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.

Dr. John E. Skandalakis
Dr. John E. Skandalakis

John E. Skandalakis, MD, PhD, FACS (1920-2009). Born in Greece, Dr. Skandalakis studied Medicine in Athens. During WWII he fought with the Greek Resistance earning a medal from the Greek government. In the USA Dr. Skandalakis obtained an additional degree in Anatomy, becoming one of the few surgeon-anatomists of our age. An extraordinary teacher, Dr. Skandalakis authored over 300 publications, including journal publications and books1. He is well known for his publications on surgical anatomy related to hernia procedures.

I had the pleasure and the opportunity of meeting and speaking with Dr. John Skandalakis a few times. He always impressed me with his dedication to Clinical Anatomy and his passion for the importance of Anatomy in Surgery. During the 1999 meeting of the American Association of Clinical Anatomists.

In 1992, Dr Skandalakis was awarded the title of "An Immortal" by the Academy of Athens, an award reserved for excellent achievement in the Arts, Sciences, and Humanities. This award has its origins from the time of Plato2.

The Journal of Clinical Anatomy published an "In Remembrance" article on Dr. Skandalakis and his life. I strongly recommend it to anyone who would like to know more about the life and works of Dr. Skandalakis. His picture in this page is a link to The Centers for Surgical Anatomy and Technique of the Emory University School of Medicine

I was saddened by the news of his passing, but he will be remembered by all those he touched in his life: family, patients, students, and peers. I am also sure that his legacy will go on through his writings, and by those who like me, influence and teach others with his knowledge. I am honored to have met him. Dr. Miranda

Original image of Dr. John E. Skandalakis courtesy of the the Centers for Surgical Anatomy and Technique.

Sources:
1. "Obituary: Dr. John Skandalakis, 1920-2009" Jones, G.  Hernia (2010) 14: 79-80              
2. "In Remembrance: John Elias Skandalakis,MD,PhD,FACS (1920–2009)Loukas,M; Colborn,L; Tubbs: RS Clin Anat 23:332–334 (2010)