The Ephraim McDowell House and Museum (4)

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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: Written by: Efrain A. Miranda, Ph.D.; Published: March 02, 2017; Hits: 4189

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.

This is the continuation of the article “The Ephraim McDowell House and Museum (3)”. For the first article, click here.

The rest of the house is interesting. The kitchen is an open hearth typical of the times and beneath the operating room. Candle molds, butter churners, baking tables, iron cooking utensils, etc. The guide explained that most of the cooking work was done by slaves.

To the back of the house if a large garden. Part of it is shaped as a Maltese cross, and this is where Dr. McDowell cultivated medicinal plants and herbs for his practice and the apothecary, The garden has several monuments, one of which is the original slab that covered Dr. McDowell's tomb.

The kitchen

The back of the house

The apothecary

This "pharmacy" of the times is incredibly well-preserved, maintained and furnished. It is said that Dr. McDowell worked so much at this place that he eventually moved to the country to a second house he named "Cambiskenneth" after a famous local native american chief.

The apothecary has a basement that is off-limits to visitors, but there are photographs of the location for visitors to see.

Some of the porcelain and glass containers still have some of their contents.

The apothecary

Additional historic buildings

Just across from the McDowell House and Museum is the Constitution Square, a site that I would encourage you to visit. Following is an excerpt of the Danville KY website on the Constitution Square Historic Site:

"This is the birthplace of Kentucky's statehood. In 1776, Kentucky was still part of the frontier and a county of Virginia. The Wilderness Road, blazed by Daniel Boone, led pioneers through the Cumberland Gap and into Central Kentucky. Danville's prominent location on the Wilderness Road caused it to become a crossroad for early settlers, and a center of political activity.

By 1785, Danville was chosen as Kentucky's first seat of government, and a meetinghouse, courthouse and jail were built to administer the growing territory. Still bound to Virginia laws, though, several Danville citizens formed the political club that recognized the need for a convention to discuss statehood. Between 1784-1792, ten constitutional conventions took place at the courthouse of Constitution Square. In 1790, Kentucky delegates accepted Virginia's terms for separation from the state. On June 1, 1792, Kentucky became the fifteenth state in the union, and Isaac Shelby, a Revolutionary War hero, was named the first Governor of the Commonwealth."

Several original buildings and replicas are found at this site.

In closing this series of articles I can only say that this was an interesting personal and learning experience. Being able to visit The Ephraim McDowell House and Museum allowed me to envision the life of this time. To place it in perspective the year that Dr. McDowell operated on Mrs. Crawford was 1809. On the same year Abraham Lincoln was born (only 35 miles from the farm of Mrs. Crawford), James Madison was the 4th president of the United States of America (which had only 15 states and 6 territories), Napoleon occupied Vienna, and Ludwig van Beethoven had just finished writing his Fifth Symphony.

Following is a large image of the original house prior to its renovation. The image is in the public domain from a biographical book by Dr. McDowell's granddaughter Mary Young Ridenbaugh.

Click on the image for a larger depiction

Sources:
1. “Ephraim McDowell and Jane Todd Crawford, the Bicentennial of a Surgical Masterpiece” Benigno, BB Obst & Gynecol (2009) 113. 5:1141-1144
2. “The Biography of Ephraim McDowell, M.D.; The Father of Ovariotomy” Ridenbaugh, MY, 1890 CL Webster & Co.
3. “Ephraim McDowell: "Father of ovariotomy" and founder of abdominal surgery, with an appendix on Jane Todd Crawford” Schachner, A 1921, J.B. Lippincott Co. (Interesting discovery in an Ex-Libris in this book)

The Ephraim McDowell House and Museum (4)

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