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 is a series of articles on depression published as a community service. The information in these articles follow our Privacy and Security Guidelines and cannot be construed as medical guidance. For additional information and counseling, consult with your physician or the appropriate health care professional of your choice. You can also find information on TMS here.

Depression
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UPDATED
: Everyone occasionally feels blue or sad. There are also those dreaded "winter blues". But these feelings are usually short-lived and pass within a couple of days, usually with no problems or persistent symptoms. Some people may even say that they are "depressed". Although this is true, that person is not clinically depressed.

When an individual has clinical depression, there are physical changes that happen within the brain which reflect in attitudes, mood, symptoms, and actions.

Clinical depression is a common but serious mental disorder that affects over 20 million people in the United States, many of which will never seek diagnosis or treatment. Patients present with depressed mood, loss of interest or pleasure, decreased energy, feelings of guilt or low self-worth, abnormal patterns of sleep or appetite, gruesome nightmares, and poor concentration. Moreover, depression may often come with symptoms of anxiety and varying complex presentations of bipolar disorder.

These problems can become chronic or recurrent and lead to substantial impairment in an individual’s ability to take care of his or her everyday responsibilities. At its worst, depression can lead to a patient's attempt on their life. Clinical Depression interferes with daily life and causes pain for both the individual, their families, and loved ones. Patients with depressive disorder often go from one job to another, cannot work, or eventually end in disability, being maintained by their family or loved ones.

Many people afflicted with Major Depressive Disorder (MDD) never seek treatment. This is specially true in males, where the World Health Organization (WHO) estimates that ”fewer than 25% of male sufferers worldwide will seek treatment because of the social stigma associated with mental disorders including depression.”

Properly and timely treated, even those with the most severe depression, can get better. Medications, psychotherapy, and electroconvulsive therapy (ECT) are the most common methods to treat depression. As patients move from one medication to the next level medication as well as augmentation medication, the annual cost for medication can be staggering, as well as the common, insidious, and problematic systemic side effects of both the drug therapy and ECT therapy.

The main objective of all treatments for MDD is to attain remission, but in many cases just reducing the symptoms of MDD and reducing the amount and types of medication used is enough to bring the patient back to a productive life and enhance the relationship with their families and loved ones.


Next article: Symptoms of Depression