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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 Eight-series landscape panorama of Vesalius' muscle men plates. Paintings attributed to Jan Stephan Van Calcar

UPDATED: There is no doubt that the book “De Humani Corporis Fabrica Libri Septem” written by Andreas Vesalius and published by Johannes Oporinus in May, 1543 is one of the most important scientific anatomical and medical books ever written. Much has been said about the place this book has in medical history as part of the discarding of dogmas and the establishment of scientific observation and thinking.

Some of the most intriguing images published in the book are fourteen woodcuts in the second book. These amazing and detailed images show the muscles in a whole body as it is dissected. The text details the structures and the procedure of how the dissection is performed.

It is believed that these images were done by Jan Stephan Van Calcar, an artist from the Titian’s studio, although there are indications that these images may have been authored by somebody else, or even that they were the effort of more than one artist working under the close supervision of Andreas Vesalius.

Today’s anatomical images are very descriptive and the artistry is relegated to the technique used for the depiction of the image. In Vesalius’ muscle men plates each image has a background showing a landscape. It was not until 1903 that it was discovered that the landscapes of the different images were part of a complete landscape. This is evident if these images are placed side by side. There have been several books and articles published on these images. Interestingly, some of the images had to be reversed to be placed in the panorama. This is due to the process of cutting the woodblocks.

The image in this article is one of two identified and composed by Harvey Cushing in 1943 (see sources). He calls it the "eight-series". The "six-series" can be seen here. To see Cushing's original template click here. The panorama of the six-series was identified by Cushing to be an area of the Euganean hills near Venice and Padua, Italy. There landscape formed by the eight-series is an actual region near Padua, Italy showing the ruins of old Roman baths. Cavanagh (1938) adds more information on these images, for his .pdf article, click here.

The image shown at the top of this article was created using original images from Vesalius’ Fabrica and composed using Adobe Fireworks CS5. Click on the image for a larger depiction. The large image is 1800px wide.

NOTE: In June 2023, I was able to purchase a single leaf of the 1543 Fabrica, page 187, which depicts one of the "muscle men". In the panorama image in this article it is figure number 3, from left to right. For more information on this image click here. This image is now properly framed in my office. Dr. Miranda.

This article continues here: "The landscape panorama of Vesalius' Muscle Men (2)"

Sources:
1. “A New View of the Vesalian Landscape” Cavanagh,  GST Med Hist 1983, 27: 77-79
2. “The Panorama of Vesalius: A 'Lost' Design From Titian's Studio” Skandalakis, JE JAMA May 28, 1997, Vol 277, No. 20
3. “A Drawing for the Fabrica; and some Thoughts Upon the Vesalius Muscle-Men” Kemp. M. Med Hist. Jul 1970; 14(3): 277–288
4. “Andreas Vesalius: The Making, the Madman and the Myth” Joffe, SN. Persona Publishing 2009
5. "A Bio-Bibliography of Andreas Vesalius" Cushing, H. (1943) Schumann's