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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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.

Sir Astley Paston Cooper
Sir Astley Paston Cooper

Sir Astley Paston Cooper (1768 - 1841). An English anatomist and surgeon, Astley Cooper started his medical studies when he was only 16, at the St. Thomas hospital in London. He studied under Henry Cline, and later under John Hunter. Astley Cooper was a well-known anatomist, lecturer, and surgeon in his time. He is known for his many studies in abdominal hernia, otology, aneurysms, and the anatomy and diseases of the breast. In 1804 he described the abdominal transversalis fascia and the internal inguinal ring.

Born in the village of Brooke, Norfolk. At 16 years of age he was placed under the tutelage of Henry Cline (1750 - 1827), senior surgeon at the St. Thomas hospital in London for a seven-year apprenticeship. In 1789 he was appointed as an anatomy lecturer at the same hospital. In 1800 Cooper was appointed Surgeon to the Guy's Hospital in London.

He was the first to attempt the ligation of the abdominal aorta in a patient that had suffered an aortic abdominal aneurysm rupture. The patient survived for one additional day. "Astley Cooper introduced no new philosophy, policy or practice into surgery but was the perfect exponent of the scientific approach to surgery combined with skillful and successful practical ability" Brock (1969)

Cooper’s name survives in several eponymous anatomical structures and diseases he described, following are two of them:

Cooper's ligaments of the breast: Connective tissue ligamentous strands between the pectoral fascia and the skin overlying the breast. (although it was first described by Andrea Vesalius).
Cooper's pectineal ligament: A thickening of the periosteum on the superior aspect of the pubic bone, lateral to the pubic tubercle. This structure is a preferred site for staple positioning during a laparoscopic herniorrhaphy. When placing the staples, consideration should be placed on the potential presence of an anatomical vascular variation named the "Corona Mortis".

Although Cooper published a number of books and research papers, his seminal contribution to surgery was his two-volume "Treatise on Hernia". The first volume was published in 1795 and the second volume in 1807, with a revised second edition published in 1827.

Personal note: Although Sir Astley Cooper has been credited with the first description of the complex mammary suspensory ligaments (Cooper's ligaments), a 2016 paper by Brinkman and Hage (see Sources) contests this and gives Andreas Vesalius the honor of describing these structures nearly 300 years before Cooper!  Dr. Miranda.

Sources:
1. "Sir Astley Paston Cooper." Singal, R. et al. Indian J Surg 73:1 (2011): 82-84.
2. "Sir Astley Paston Cooper, 1768-1841:the prince of surgery"Rawling, EG. Can Med Assoc J 99.5 (1968): 221.
3. "The life and work of Sir Astley Cooper" Brock, RC. Ann Royal Coll Surg England 44.1 (1969): 1-18
4. "Andreas Vesalius’ 500th Anniversary: First Description of the Mammary Suspensory Ligaments" Brinkman, RJ; Hage JJ. World J Surg (2016) 40:2144–2148