Andreas Vesalius’ fatal voyage to Jerusalem (3)

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A Moment in History

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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Details: Published: June 15, 2016; Hits: 6843

By Maurits Biesbrouck, MD. Continued from "Andreas Vesalius’s fatal voyage to Jerusalem (2)".

For the first page of this article, click here.

Title page of Jean Zuallart’s
Le tresdevot voyage de Iervsalem (1608)

This important letter was written in Monzon. Barón Fernández points out that it must date from the 24th of January, at the latest, as the monarch then left Monzon, after the sessions of the Cortes of Aragon were over. Vesalius was also in Monzon with the king. The king himself returned in January 1564, to Madrid, arriving there in May. So Vesalius must have received permission for his trip to Jerusalem while in Monzon, situated approximately 240 km from Perpignan, at the French border, while Madrid is 600 km from Perpignan. Presumably Vesalius left Spain directly via Monzon in order to avoid returning to the capital and making the far longer journey to France from Madrid. He definitely cannot have accompanied the king all the way back to the Spanish capital, as he was already in Venice by the 10th of March, as we shall see in the second letter.

But first some other important remarks. It is hard to imagine that the ultra-Catholic king would have written about Vesalius, to his ambassador, in such terms, if he had been condemned by the Inquisition, let alone, if he himself had had to intervene to protect him from the death penalty. If any of this had been true, we may suppose that the king would have expressed himself very differently. Second, the letter also undermines any claim that there was an ambivalent relationship between Vesalius and his king. Third, Philip II is apparently concerned about Vesalius’s welfare and takes safety measures. This was in no way excessive, as Jean Zuallart describes this journey as one of the most dangerous (10). Fourth, it is striking how Philip II expressly asks his ambassador to urge Vesalius to return swiftly. He will probably also have asked him this in person in Monzon, at the point when he gave him his permission to depart. It is just as if he was not entirely relaxed about the matter.

Letter 2: from Garcihernandez to Philip II

The second letter is the reply of Garcihernandez to the king, on March the 13th. Its translation reads: “Doctor Vesalius arrived here on the tenth of this month, and in order not to waste any time during his journey will, when conditions are favourable, sail from here to Cyprus, and will travel very well equipped, and in company, to Jerusalem. He says that he will travel as swiftly as possible. Ambassador Paulo Tiepolo and a brother of Giovanni Soranzo have very kindly helped him, to comply with [the wish of] Your Majesty. … Venice, the 13th of March 1564.” Signed: “Garcihernandez”.

So, in this letter Garciherandez states, that Vesalius had arrived in Venice on March the 10th, and would be sailing from there to Cyprus, with the support of several people. He stresses that no time will be wasted, and that he has conveyed to Vesalius the king’s wish that he should return as soon as possible. The theory that Vesalius used the journey, so that he could afterwards travel to Padua, seems to be undermined here, by the reply of Vesalius from Venice - albeit given indirectly -, that he will return to the royal court, as soon as possible.

Letter 3: also from Garcihernandez to Philip II

Fifteen days later, on March the 28th, ambassador Garcihernandez sent the king another letter, with only a short passage on Vesalius. Here we read in translation:

“Five hundred soldiers are being sent to Cyprus and a hundred to Corfu. The ships have remained in port because of the adverse weather, and Doctor Vesalius will be sailing in one of them, as I wrote to your Majesty...”

This short fragment means that Vesalius was still in Venice on March 28th, and that he was only waiting for better weather to embark.

Article continued here: Andreas Vesalius’s fatal voyage to Jerusalem (4).

Sources and author's comments:
10. Jean ZUALLART, Le tresdevot voyage de Iervsalem, auecq les figures des lieux saincts, & plusieurs autres, tirées au naturel, Anvers, Arnovld s’Conincx, 1608 ; see p. 85. First edition in Italian Il devotissimo viaggio di Gierusalemme (Roma, 1595).

Andreas Vesalius’ fatal voyage to Jerusalem (3)

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