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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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The word [peritoneum] has a Greek origin [περίτόνοςαιον]. Loosely translated it has the prefix [peri-] meaning "around", the root [-ton-] from the Greek [tonos], meaning "to stretch", and the suffix [-eum] meaning "a membrane". It is "a membrane that is stretched around".
The peritoneum is a thin serosal membranous sac found in the abdominopelvic cavity. Histologically it is composed of a layer of mesothelium supported by a layer of connective tissue. Being a serosal sac, it contains in its interior a small amount of peritoneal fluid. The pathological accumulation of peritoneal fluid is called ascitis.
Although the peritoneum is one continuous membrane, and because of its relation to the organs and the abdominal wall, the peritoneum is described as formed by two components:
• Parietal peritoneum: The parietal peritoneum is that portion of the peritoneal sac related to or in contact with the walls of the abdomen and the pelvis.
• Visceral peritoneum: The visceral peritoneum is that portion of the peritoneal sac related to or in contact with the abdominopelvic viscera. I this case the peritoneum encases the viscera almost completely and is referred to as their serosa layer i,e: serosa layer of the ileum.
The double-layered portions of the peritoneal sac that stretch between organs or between organs and the abdominal wall are known by different names. They can be called an abdominopelvic [ligament], a [mesentery], a [meso..(something)], or an [omentum]. These structures are covered in separate articles. Some of these structures are:
- Falciform ligament: A sickle-shaped double fold of peritoneum related to the liver
- Ligament of Treitz: Also known as the "suspensory ligament of the duodenum"
- Infundibulopelvic ligament: A fold of peritoneum containing the ovarian arteries and veins
- Lesser omentum: The lesser omentum is one of the two double-folds of peritoneum related to the stomach
- Mesosigmoid: A double peritoneal membrane related to the sigmoid colon
- Transverse mesocolon: A double peritoneal membrane related to the transverse colon
- Mesoappendix: A double peritoneal membrane related to the vermiform appendix, etc.
Sources:
1. "Clinically Oriented Anatomy" Moore, KL. 3r Ed. Williams & Wilkins 1992
2. "The origin of Medical Terms" Skinner, AH, 1970
3. "Tratado de Anatomia Humana" Testut et Latarjet 8 Ed. 1931 Salvat Editores, Spain
Image modified from the original from Testut and Latajet, 1931. Public domain.
Thanks to Dr. Randall Wolf for suggesting this article
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A derivate of the Latin root [cervix] or [cervicis] meaning "neck". The word [cervical] means "pertaining to the neck".
The term is used in many areas and structures of the human body:
• Cervical spine: refers to the spinal column region formed by the seven cervical vertebrae. See image
• Uterine cervix: The inferior region of the uterus which projects partially into the vagina.
• Cervical rib: An anatomic variation where one or more supernumerary ribs are found related to the lower cervical vertebrae. This anomaly can cause clinical symptoms.
Images property of: CAA.Inc. Artist: Dr. E. Miranda
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This term can be a suffix or a word by itself. It arises from the Greek Arabic [στάσις] (stasis) and means "to stand still" or "to stop". This term can be found in several medical words:
- Hemostasis: Stoppage of blood flow
- Metastasis: The prefix [meta-] means "beyond", or "at a distance". Something that stops at a distance, such as a cancer tumor that stops away from the primary tumor
- Bacteriostasis: To stop bacteria. A [bacteriostatic] agent stops bacterial invasion
- Intestinal stasis: Stoppage of flow of intestinal content
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The [ligamentum nuchae] is the Latin term to describe the nuchal ligament. It arises from the word [nucha] meaning the “back” or “nape” of the neck.
The ligamentum nuchae is a midline or median structure found in the posterior aspect of the neck. It is a fibroelastic tendon-like bilaminar structure with a triangular shape. Because of its location the ligamentum nuchae froms a septum that divides the posterior aspect of the neck in the midline providing an attachment for several muscles. These muscles are the trapezius, splenius capitis, rhomboid minor and serratus posterior superior.
The ligamentum nuchae attaches superiorly to the inion (external occipital protuberance) and the midline of the occipital bone. Inferiorly it attaches to the spinous process of C7 (vertebra prominens). Anteriorly it attaches to the posterior tubercle of C1 and all the cervical vertebrae in the midline. Interestingly, anatomical studies have shown the ligamentum nuchae to have small attachments to the spinal dural (thecal) sac superior and inferior to C1
There is a discussion as to the relationship of the ligamentum nuchae and the supraspinous and interspinous ligaments. Some say that the ligamentum nuchae is a discrete structure distinct from the supraspinous and interspinous ligaments, while others contest that the ligamentum nuchae is a continuation of the supraspinous and interspinous ligaments.
Thanks to Jackie Miranda-Klein for suggesting this article.
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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.
Empedocles of Agrigentum
Empedocles of Agrigentum (ca. 495–430 BC). Greek philosopher, poet, physician, physiologist, politician, Empedocles was born in the city of Agrigentum, a Greek colony in Sicily.
Empedocles presented himself as an immortal god. Versed in magic and incantations, he was seen as a healer by people that followed him.
A philosopher, Empedocles developed the theory that nature consists of the combination of four “elements”— earth, water, air, and fire —with each of these elements being a combination of two qualities: water is wet and cold, air is dry and cold, fire is dry and hot, and earth is wet and hot. Empedocles went further to explain that the combination of these elements is based on the balance of love and hate. The balance of the elements represented balance in life.
Further development of this theory by observation of the human body, led to the “Humor theory” or “bodily fluids” theory based on four fluids whose imbalance led to disease. The four humors were “blood” or sanguineous, which belongs to the air element, “phlegm”, which belongs to water, “yellow bile”, which corresponds to fire, and “black bile” or “melancholy” which corresponds to earth. This theory dominated human physiology and medicine until the 17th century.
Because the humor theory also explained moods and temperaments, Empedocles’ influence is still seen in our language as we refer to people and personalities as “phlegmatic”, “sanguine”, “bilious”, and “melancholy”.
Empedocles’ death is the stuff of legend. To maintain his image as a god, he threw himself into the Etna volcano to disappear. This was foiled as it is said that the volcano spew one of his golden sandals. Others said that he made a “divinity” party and after dinner when everyone was asleep he disappeared, making everyone believe he had risen to heaven. Fact is, we do not know.
Sources
1. “Mythical Conceptions of the Problem of the Unity of Culture” Tagliacozzo, G. Am Behav Scient Apr 1963; 6-8
2. “The Nature and Formation of Teeth According to Spanish Authors from the 16th to the 18th Centuries” Romero-Maroto, M. J Dent Res (2008) 87(2):103-106
3. “The evolution of Modern Medicine” Osler, W. 2nd Ed. Yale University Press 1922
4. “Empedocles” N Brit Rev Vol LXV (1866) 420-440
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This term is originally Arabic [nukha] and at the time of its first use it meant "spinal marrow". It was used by Avicenna with this meaning around 1000 A.D.
Today it is used to mean the "nape" or the "back of the neck". Apparently at some point in time the Arab word [nukha] was confused with another Arab term [nugraf] which actually means "back of the neck". The error has persisted to our times. In French the word is [nuque] and in Spanish [nuca]. The term is used in some medical and anatomical terms such as:
• Ligamentum nuchae: Nuchal ligament. A thick ligament in the back of the neck that reinforces the supraspinous ligament
• Nuchal cord: An obstetrical condition where the umbilical cord is wrapped around the neck of the fetus