wound with multiple pieces of skull noted next with the brain and with a tremendous amount of clot and blood.
Mr. SPECTER. Will you describe as precisely as you can the wound that you observed in the throat ?
Dr. JONES. The wound in the throat was probably no larger than a quarter of an inch in diameter. There appeared to be no powder burn present, although this could have been masked by the amount of blood that was on the head and neck, although there was no obvious, amount of powder present. There appeared to be a very minimal amount of disruption of interruption of the surrounding skin. There appeared to be relatively smooth edges around the wound, and if this occurred as a result of a missile, you would have probably thought it was a missile of very low velocity and probably could have been compatible with a bone fragment of either--probably exiting from the neck, but it was a very small, smooth wound.

Mr. Specter.

Did you notice any lump in the throat area ?
Dr. JONES. No; I didn't.
Mr. SPECTER. Was there any blood on the throat area in the vicinity of the wound which you have described of the throat?
Dr. JONES. Not a great deal of blood, as if in relation to the amount that was around the head--not too much.
Mr. SPECTER. What further action was taken by the medical team in addition to that which you have described on the tracheotomy?
Dr. JONES: Well, as Dr. Perry started the tracheotomy, I started the cut down in the left arm to insert a large polyethylene catheter, to give an I.V. so that we could give I.V. solutions as well as blood, and at the same time another doctor or two were doing some cutdowns in the lower extremities around the ankle. We made the cutdown in the left arm in the cephalic vein very rapidly and I.V. fluids were started immediately and as I was doing this, Dr. Perry was performing the tracheotomy, and it was about this time that Dr. Baxter came in and went ahead to assist Dr. Perry with the tracheotomy, and as they made a deeper incision in the neck to isolate the trachea, they thought they saw some gush of air and the possibility of a pneumothorax on one side or the other was entertained, and since I was to the left of the President, I went ahead and put in the anterior chest tube in the second intercostal space.

Mr. Specter.

Was that tube fully inserted, Doctor?

Dr. JONES. I felt that the tube was fully inserted, and this was immediately connected to underwater drainage.
Mr. SPECTER. What do you mean by "connected to underwater drainage", Dr. Jones?
Dr. JONES. The tube is connected to a bottle whereby it aerates in the chest from a pneumothorax and as the patient breathes, the air is forced out under the water and produces somewhat of a suction so that the lung will reexpand and will not stay collapsed and this will give adequate aeration to the body, and we decided to go ahead and put in a chest tube on the opposite side; since I could not reach the opposite side due to the number of people that were working on the President. Dr. Baxter was over there helping Dr. Perry on that side, as well as Dr. Paul Peters, the assistant head of urology here, and the three of us then inserted the chest tube on the right side, primarily done by Dr. Baxter and Dr. Peters on the right side.
Mr. SPECTER. Then what other treatment, if any, was afforded President Kennedy?
Dr. JONES. After the tracheotomy was done, the intravenous fluid blood was started--I believe that the President was also administered some hydrocortisone because of his history of adrenal insufficiency, and at this time an electrocardiogram had been connected and it showed no evidence of a heartbeat. Closed cardiac massage was then first begun by Dr. Perry and then I believe that after about 5 minutes no significant or no myocardial activity was present and he was pronounced dead.
Mr. SPECTER. What history did you refer to of President Kennedy's adrenal insufficiency ?
Dr. JONES. As I recall, there had been in news that the President had several years ago been on some type of steroid therapy and that he possibly had