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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Andreas Vesalius Bruxellensis
Click for Vesalius' biography 

UPDATED: We have discussed many times on this blog the importance of Andreas Vesalius (1514 – 1564), his impact on modern science and anatomy, and the influence of his opus magnum publication in 1543, the Fabrica. The complete name of this publication is “De Humani Corporis Fabrica, Libri Septem” (Seven books on the structure of the human body).

Harvey Cushing wrote in his Vesalius bio-bibliography of 1943:”As a book, the Fabrica has been probably more admired and less read than any publication of equal significance in the history of science”.

The first (1543) and second (1555) editions of the Fabrica were published in Basel, Switzerland by Johannes Oporinus (1507 – 1568). With few exceptions, the Fabrica was sold as an unbound book and it was the owner’s responsibility to bind the book. One of the exceptions was the sumptuous purple silk-bound presentation copy delivered to the Emperor Charles V. As an interesting note, a Fabrica was discovered in Canada that was heavily annotated and as such had a low value. Who wants a book that of this importance that is so heavily hand-written? Analysis of the writing and style indicate that this copy belonged to Vesalius himself and was most probably the basis for a third edition that was never published. The annotations are used in the "New Fabrica" and if you are interested,  here is a PDF file of a 2014 article on this topic.

Today we do not know how many books were actually printed as part of the first and the second edition of the Fabrica. Because of the time passed, lost or damaged books, during the last century efforts have been made to inventory the number of Fabricas still in existence, in studies made by Cushing in 1943 and Horowiz and Collins in 1984.The latest effort to account for the total number of these books was made by Stephen N. Joffe, MD, and Veronica Buchanan, MA in 2015 for both the 1543 and the 1555 editions of the Fabrica. Their papers were presented in February 2015 at the interdisciplinary symposium “Vesalius and the Invention of the Modern Body” in St. Louis, MO.

Dr. Joffe  is the author of the book “Andreas Vesalius: The Making, the Madman, and the Myth”. Veronica Buchanan is the Archivist at the University of Cincinnati Henry R. Winkled Center for the History of the Health Professions.

The authors of these papers estimate that there are 64 complete copies surviving of the estimated 300 – 500 first edition printed in 1543. While a similar printing run is estimated for the 1555 edition, only 58 complete copies survive in the USA The papers can be read and downloaded on the following links:

"Updated Census in USA of First Edition of Andreas Vesalius’ ‘De Humani Corporis Fabrica’ of 1543”
READ DOWNLOAD 

 “An Updated Census of the Edition of 1555 of Andreas Vesalius’ De Humani Corporis Fabrica in the United States of America” READ DOWNLOAD

Note: The following link was sent to me by Dr. Elizabeth Murray and refers to the study by Joffe and Buchanan. The article “Accounting for an Historic Text” is from the University of Cincinnati Newsletter. Dr. Miranda

Sources
1. “Updated Census in USA of First Edition of Andreas Vesalius’ ‘De Humani Corporis Fabrica’ of 1543” Joffe, SN; Buchanan V. International Archives of Medicine; 2015: 8:1
2. “An Updated Census of the Edition of 1555 of Andreas Vesalius’ De Humani Corporis Fabrica in the United States of America” International Archives of Medicine; 2015: 8:1
3. Cushing, Harvey: A Bio-bibliography of Andreas Vesalius 2nd edition. Hamden: Conn.
4. Garrison, Daniel H., Hast, Malcom H.: Andreas Vesalius: The Fabric of the Human Body. Published S. Karger, Basel; 2014
5. "Andreas Vesalius; The Making, the Madman, and the Myth" Joffe, Stephen N. Persona Publishing 2009