Medical Terminology Daily - Est. 2012

Medical Terminology Daily (MTD) is a blog sponsored by Clinical Anatomy Associates, Inc. as a service to the medical community. We post anatomical, medical or surgical terms, their meaning and usage, as well as biographical notes on anatomists, surgeons, and researchers through the ages. Be warned that some of the images used depict human anatomical specimens.

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A Moment in History

Jean George Bachman

Jean George Bachmann
(1877 – 1959)

French physician–physiologist whose experimental work in the early twentieth century provided the first clear functional description of a preferential interatrial conduction pathway. This structure, eponymically named “Bachmann’s bundle”, plays a central role in normal atrial activation and in the pathophysiology of interatrial block and atrial arrhythmias.

As a young man, Bachmann served as a merchant sailor, crossing the Atlantic multiple times. He emigrated to the United States in 1902 and earned his medical degree at the top of his class from Jefferson Medical College in Philadelphia in 1907. He stayed at this Medical College as a demonstrator and physiologist. In 1910, he joined Emory University in Atlanta. Between 1917 -1918 he served as a medical officer in the US Army. He retired from Emory in 1947 and continued his private medical practice until his death in 1959.

On the personal side, Bachmann was a man of many talents: a polyglot, he was fluent in German, French, Spanish and English. He was a chef in his own right and occasionally worked as a chef in international hotels. In fact, he paid his tuition at Jefferson Medical College, working both as a chef and as a language tutor.

The intrinsic cardiac conduction system was a major focus of cardiovascular research in the late nineteenth and early twentieth centuries. The atrioventricular (AV) node was discovered and described by Sunao Tawara and Karl Albert Aschoff in 1906, and the sinoatrial node by Arthur Keith and Martin Flack in 1907.

While the connections that distribute the electrical impulse from the AV node to the ventricles were known through the works of Wilhelm His Jr, in 1893 and Jan Evangelista Purkinje in 1839, the mechanism by which electrical impulses spread between the atria remained uncertain.

In 1916 Bachmann published a paper titled “The Inter-Auricular Time Interval” in the American Journal of Physiology. Bachmann measured activation times between the right and left atria and demonstrated that interruption of a distinct anterior interatrial muscular band resulted in delayed left atrial activation. He concluded that this band constituted the principal route for rapid interatrial conduction.

Subsequent anatomical and electrophysiological studies confirmed the importance of the structure described by Bachmann, which came to bear his name. Bachmann’s bundle is now recognized as a key determinant of atrial activation patterns, and its dysfunction is associated with interatrial block, atrial fibrillation, and abnormal P-wave morphology. His work remains foundational in both basic cardiac anatomy and clinical electrophysiology.

Sources and references
1. Bachmann G. “The inter-auricular time interval”. Am J Physiol. 1916;41:309–320.
2. Hurst JW. “Profiles in Cardiology: Jean George Bachmann (1877–1959)”. Clin Cardiol. 1987;10:185–187.
3. Lemery R, Guiraudon G, Veinot JP. “Anatomic description of Bachmann’s bundle and its relation to the atrial septum”. Am J Cardiol. 2003;91:148–152.
4. "Remembering the canonical discoverers of the core components of the mammalian cardiac conduction system: Keith and Flack, Aschoff and Tawara, His, and Purkinje" Icilio Cavero and Henry Holzgrefe Advances in Physiology Education 2022 46:4, 549-579.
5. Knol WG, de Vos CB, Crijns HJGM, et al. “The Bachmann bundle and interatrial conduction” Heart Rhythm. 2019;16:127–133.
6. “Iatrogenic biatrial flutter. The role of the Bachmann’s bundle” Constán E.; García F., Linde, A.. Complejo Hospitalario de Jaén, Jaén. Spain
7. Keith A, Flack M. The form and nature of the muscular connections between the primary divisions of the vertebrate heart. J Anat Physiol 41: 172–189, 1907.


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This article is part of the series "A Moment in History" where we honor those who have contributed to the growth of medical knowledge in the areas of anatomy, medicine, surgery, and medical research.

Dr. Otto C. Brantigan
Dr. Otto C. Brantigan

Otto C. Brantigan, MD. (1904-1981) An American surgeon and anatomist, Otto Charles Brantigan  was born in Chattanooga, TN in 1904. Having dropped out of high school to help his family and working as a first class machinist, he decided to continue with graduate school. He studied at the Northwestern University in Chicago, where he graduated from the Medical School in 1933.  In 1948 he became Chief of Surgery, and eventually became Professor of Surgery, Professor of Thoracic Surgery, and Professor of Anatomy at the Maryland School of Medicine.  He retired in 1976 having earned many accolades for his profuse surgical work and publications.

As a surgeon of the times, Dr. Brantigan had a wide area of interest. His over 110 publications and surgical work range from thoracoscopy to vascular, plastic, cardiac, and orthopedic surgery. He is most remembered for the pioneer work he did on chronic obstructive pulmonary disease (COPD), emphysema and lung volume reduction surgery (LVRS), which he presented in 1958. The procedure had (at the time) a very high mortality rate  (16 -20%) and Brantigan's work was not readily accepted.

It was not until J. Cooper and his team, revisited the operation proposed by Brantigan  that the operation was accepted, now with new surgical stapling and staple line buttressing technology.  Dr. Brantigan's name was recognized as a pioneer in lung emphysema surgery, unfortunately 14 years after his death. In 1994 his son, Dr Charles O. Brantigan delivered a beautiful biography of Dr. Otto Brantigan in the same meeting where Cooper presented his results with LVRS.

Personal note: I am proud to own one of the copies of Dr. O.C. Brantigan;s "Clinical Anatomy", a book that I use quite frequently. It is listed in my library catalog. Dr. Miranda.

Sources:
1. "Biography of Otto C Brantigan" C.O. Brantigan 1994 Meeting of the American Association for Thoracic Surgery
2. "LVRS in chronic obstructive pulmonary disease" Davies, L; Calverley, P. Thorax 1996;51(Suppl 2):S29-S34
3. ""Bilateral pneumectomy (volume reduction) for chronic obstructive pulmonary disease" Cooper, J.,The Journal of Thoracic and Cardiovascular Surgery Volume 109, Number 1:106-119
4. "The Surgical Approach to Pulmonary Emphysema" Brantigan, OC; Kress, MB; Mueller, EA. Chest. 1961; 39(5):485-499
5. "History of Emphysema Surgery" Naef, AP. Ann Thorac Surg 1997;64:1506-1508
Original image courtesy of National Institutes of Health.Biography of Dr. Otto Brantigan courtesy of Dr. Charles O. Brantigan.