilum and the bronchus and blood vessels passing through it. If blood was building up in the right pleural cavity (hemothorax) it too would escape out through the hilum. With JFK on his back, and his trachea exposed below the larynx, this blood and air would find its way out through this opening. The fact that Perry could see this, so shortly after the respirator was connected, is an indication of the amount of damage to the right lung.

So, seeing blood and air in the mediastinum, how did Perry interpret this? What measures did he undertake to deal with what he perceived?

"I noticed there was free air and blood in the right mediastinum and although I could not see any evidence, myself any evidence, of it in the pleura of the lung the presence of this blood in this area could be indicative of the underlying condition."

Notice Perry immediately makes the connection between air and blood in the mediastinum, and there being something wrong in the pleura (pleural cavity)? Care to guess what he meant by "the underlying condition"? Don't bother, Perry tells you in the next breath.

"I asked someone to put in a chest tube to allow sealed drainage of any blood or air which might be accumulated in the right hemothorax."

Not "suspected" right hemothorax or "possible" right hemothorax, but plain old right hemothorax. Perry was a good man, well trained in his profession, and he was responding instinctively to very obvious signs of a medical emergency in JFK's right lung. Now before anyone says, "Hey! Perry said hemothorax, not pneumothorax!" I would recommend you hold your water and read what Perry said in his next breath.

"This occurred while I was doing the tracheotomy. I did not know at the time when I inserted the tube but I was informed subsequently that Dr. Paul Peters, assistant professor of urology, and Dr. Charles Baxter, previously noted in this record, inserted the chest tube and attached it to underwater seal or drainage of the right pneumothorax."

At this point, Perry is calling it the right pneumothorax. I don't believe there was any doubt in Perry's mind at this point that, should JFK have lived, they would be doing emergency surgery on JFK's right lung. Imagine how puzzled Perry and the other Parkland doctors must have been when they learned that Humes and Arlen Specter had determined the bullet had missed the lung altogether!

Take note that, despite the insertion of left and right chest tubes at Parkland, Perry only requested the insertion of a right chest tube, as this was the side he observed the deficiencies on. Also take note that Perry states he was informed subsequently that Drs. Peters and Baxter not only inserted the chest tube, they also connected the tube to underwater sealed drainage. Would this statement not make a xxxx out of Humes, who testified that no chest tubes were found to be inserted at the autopsy, and that only shallow incomplete incisions had been made in JFK's chest? What reason would Perry and the other Parkland doctors have to lie about the chest tubes? Can we believe anything that came out of Humes?

Perry's final comment on the condition of JFK's right lung, followed closely by badgering from Specter:

"Mr. SPECTER - Now, you described a condition in the right mediastinum. Would you elaborate on what your views were of the condition at the time you were rendering this treatment?

Dr. PERRY - The condition of this area?
Mr. SPECTER - Yes, sir.
Dr. PERRY - There was both blood, free blood and air in the right superior mediastinum. That is the space that is located between the lungs and the heart at that level.
As I noted, I did not see any underlying injury of the pleura, the coverings of the lungs or of the lungs themselves. But in the presence of this large amount of blood in this area, one would be unable to detect small injuries to the underlying structures. The air was indicated by the fact that there was some frothing of this blood present, bubbling which could have been due to the tracheal injury or an underlying injury to the lung.
Since the morbidity attendant upon insertion of an anterior chest tube for sealed drainage is negligible and the morbidity which attends a pneumothorax is considerable, I elected to have the chest tube put in place because we were giving him positive pressure oxygen and the possibility of inducing a tension on pneumothorax would be quite high in such instances.
Mr. SPECTER - What is pneumothorax?
Dr. PERRY - Hemothorax would be blood in the free chest cavity and pneumothorax would be air in the free chest cavity underlying collapse of the lungs.
Mr. SPECTER - Would that have been caused by the injury which you noted to the President's trachea?
Dr. PERRY - There was no evidence of a hemothorax or a pneumothorax my examination; only it is sufficient this could have been observed because of the free blood in the mediastinum.

Mr. SPECTER - Were the symptoms which excited your suspicion causable by the injury to the trachea?

Dr. PERRY - They were."

Good old Specter, faithful mutt right to the end.

Can you imagine yourself in Perry's shoes? He never got beyond performing a tracheotomy on JFK, and despite what he suspected was going on in JFK's right lung, without opening JFK's chest up, there was no way to confirm his suspicions. Then, of course, there is Specter pressuring him to state that all of the signs he observed were caused by the trachea wound. But, they weren't. Know why?

1. With the open wound in JFK's throat, how did free air accumulate in JFK's right superior (upper) mediastinum, nowhere close to the trachea wound? If the tracheal wound was connected through the throat wound to the outside air, would not any air from the tracheal wound simply escape, instead of building up in the mediastinum?

2. If enough blood accumulated to be observed in the right upper mediastinum, why was JFK's shirt collar and tie not soaked in blood on the trip to Parkland, while JFK was lying in the back seat of the limo? With the open wound in the throat, it would be very easy for this blood to escape out this wound. Could it be because the blood only escaped from the right pleural cavity, through the right hilum, when positive pressure ventilation from the respirator forced blood and air from his right pleural cavity?

Here is one exchange that was guaranteed to never have taken place:

"Mr. Specter: When JFK's right chest tube was connected to sealed drainage, what was the nature of the material being drained from JFK's right pleural cavity?

Dr. Perry: When the chest tube was first connected, there was a great escape of frothy red-tinged air escaping as the pressure from the pneumothorax was relieved. Once connected to sealed drainage, a mixture of air and blood continued to drain from the right pleural cavity."

Edited by Robert Prudhomme
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If an animal is shot through the lungs or (God forbid) through the guts, there is NO mistaking the fact a bullet has passed through these organs. There will always be blood clotting along the track. The same goes for after the animal has been skinned. A bullet passing through a hind quarter, front quarter or other muscle tissue will leave a trail of blood clots and bruised tissue obvious for anyone to see.

My question is this: Unless Humes was a complete idiot, why would he be dissecting organs if there was absolutely no sign whatsoever that a bullet had passed through JFK's thorax or abdomen?

Bob,

Your analysis has me thoroughly convinced that the right pleural sack was indeed punctured. That being the case, it is reasonable to conclude the Humes did indeed see signs that a bullet, or something else (frangible bullet particles), had passed through. So that would explain his search for the bullet within the internal organs.

But there was that one technician who said he saw Humes push a metal probe up against an intact pleural lining. I don't remember the tech's name, but I'm pretty sure that he was a medical professional. It baffles me that he would talk as though the pleural lining was intact, but not make the point that, on the other hand, the lung had clearly been hit. Unless the lung didn't show as much damage as is typical.

I've wondered if a special bullet might have been developed specifically for shots to the thorax, designed to make numerous puncture holes in the pleural lining. And maybe also to pepper the lungs with particles. (I don't know how serious a condition a lung peppered with particles is compared to a collapsed lung.) But not exit the body so as to not risk injury to others.

This is the reason I wanted to know earlier if the shooter may have intentionally shot JFK in the back.

(BTW, don't assume that I am here only to interrupt and ask these questions. I am following your presentation carefully.)

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Bob,

Like Sandy I am not here to interrupt your thread which I find interesting. However, though I agree the right lung was indeed damaged, it was damaged at the top and not in the body of the lung. In a document I wrote about JFK's injuries I described this observation. It is a wonderful description by Humes. Senator Cooper asks him what was the character of this bruise at the top of the lung. Humes reply is wonderful and I am not sure he was fully aware of what he actually said. Below is the section describing this moment.

A few pages later, Senator Cooper interrupts Commander Humes and asks him what was the character of this bruise that he saw. Humes replies and in doing so describes just what an incredible anomaly this “bruise” was. This is just such an important point I will parse what he says.

First Commander Humes reply.

Commander HUMES. The bruise here, photographs are far superior to my humble verbal description, but if I let my hand in cup shaped fashion represent the apical parietal pleura, it was an area approximately 5 cm. in greatest diameter of purplish blue discoloration of the parietal pleura. Corresponding exactly with it, with the lung sitting below it, was a roughly pyramid-shaped bruise with its base toward the surface of the upper portion of the lung, and the apex down into the lung tissue, and the whole thing measured about 5 cm., which is a little - 2 inches in extent, sir.” H2 369

a) First Humes describes the shape of the Apical Parietal Pleura.

if I let my hand in cup shaped fashion represent the apical parietal pleura, it was an area approximately 5 cm. in greatest diameter of purplish blue discoloration of the parietal pleura.”

• So what he is saying is that the Apical Parietal Pleura was rounded like his cupped hand.

• He then says that this area of the Apical Parietal Pleura was bruised and the size of the bruise was 5cm.

• Then he describes the colour of the Pleura as purpilish blue.

Now this first reference of 5cm refers not just to the size of the Apical Parietal Pleura that was damaged but also the size of the base of the anomaly, which was underneath it.

B) Now Humes goes on to describe the shape of the anomaly.

“Corresponding exactly with it, with the lung sitting below it, was a roughly pyramid-shaped bruise with its base toward the surface of the upper portion of the lung, and the apex down into the lung tissue, and the whole thing measured about 5 cm., which is a little - 2 inches in extent, sir. ”

a) “Corresponding exactly with it, with the lung sitting below it,” The “it” refers to the bruise on the Apical Parietal Pleura. He then says that the lung was positioned below the Apical Parietal Pleura .. as indeed it is.

B)was a roughly pyramid-shaped bruise.”

He now describes what the shape looked like. He likens it to a pyramid.

c)with its base toward the surface of the upper portion of the lung.” Normally pyramids have their pointed portion facing upwards. However, this anomaly is actually upside down and it is the base, or bottom, which is facing upwards. However there is another point he makes here. Humes says that the base of this anomaly is towards the surface of the lung itself. Above the surface of the lung are the Apical Parietal Pleura, the Parietal Pleura and finally the Visceral Pleura. If the base is toward the surface of the lung, then it has to be below these three surfaces.

d)and the apex down into the lung tissue.” The pointed end of this pyramid is not just facing downwards, with the use of the word “into” Humes is saying that this part of the anomaly is actually inside the actual tissue of the lung.

e)and the whole thing measured about 5 cm., which is a little - 2 inches in extent, sir.” The use of the word “thing” refers to the shape of the anomaly. This part of the description has been about where the base of the anomaly was in relation to the top of it. Therefore this reference to 5cm, refers to distance between the base and the top. It is that which is 5 cm. Hence the anomaly is 2 inches tall. The first description of 5cm, although describing the area of the Apical Parietal Pleura that was bruised, is also describing the measurement of the base of the object that lies below it.

In his description Humes has just admitted that the right lung was damaged. He has said that:-

a) The base of this anomaly is towards the “surface of the upper portion of the lung.”

AND

B)and the apex down into the lung tissue.” The top of this pyramid is inside the lung itself. He is therefore saying that the tissue of the lung has been pierced.

​What caused this damage is another matter. However, Humes is quite clear that the damage is at the top of the lung and not the middle and body of the lung. Unless you have evidence that I had been unaware of, there is no evidence that the body of the lung was damaged or pierced.

I disagree that the wound to the back was anything but a shallow wound. However I am not going to interrupt your thread by arguing my corner. Nor am I going to interrupt the thread by arguing where I believe the lung was damaged. However I did want to place my opinion into the record.

James.

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If an animal is shot through the lungs or (God forbid) through the guts, there is NO mistaking the fact a bullet has passed through these organs. There will always be blood clotting along the track. The same goes for after the animal has been skinned. A bullet passing through a hind quarter, front quarter or other muscle tissue will leave a trail of blood clots and bruised tissue obvious for anyone to see.

My question is this: Unless Humes was a complete idiot, why would he be dissecting organs if there was absolutely no sign whatsoever that a bullet had passed through JFK's thorax or abdomen?

Bob,

Your analysis has me thoroughly convinced that the right pleural sack was indeed punctured. That being the case, it is reasonable to conclude the Humes did indeed see signs that a bullet, or something else (frangible bullet particles), had passed through. So that would explain his search for the bullet within the internal organs.

But there was that one technician who said he saw Humes push a metal probe up against an intact pleural lining. I don't remember the tech's name, but I'm pretty sure that he was a medical professional. It baffles me that he would talk as though the pleural lining was intact, but not make the point that, on the other hand, the lung had clearly been hit. Unless the lung didn't show as much damage as is typical.

I've wondered if a special bullet might have been developed specifically for shots to the thorax, designed to make numerous puncture holes in the pleural lining. And maybe also to pepper the lungs with particles. (I don't know how serious a condition a lung peppered with particles is compared to a collapsed lung.) But not exit the body so as to not risk injury to others.

This is the reason I wanted to know earlier if the shooter may have intentionally shot JFK in the back.

(BTW, don't assume that I am here only to interrupt and ask these questions. I am following your presentation carefully.)

This is a perfect example of the mixed bag of half truths and fabrications that came out of the autopsy that night.

The mere fact this technician recalls seeing, from inside the chest cavity, a probe pushed up against an intact pleural lining is itself a contradiction of everything the autopsy results told us, placing the entrance wound on the back much lower than Humes stated. If the bullet entered JFK's neck where Humes claimed it did, 14 cm. (5.5 inches) below the mastoid process, there should not have been a wound track leading anywhere near the top of JFK's right lung or right parietal pleura.

Location-of-Mastoid-Process-picture.jpg

"I've wondered if a special bullet might have been developed specifically for shots to the thorax, designed to make numerous puncture holes in the pleural lining. And maybe also to pepper the lungs with particles. (I don't know how serious a condition a lung peppered with particles is compared to a collapsed lung.) But not exit the body so as to not risk injury to others."

The problem with this theory is there is so little distance between the surface of the back, at the level of the T3 vertebra, and the parietal pleural lining that I cannot see how a bullet could make such a small entrance wound and be able to break up and spread out in such a tiny distance. Even if the lung was "peppered" with tiny particles, in order to produce the signs of pneumothorax observed by Carrico and Perry still requires considerable damage to the right lung, and this damage would have been quite obvious.

Edited by Robert Prudhomme
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Bob,

Like Sandy I am not here to interrupt your thread which I find interesting. However, though I agree the right lung was indeed damaged, it was damaged at the top and not in the body of the lung. In a document I wrote about JFK's injuries I described this observation. It is a wonderful description by Humes. Senator Cooper asks him what was the character of this bruise at the top of the lung. Humes reply is wonderful and I am not sure he was fully aware of what he actually said. Below is the section describing this moment.

A few pages later, Senator Cooper interrupts Commander Humes and asks him what was the character of this bruise that he saw. Humes replies and in doing so describes just what an incredible anomaly this “bruise” was. This is just such an important point I will parse what he says.

First Commander Humes reply.

Commander HUMES. The bruise here, photographs are far superior to my humble verbal description, but if I let my hand in cup shaped fashion represent the apical parietal pleura, it was an area approximately 5 cm. in greatest diameter of purplish blue discoloration of the parietal pleura. Corresponding exactly with it, with the lung sitting below it, was a roughly pyramid-shaped bruise with its base toward the surface of the upper portion of the lung, and the apex down into the lung tissue, and the whole thing measured about 5 cm., which is a little - 2 inches in extent, sir.” H2 369

a) First Humes describes the shape of the Apical Parietal Pleura.

if I let my hand in cup shaped fashion represent the apical parietal pleura, it was an area approximately 5 cm. in greatest diameter of purplish blue discoloration of the parietal pleura.”

• So what he is saying is that the Apical Parietal Pleura was rounded like his cupped hand.

• He then says that this area of the Apical Parietal Pleura was bruised and the size of the bruise was 5cm.

• Then he describes the colour of the Pleura as purpilish blue.

Now this first reference of 5cm refers not just to the size of the Apical Parietal Pleura that was damaged but also the size of the base of the anomaly, which was underneath it.

B) Now Humes goes on to describe the shape of the anomaly.

“Corresponding exactly with it, with the lung sitting below it, was a roughly pyramid-shaped bruise with its base toward the surface of the upper portion of the lung, and the apex down into the lung tissue, and the whole thing measured about 5 cm., which is a little - 2 inches in extent, sir. ”

a) “Corresponding exactly with it, with the lung sitting below it,” The “it” refers to the bruise on the Apical Parietal Pleura. He then says that the lung was positioned below the Apical Parietal Pleura .. as indeed it is.

B)was a roughly pyramid-shaped bruise.”

He now describes what the shape looked like. He likens it to a pyramid.

c)with its base toward the surface of the upper portion of the lung.” Normally pyramids have their pointed portion facing upwards. However, this anomaly is actually upside down and it is the base, or bottom, which is facing upwards. However there is another point he makes here. Humes says that the base of this anomaly is towards the surface of the lung itself. Above the surface of the lung are the Apical Parietal Pleura, the Parietal Pleura and finally the Visceral Pleura. If the base is toward the surface of the lung, then it has to be below these three surfaces.

d)and the apex down into the lung tissue.” The pointed end of this pyramid is not just facing downwards, with the use of the word “into” Humes is saying that this part of the anomaly is actually inside the actual tissue of the lung.

e)and the whole thing measured about 5 cm., which is a little - 2 inches in extent, sir.” The use of the word “thing” refers to the shape of the anomaly. This part of the description has been about where the base of the anomaly was in relation to the top of it. Therefore this reference to 5cm, refers to distance between the base and the top. It is that which is 5 cm. Hence the anomaly is 2 inches tall. The first description of 5cm, although describing the area of the Apical Parietal Pleura that was bruised, is also describing the measurement of the base of the object that lies below it.

In his description Humes has just admitted that the right lung was damaged. He has said that:-

a) The base of this anomaly is towards the “surface of the upper portion of the lung.”

AND

B)and the apex down into the lung tissue.” The top of this pyramid is inside the lung itself. He is therefore saying that the tissue of the lung has been pierced.

​What caused this damage is another matter. However, Humes is quite clear that the damage is at the top of the lung and not the middle and body of the lung. Unless you have evidence that I had been unaware of, there is no evidence that the body of the lung was damaged or pierced.

I disagree that the wound to the back was anything but a shallow wound. However I am not going to interrupt your thread by arguing my corner. Nor am I going to interrupt the thread by arguing where I believe the lung was damaged. However I did want to place my opinion into the record.

James.

James

What do you make of the HSCA testimony of Lt. Richard Lipsey, in which he describes Humes et al spending a good portion of the autopsy dissecting chest and abdominal organs in search of a bullet or bullet fragments?

Also, how much damage do you believe the 5 cm. bruise reported at the top of JFK's right lung caused? Did Humes report rupturing of the visceral pleura and lung at the site of the bruise, or did he report the lung to be bruised but still intact, and capable of normal respiration?

Edited by Robert Prudhomme
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Bob,

I have not read Lipsey's testimony. I accept you have. Might I ask is Richard Lipsey your central source and if other sources contradict him are those sources discounted by you.

Five centimetres is 2 inches. We are talking about a 2 inch damage from the apex of the lung. On the 6th of December 1963, the Supplemental Autopsy report was submitted. And it was in that document that Humes acknowledged that indeed the right lung had been damaged. “Sections through the grossly described area of contusion in the right upper lobe exhibit disruption of alveolar walls and recent hemorrhage into alveoli.CE 391 P. 2 My emphasis added.

The consequence of this damage was what caused blood and air to escape into the Mediastinum. It was this situation that persuaded Dr. Perry to request chest tubes to be inserted.

Like many others I had read this before and I had been blinded by the word “haemorrhage” and just thought it was description of a bruise to the lung the collection of blood around the lung: something we all had known before.

Actually what Humes was saying something quite different.

a) The trachea eventually branches into two pipes called the Bronchi one for each lung.

B) As these pipes grow within the lung they continue to subdivide and branch out.

c) As they do so they get smaller and continue to do so until they have covered the entire area of the lung.

d) At the end of each branch line is a small air sack called an Alveoli. Each lung has around 300 million of these Alveoli, which gives you an idea of the number of branches that have subdivided within each lung

e) Each Alveoli is connected to a Pulmonary ( a lung ) artery and a Pulmonary ( a lung ) vein.

d) And basically what the Alveoli do is transfer air from the arteries to the veins. It is the process by which air gets into our blood.

So what Humes is actually describing is this:-

a) When the bullet landed on the Apex of the lung it ruptured a significant number of these Alveoli. This is my view that the bullet that couse the throat wound came to rest on top of the right lung and it was this that caused damage to the Apex of the right lung.

B) That meant these Alveoli’s associated arteries and veins were also damaged.

c) As a consequence of these vessels being damaged, blood now poured into the Lung.

d) One consequence of this flow of blood was that it created the bruise Humes talked about.

e) However a second consequence was that the blood also broke through the Visceral Pleura as well as the Parietal Pleural.

d) It was through this damage that air from the lung also escaped: the air that Malcolm Perry had noticed and caused him to ask for the Chest Tubes to be inserted.

e) Blood also escaped through this damage and collected in the Mediastinum – the upper chest area. This was some of the blood that Malcolm Perry noticed once he had cut the Tracheotomy.

f) Once the right lung was damaged, the Trachea now deviated to the left .. towards the undamaged lung.

Now it is true that Malcolm Perry is on record stating that as far as he was concerned the Pleural cavity was not damaged. When Malcom Perry was interviewed by the HSCA he was asked about the Pleural cavity, the space between the two Pleural skins:-

“PURDY “How did you determine that the pleural cavity was not violated?”

PERRY “Found that out later in the autopsy report.” HSCA1 304

So Malcolm Perry is on record stating that the Pleural cavity was not damaged, not from personal observation, but because the Autopsy report said it was not damaged. His personal observation was quite different and was the reason he had asked for the Chest Tubes to be inserted in the first place.

And hidden in CE 391, the Supplemental Report, was confirmation that Malcolm Perry’s initial judgment had been right all along: the right lung had indeed been damaged.

From what I can see there is significant evidence that the top of the right lung was damaged. From what I have read there is no evidence that the central portion of the right lung whereas there is critical evidence that the top of the lung was damaged.

James.

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Bob,

There certainly was damage to the upper portion of the right lung, but I'm undecided as to whether or not the pleura was penetrated. I'm not aware of any evidence stating that the cited damage at the apex of the right lung could only occur if the pleura was ruptured.

If the pleura was NOT damaged at the apex of the lung, then what you are saying can only be true IF there was significant lung damage elsewhere. Do you agree?

Also, IMO, the damage at the apex of the lung is associated ONLY with the throat wound, NOT the back wound. What is your position on this? If this is true then we have the entry wound in the back that due to its location MUST have caused SOME damage to the right lung. IMO this damage alone could have caused all of the symptoms as you have described.

Tom

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Bob,

Like Sandy I am not here to interrupt your thread which I find interesting. However, though I agree the right lung was indeed damaged, it was damaged at the top and not in the body of the lung. In a document I wrote about JFK's injuries I described this observation. It is a wonderful description by Humes. Senator Cooper asks him what was the character of this bruise at the top of the lung. Humes reply is wonderful and I am not sure he was fully aware of what he actually said. Below is the section describing this moment.

A few pages later, Senator Cooper interrupts Commander Humes and asks him what was the character of this bruise that he saw. Humes replies and in doing so describes just what an incredible anomaly this “bruise” was. This is just such an important point I will parse what he says.

First Commander Humes reply.

Commander HUMES. The bruise here, photographs are far superior to my humble verbal description, but if I let my hand in cup shaped fashion represent the apical parietal pleura, it was an area approximately 5 cm. in greatest diameter of purplish blue discoloration of the parietal pleura. Corresponding exactly with it, with the lung sitting below it, was a roughly pyramid-shaped bruise with its base toward the surface of the upper portion of the lung, and the apex down into the lung tissue, and the whole thing measured about 5 cm., which is a little - 2 inches in extent, sir.” H2 369

a) First Humes describes the shape of the Apical Parietal Pleura.

if I let my hand in cup shaped fashion represent the apical parietal pleura, it was an area approximately 5 cm. in greatest diameter of purplish blue discoloration of the parietal pleura.”

• So what he is saying is that the Apical Parietal Pleura was rounded like his cupped hand.

• He then says that this area of the Apical Parietal Pleura was bruised and the size of the bruise was 5cm.

• Then he describes the colour of the Pleura as purpilish blue.

Now this first reference of 5cm refers not just to the size of the Apical Parietal Pleura that was damaged but also the size of the base of the anomaly, which was underneath it.

B) Now Humes goes on to describe the shape of the anomaly.

“Corresponding exactly with it, with the lung sitting below it, was a roughly pyramid-shaped bruise with its base toward the surface of the upper portion of the lung, and the apex down into the lung tissue, and the whole thing measured about 5 cm., which is a little - 2 inches in extent, sir. ”

a) “Corresponding exactly with it, with the lung sitting below it,” The “it” refers to the bruise on the Apical Parietal Pleura. He then says that the lung was positioned below the Apical Parietal Pleura .. as indeed it is.

B)was a roughly pyramid-shaped bruise.”

He now describes what the shape looked like. He likens it to a pyramid.

c)with its base toward the surface of the upper portion of the lung.” Normally pyramids have their pointed portion facing upwards. However, this anomaly is actually upside down and it is the base, or bottom, which is facing upwards. However there is another point he makes here. Humes says that the base of this anomaly is towards the surface of the lung itself. Above the surface of the lung are the Apical Parietal Pleura, the Parietal Pleura and finally the Visceral Pleura. If the base is toward the surface of the lung, then it has to be below these three surfaces.

d)and the apex down into the lung tissue.” The pointed end of this pyramid is not just facing downwards, with the use of the word “into” Humes is saying that this part of the anomaly is actually inside the actual tissue of the lung.

e)and the whole thing measured about 5 cm., which is a little - 2 inches in extent, sir.” The use of the word “thing” refers to the shape of the anomaly. This part of the description has been about where the base of the anomaly was in relation to the top of it. Therefore this reference to 5cm, refers to distance between the base and the top. It is that which is 5 cm. Hence the anomaly is 2 inches tall. The first description of 5cm, although describing the area of the Apical Parietal Pleura that was bruised, is also describing the measurement of the base of the object that lies below it.

In his description Humes has just admitted that the right lung was damaged. He has said that:-

a) The base of this anomaly is towards the “surface of the upper portion of the lung.”

AND

B)and the apex down into the lung tissue.” The top of this pyramid is inside the lung itself. He is therefore saying that the tissue of the lung has been pierced.

​What caused this damage is another matter. However, Humes is quite clear that the damage is at the top of the lung and not the middle and body of the lung. Unless you have evidence that I had been unaware of, there is no evidence that the body of the lung was damaged or pierced.

I disagree that the wound to the back was anything but a shallow wound. However I am not going to interrupt your thread by arguing my corner. Nor am I going to interrupt the thread by arguing where I believe the lung was damaged. However I did want to place my opinion into the record.

James.

Hi James

This is likely one of the best presentations of Humes describing the bruise at the apex (top) of JFK's right lung that I have seen to date. You have obviously spent some time studying this matter.

The only problems with linking this bruise to the suspected pneumothorax and hemothorax I have described in JFK's right pleural cavity are the extremely small size of this bruise and the fact that Humes does not describe it as anything more than a bruise. In his own words, the right lung was completely intact and there was no great accumulation of blood in JFK's right pleural cavity.

In order for Dr. Perry to be able to observe blood in the right mediastinum, from the perspective of an incision in the throat to gain access to the trachea, do you have any idea how much blood had to accumulate in the right pleural cavity, in order to leak out the right hilum of the lung and migrate out past the trachea wound? Where is Humes' account of the discovery of this accumulation of blood in the right pleural cavity?

If we are to take Humes strictly at his word, which you seem so inclined to do regarding the shallow back wound and the 5 cm. bruising of the top of the right lung, there would be no further injury to the lung than the bruising, and certainly no tension pneumothorax or hemothorax in the right pleural cavity. Humes' description of an intact pristine right lung and right pleural cavity simply do not jive with the signs of damage observed by Carrico and Perry. This is hardly surprising, though, as Humes' observations are in complete contradiction of everything else observed by the doctors at Parkland.

Why you continue to treat Humes' word as Gospel is beyond me, James.

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Bob,

There certainly was damage to the upper portion of the right lung, but I'm undecided as to whether or not the pleura was penetrated. I'm not aware of any evidence stating that the cited damage at the apex of the right lung could only occur if the pleura was ruptured.

If the pleura was NOT damaged at the apex of the lung, then what you are saying can only be true IF there was significant lung damage elsewhere. Do you agree?

Also, IMO, the damage at the apex of the lung is associated ONLY with the throat wound, NOT the back wound. What is your position on this? If this is true then we have the entry wound in the back that due to its location MUST have caused SOME damage to the right lung. IMO this damage alone could have caused all of the symptoms as you have described.

Tom

Hi Tom

It is possible to have a tension pneumothorax without the parietal (outer) pleura having an opening in it. A classic example is a blunt blow to the rib cage severe enough to rupture the lung and visceral (inner) pleura surrounding the lung, but not severe enough to rupture the parietal (outer) pleura. This would prevent the lung from fully inflating, and allow air to escape through the damage in the lung into the pleural cavity outside of the lung. However, this kind of damage is almost guaranteed to rupture several blood vessels, and there will inevitably be an accumulation of blood in the pleural cavity, referred to as a "hemothorax" by Perry.

If the back wound was moved from the level of T3, almost 6 inches below the collar line, to the level of C7, right at the collar line, what was to stop them from moving the damage in the lung upward as well?

Correction: The ribs are outside of both pleura, and to tear the visceral pleura with a broken rib, it is necessary to first tear the parietal (outer) pleura. the only difference is there is no opening to the atmosphere from the pleural cavity, still making this a tension pneumothorax.

Edited by Robert Prudhomme
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I think that James's theory, where the bruise to the right apical lobe is attributed to a bullet to the throat, is an interesting one. And is worthy of further study (though in another, dedicated thread).

James's theory requires that the throat wound be one of entrance. Which, I believe, requires that the location of the throat wound be above the shirtline. And this possibility has NOT been ruled out AFAIK. (Though there are some arguments against it.)

I currently believe that the throat wound is one of exit, and was probably made by a bone fragment. If true, Jame's theory would be invalid. So Robert's presentation here is of great interest to me.

It has been demonstrated to my satisfaction that Humes fibbed in his accounts when necessary. So if his account of something disagrees with others' accounts, I tend to question his first. Especially when it would make sense for him to fudge the story in order to support the lone nut theory.

I believe that Robert has demonstrated that pneumothorax did occur, and probably tension pneumothorax as well. He has indicated that a large amount of damage would have been required for that to have occurred. I confess that I would like to hear from some doctors on this point. Because I am wondering if the level of damage reported by Humes could have been sufficient to cause pneumothorax. If so, that could resolve some unexplained issues.

I'm glad that James reminded us of the triangle shaped damage described by Humes. I'd forgotten about it. In my opinion, Humes's detailed description of the damage's shape gives it some credibility. However, I wouldn't be surprised if Humes fibbed regarding the location of the damage. Apparently Robert feels the same, given that he said:

If the back wound was moved from the level of T3, almost 6 inches below the collar line, to the level of C7, right at the collar line, what was to stop them from moving the damage in the lung upward as well?

Here is a hypothetical summary of autopsy events that attempts to explain all the testimony regarding the autopsy:

  • Humes sees the back wound and assumes a bullet penetrated the pleural lining.
  • He removes the organs and sees the bruise on the pleura, and the triangular damage to the lung, at roughly the location of the back wound.
  • He searches the organs for the bullet but cannot find it.
  • He gives up and pretends to probe the back wound with his finger, and to probe the pleura. He proclaims that the bullet wound was shallow.
  • What actually happened was that a frangible bullet hit the back, fragmented into particles, and many of these particles penetrated the pleural linings and the right lung. These particles show up on x-ray but are wrongly attributed to film cartridge dust.
  • A rib took the bulk of the blow and absorbed most the kinetic energy. Only a small percentage of the bullet particles actually enter the lung. This explains the minimal damage to the lung.
Edited by Sandy Larsen
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  • A rib took the bulk of the blow and absorbed most the kinetic energy. Only a small percentage of the bullet particles actually enter the lung. This explains the minimal damage to the lung.

Was there a damaged rib? I confess I haven't read this whole thread, but this is the first time I've heard of a damaged rib as far as I can recall.

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Bob,

There certainly was damage to the upper portion of the right lung, but I'm undecided as to whether or not the pleura was penetrated. I'm not aware of any evidence stating that the cited damage at the apex of the right lung could only occur if the pleura was ruptured.

If the pleura was NOT damaged at the apex of the lung, then what you are saying can only be true IF there was significant lung damage elsewhere. Do you agree?

Also, IMO, the damage at the apex of the lung is associated ONLY with the throat wound, NOT the back wound. What is your position on this? If this is true then we have the entry wound in the back that due to its location MUST have caused SOME damage to the right lung. IMO this damage alone could have caused all of the symptoms as you have described.

It is possible to have a tension pneumothorax without the parietal (outer) pleura having an opening in it. A classic example is a blunt blow to the rib cage severe enough to rupture the lung and visceral (inner) pleura surrounding the lung, but not severe enough to rupture the parietal (outer) pleura. This would prevent the lung from fully inflating, and allow air to escape through the damage in the lung into the pleural cavity outside of the lung.

Yes, that was my point and we are in agreement. Also, In this example I believe that ALL blood and escaping air REMAIN contained within the outer pleura. It seems virtually impossible that inflicting a "bruise" at the apex of the right lung would rupture enough blood vessels to create the situation as described by Perry and Baxter. I believe we are in agreement on this, also. It's been a LONG time since I've read these statements so I may be incorrect as to their blood/air descriptions.

If true, then a considerably more severe wound MUST exist elsewhere. Such as the acknowledged back wound that according to Humes did no lung damage at all.

If the back wound was moved from the level of T3, almost 6 inches below the collar line, to the level of C7, right at the collar line, what was to stop them from moving the damage in the lung upward as well?

Certainly not Gerald Ford, nor Humes veracity... Edited by Tom Neal
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  • A rib took the bulk of the blow and absorbed most the kinetic energy. Only a small percentage of the bullet particles actually enter the lung. This explains the minimal damage to the lung.

Was there a damaged rib? I confess I haven't read this whole thread, but this is the first time I've heard of a damaged rib as far as I can recall.

That's a good question/point, Ron. The reason I hypothesized that a rib took the bulk of the energy is because the lung apparently didn't (if we can believe that part of Humes's testimony).

I wonder if a rib could have taken the bulk of the energy, distributed it to surrounding tissue, and then bounced back. Or cracked.

The energy had to go somewhere.

Edited by Sandy Larsen
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I think that James's theory, where the bruise to the right apical lobe is attributed to a bullet to the throat, is an interesting one. And is worthy of further study (though in another, dedicated thread).

James's theory requires that the throat wound be one of entrance. Which, I believe, requires that the location of the throat wound be above the shirtline. And this possibility has NOT been ruled out AFAIK. (Though there are some arguments against it.)

I currently believe that the throat wound is one of exit, and was probably made by a bone fragment. If true, Jame's theory would be invalid. So Robert's presentation here is of great interest to me.

It has been demonstrated to my satisfaction that Humes fibbed in his accounts when necessary. So if his account of something disagrees with others' accounts, I tend to question his first. Especially when it would make sense for him to fudge the story in order to support the lone nut theory.

I believe that Robert has demonstrated that pneumothorax did occur, and probably tension pneumothorax as well. He has indicated that a large amount of damage would have been required for that to have occurred. I confess that I would like to hear from some doctors on this point. Because I am wondering if the level of damage reported by Humes could have been sufficient to cause pneumothorax. If so, that could resolve some unexplained issues.

I'm glad that James reminded us of the triangle shaped damage described by Humes. I'd forgotten about it. In my opinion, Humes's detailed description of the damage's shape gives it some credibility. However, I wouldn't be surprised if Humes fibbed regarding the location of the damage. Apparently Robert feels the same, given that he said:

If the back wound was moved from the level of T3, almost 6 inches below the collar line, to the level of C7, right at the collar line, what was to stop them from moving the damage in the lung upward as well?

Here is a hypothetical summary of autopsy events that attempts to explain all the testimony regarding the autopsy:

  • Humes sees the back wound and assumes a bullet penetrated the pleural lining.
  • He removes the organs and sees the bruise on the pleura, and the triangular damage to the lung, at roughly the location of the back wound.
  • He searches the organs for the bullet but cannot find it.
  • He gives up and pretends to probe the back wound with his finger, and to probe the pleura. He proclaims that the bullet wound was shallow.
  • What actually happened was that a frangible bullet hit the back, fragmented into particles, and many of these particles penetrated the pleural linings and the right lung. These particles show up on x-ray but are wrongly attributed to film cartridge dust.
  • A rib took the bulk of the blow and absorbed most the kinetic energy. Only a small percentage of the bullet particles actually enter the lung. This explains the minimal damage to the lung.

Hi Sandy

Well, there's another way of looking at this.

A lot of people don't realize this but, the apex of the lung is much higher than most think, as these diagram show.

Grays%203.104a.jpg

nursing-205-21-638.jpg?cb=1350451225

Do you see how far above the clavicle (collarbone) the apex of the right lung extends? If the widest part of the bruise was at the apex of the lung, and the bruise only extended 2 inches downward, and diminished drastically as it extended downward, wouldn't Humes be just a bit puzzled as to how a bullet entering at the level of T3 vertebra could do such damage, and not even make a hole in the outer pleural lining?

I have seen many lung shots on deer, and even a .22 Long Rifle bullet travelling through a lung makes a lot of very messy and very obvious damage. Humes had to know there was something fishy going on.

A rib is not a thick enough or heavy enough bone to absorb enough of a bullet's energy to make any difference in a wound in a lung. I have seen chest shots on deer where the bullet missed the rib and where the bullet struck the rib. The difference in damage is negligible. In fact, as in the case of John Connally, the shattering of the rib only serves to make more secondary missiles that go on to cause their own damage in the lung.

However, as none of JFK's ribs were struck by a bullet, we can only conclude a frangible bullet disintegrated into dust as it was travelling through his right lung.

Edited by Robert Prudhomme
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Bob,

There certainly was damage to the upper portion of the right lung, but I'm undecided as to whether or not the pleura was penetrated. I'm not aware of any evidence stating that the cited damage at the apex of the right lung could only occur if the pleura was ruptured.

If the pleura was NOT damaged at the apex of the lung, then what you are saying can only be true IF there was significant lung damage elsewhere. Do you agree?

Also, IMO, the damage at the apex of the lung is associated ONLY with the throat wound, NOT the back wound. What is your position on this? If this is true then we have the entry wound in the back that due to its location MUST have caused SOME damage to the right lung. IMO this damage alone could have caused all of the symptoms as you have described.

It is possible to have a tension pneumothorax without the parietal (outer) pleura having an opening in it. A classic example is a blunt blow to the rib cage severe enough to rupture the lung and visceral (inner) pleura surrounding the lung, but not severe enough to rupture the parietal (outer) pleura. This would prevent the lung from fully inflating, and allow air to escape through the damage in the lung into the pleural cavity outside of the lung.

Yes, that was my point and we are in agreement. Also, In this example I believe that ALL blood and escaping air REMAIN contained within the outer pleura. It seems virtually impossible that inflicting a "bruise" at the apex of the right lung would rupture enough blood vessels to create the situation as described by Perry and Baxter. I believe we are in agreement on this, also. It's been a LONG time since I've read these statements so I may be incorrect as to their blood/air descriptions.

If true, then a considerably more severe wound MUST exist elsewhere. Such as the acknowledged back wound that according to Humes did no lung damage at all.

If the back wound was moved from the level of T3, almost 6 inches below the collar line, to the level of C7, right at the collar line, what was to stop them from moving the damage in the lung upward as well?

Certainly not Gerald Ford, nor Humes veracity...

The main point is that Humes never reported seeing a collection of blood in the pleural cavity between the parietal (outer) pleura and the visceral (inner) pleura that envelops the lung. All Humes reported was this nice intact right lung with a tiny 2 inch bruise at the apex, much higher than the entrance wound at T3 and even more impossible if you believe the bullet was travelling downward when it struck JFK.

Humes' report of an intact lung and pleurae is in total contradiction of the signs of right pneumothorax and hemothorax reported by Humes.

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