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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 term [zygapophysis] is Greek. [-zyg-] means "yoked" or "paired", [-ap-] means "away" or "out", while the suffix [-(o)physis] means "growth". The term means "a paired outgrowth". Its plural form is "zygapophyses".
The term zygapophysis is used to denote four bony outgrowths or processes found in the posterior aspect of most vertebrae, arising in the zone of junction of pedicle and lamina. The zygapophyses are paired (left and right) and then they are inferior and superior. They are also called "articular processes".
Each zygapophysis presents with a smooth articular surface called an [articular facet]. Each articular facet is covered with hyaline cartilage. Two adjacent articular facets will form a synovial type joint known as a zygapophyseal joint or a facet joint.
In the cervical region the zygapophyseal joints are so close that they form a lateral pillar, known as the "lateral mass" or "articular pillar".
Arthritic degeneration of the zygapophyseal joints can lead to reduced spinal mobility and pain. The image shows the posterior view of a lumbar vertebra. Click on the image for a larger depiction.
Image property of: CAA.Inc. Photographer: David M. Klein
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The suffix [-(o)cyte] arises from the Greek [κελί] meaning "a hollow vessel" or a"cell". The term [-cyt-] can also be used as a root term, also meaning "cell". Examples of its use are:
- Leukocytopenia: A combination of root terms; [leuk], means "white", and [-cyt-] means "cell". The suffix [-(o)penia] means deficiency. A white cell deficiency
- Erythrocyte: The root [-erythr-] means "red". A red cell, referring to a red blood cell
- Leukocyte: The root [-leuk-] means "white". A white cell, referring to a white blood cell
- Blastocyte: The root term [-blast-] is used to mean "to build". A cell that builds. Usually refers to a fibroblast
- Osteoclastocyte: A combination of root terms; [-oste-], means "bone", and [-clast-] means "to destroy". A cell that destroys bone.
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The word [axis] arises from the Greek [άξων] meaning "axle".
[Axis] is the proper name given to the second cervical vertebra (C2). The name is from the action of C2. Because of its odontoid process and associated ligaments and joints, the axis allows the head to pivot around the axis of the odontoid process or dens.
As with all cervical vertebrae, the axis presents with foramina transversaria (no readily visible in the accompanying image), lateral masses with superior and inferior articular facets, pedicles and laminae. Usually the spinous process of C2 is bifid.
There are three atlantoaxial joints (between atlas and axis). Two of them are posterolateral, the zygapophyseal or facet joints. The median atlantoaxial joint between the atlas and the odontoid process of the axis is important in axial rotation of the head.
The superior articular processes of the axis forms part of the posterolateral atlantoaxial joints . In an uncharacteristic situation, the superior articular facet extends slightly from the lateral mass into what is considered the body of C2.
The median atlantoaxial joint components and its related ligaments, the alar ligament, the cruciform ligament, and the apical ligamen of the dens will be featured in separate articles.
Image property of: CAA.Inc. Photographer: David M. Klein
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The term [odontoid] arises from the Greek [δόντι] meaning "tooth". The suffix [-oid] means "similar to". Similar to a tooth.
The odontoid process, also known as the "dens", is a tooth-like bony process found in the anterior aspect of the second cervical vertebra (C2), also known as the "axis" because of its function, serving as a pivot point to the head.
Embryologically, the odontoid process is the body of the first cervicalvertebra (C1, atlas) that has been incorporated into C2. This is proven by the presence, deep in the structure of the dens, of a small remnant of an intervertebral disc-like structure. This concept has been challenged by different authors.
The dens presents a small anterior facet to articulate with the posterior aspect of the anterior arch of the atlas (C1), a posterior area for the attachment of the alar ligaments, and a small ligament at its apex, the apical ligament, that attaches to the inferior aspect of the occipital bone.
Image property of: Photographer: David M. Klein
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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.
Paracelsus
Paracelsus (1493 – 1541). Swiss physician and alchemist , Phillipus Aureolus Theophrastus Bombastus Von Hohenheim was born in Einsiedeln in 1493 (one year after Columbus discovered America) in what is today is Switzerland. At an early age he became a migrant student, visiting several universities including Tubingen, Vienna, Wirttemberg, Heidelberg, and Cologne. There is discussion as to whether he received or not a medical degree, although most authors today agree he might had. In 1510 he moved to Ferrara where he attained (apparently) his medical degree in 1516. During his constant travels he started to understand that folk medical treatment based on actual observation was better than what was published and followed blindly by the physicians of the time.
He started to call himself “Paracelsus” which means “alongside Celsus”, seen as one of the greatest physicians in history. Paracelsus continued his travels, visiting Egypt and Jerusalem. It is at this time that he started delving into the world of alchemy, returning to his home circa 1524.
Paracelsus was appointed “Town Physician” of the city of Basle but created controversy when he started lecturing in German (not Latin) and invited the general public as well as his students to his lectures. In his presentations he introduced the concepts of direct observation of the patient and empirical treatment, based his statements on experiments and reasoning opposing the “classics” Galen, and Avicenna.
In 1527, during a demonstration he publicly burned the works of Avicenna to prove his point. This caused a backlash from the university and town authorities who expelled him in 1528. From this point on, Paracelsus’ life is constant wandering. He settles for a time and then travels again. In spite of his disdain for the works of the “medical greats”, he himself writes a large number of works, including medicine, surgery, theology, astronomy, magic, etc. Many of these works are not published until after his death as he is considered to be contradicting Galen. In 1530 he writes the best description of syphilis and recommended its treatment with mercury.
In 1541 he was appointed to a post on the staff of Duke Ernest of Bavaria, but he died in mysterious circumstances on September 24 of that year at the White Horse Inn in Salzburg.
Paracelsus is a controversial image, bound in legend. For many, Paracelsus was bombastic, quarrelsome, opinionated and a drunkard. For others he is a figure of his time, clashing with the classics and giving us a new way to look at the world and at diseases. He taught that wounds must be allowed to drain and not, as was common, packed with unhealthy materials. According to him, the human body primarily consists of salt, sulphur, and mercury, and it is the separation of these elements that causes illness. He introduced mineral baths and made opium, mercury, lead and other minerals part of his treatment, foreshadowing modern pharmacology with the use of chemical remedies, mercury for syphilis, laudanum and antimony. Paracelsus stated in 1538 that “Everything is a poison, the dose alone which makes a thing not a poison”.
I just discovered an interesting chain of events. For a time Paracelsus had a medical student that later decided not to continue his medical studies and instead dedicated himself to the new art of printing. His name was Johannes Oporinus and he was the printer that Andreas Vesalius selected to print his masterpiece, the "Fabrica".
Sources
1. “Paracelsus” Abbott.A. Nature 366: (1993) 98
2. “Paradigm lost: a celebration of Paracelsus on his quincentenary” Feder. G. Lancet. 341: (1993) 1396-1397
3. “Does Paracelsus deserve a place in the medical pantheon?” Bynum, B. 367: (2006) 29; 1389–1390
4. “Paracelsus: founder of medical chemistry” Endeavour 15:4 (1991) 147
5. “Paracelsus: the medical Luther” Leary B. 73: 3(1984) 131-133
6. “Paracelsus and the Philosopher’s Stone” TenHoor, W. Am J Surg (1935) 30:3 563-572
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This word is of Greek origin composed of the root term [-arthr-], meaning "joint", as in an bony articulation, and the suffix [-(o)desis], meaning "to bind together".
An arthrodesis is the surgical immobilization of a joint by fusion or the application of surgical devices (rods, screws, etc) to the bony components of a joint.