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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1543 Fabrica Title Page
1543 Fabrica Title Page

One of the most collectible books in medical sciences and specifically in human anatomy is “De Humani Corporis Fabrica; Libri Septem” (Seven books on the structure of the Human Body) published in 1543 by Andreas Vesalius. This book is known as the “Fabrica” among Vesaliana enthusiasts.

The story of the Fabrica is complicated and the books, research papers, paintings, statues, medals, etc. on Vesalius and the Fabrica number in the thousands.

The first edition of the Fabrica was published in 1543, it was well received and was followed by the second edition in 1555. Vesalius died in 1564 and no further editions of the Fabrica were published. There are several translations in different languages, the latest is the “New Fabrica” published in 2013. This book included annotations by Vesalius himself found in a 1555 Fabrica. This particular “Annotated Fabrica” has a history worth reading and is one of the most expensive books ever sold at an auction in February 2024 for 2.23 million US dollars.

Part of book collectibles are single pages cut off a book. This method was quite common among antiquarians in the late 1800’s and early 1900’s. As a book collector, I think it is not a good idea to destroy a great book in the quest to obtain more money selling it as individual pages.

Be that as it may, in early 2023 I was notified by my good friend Dr. Randall Wolf, one of the contributors of Clinical Anatomy Associates, of an auction by Potter and Potter where two loose pages of the 1543 Fabrica would be placed on the auction block. With his help and lots of luck, I was able to secure item 298, which was a single page of the Fabrica, page 187, one of the “muscle men”, which depicts the “Liber II, Sexta Musculorum Tabula” (Book 2, Sixth Muscle Image).

Potter and Potter Auctions June 2023Cover page of the June 2023 Potter&Potter Auction

Potterandpotter187 smItem 298 description

One of the problems that collectors face is to prove that a certain item is original, the second one is provenance (where does the item come from?).

The first question was answered in Belgium when Dr. Wolf and I visited Dr. Francis Van Glabbeek and his personal collection in June 2023 with occasion of the 2023 Vesalius Triennial Meeting in the city of Antwerp. We were able to compare in minute detail the original image and my single page, including the type of paper and the text on the opposite page. They were a perfect match, proving that this page was indeed taken of an original 1543 Fabrica.

Reviewing the 1543 Fabrica with Drs. Wolf and Van GlabbeekStudying page 187

Getting goosebumps...
Getting goosebumps...

Reviewing the 1543 Fabrica with Drs. Wolf and Van GlabbeekLooking at details...

Confirmed

Confirmed!! It is an original 1543 page!

The second question was answered by the auctioneer, as the page belonged to the library of Ronald K. Siegel, PH.D. (1943-2019), an American psychopharmacologist and associate research professor in the Department of Psychiatry and Behavioral Sciences at the University of California, Los Angeles (UCLA). Before Dr. Siegel, we do not know how or when he acquired this single leaf of the Fabrica.

The page was carefully framed by Becky Gebhart, owner of “Picture This” in Lebanon, OH, and is secured with museum-quality glass. It in now on the wall facing my desk. Here it is:

Page 187 of the 1534 FabricaPage 188, the verso of page 187 is not visible because of the frame. This page title is "Sextæ Musculorum tabulæ charactermum index" and lists the symbols on the image.

Fabrica page 188