Dickinson Richards Jr. American cardiologist, awarded the 1956 Nobel Prize in Physiology or Medicine Date of Birth: 30.10.1895 Country: USA

American cardiologist Richard Dickinson

Richard Dickinson Richards was an American cardiologist and recipient of the 1956 Nobel Prize in Physiology or Medicine. He was born to parents Sally Richard (Lambert) and Dickinson Woodruff Richards. After graduating from Hotchkiss School in Connecticut, Richards attended Yale University and graduated in 1917 with a bachelor's degree. Three months later, he enlisted in the United States Army and served in France in the American Expeditionary Force in 1918. Upon returning to the United States, Richards entered the College of Physicians and Surgeons at Columbia University and received a master's degree in physiology in 1922, followed by a medical degree the following year. He then became an intern and resident at the New York Presbyterian Hospital. After a year of work at the National Institute for Medical Research in London, Richards returned to work at the Presbyterian Hospital and the College of Physicians and Surgeons.
Research on the respiratory system

Based on the physicochemical properties and respiratory function of blood, as investigated by Lawrence Henderson at Harvard University, Richards and his colleague André Cournand arrived at the "simple but important conclusion that the lungs, heart, and blood vessels should be considered as a single system that transports respiratory gases from atmospheric air to functioning tissues," as Richards later wrote. This finding had a significant impact on further research in the field. Richards began collaborating with Cournand in 1913 when he worked as a physician under the guidance of James Alexander Miller at Bellevue Hospital, the College of Physicians and Surgeons clinic. There, he had the opportunity to observe and study many patients with chronic pulmonary insufficiency, which affects pulmonary circulation.
During the first three years of clinical research, Richards confirmed the fact that normal gas exchange cannot occur in the alveoli of patients with chronic lung diseases, as other scientists had already discovered. Later, together with Robert Darling and Eleanor Baldwin, he developed a method for evaluating lung function. Richards noted that there was a "clear gap" in the study of the cardiovascular system regarding methods of evaluating the blood entering the right atrium, the gas content in the blood, blood pressure, and blood flow rate. Four decades before Richards' work, many scientists had attempted similar measurements. In 1929, German physician Werner Forssmann successfully inserted a thin rubber catheter approximately 60 cm long through a vein in the arm into the right atrium (one of the heart chambers) under the guidance of an X-ray machine.
Understanding that precise measurement of the gas content (oxygen and carbon dioxide) in the blood entering the right atrium from the systemic circulation would allow for the "reliable measurement of total pulmonary blood flow," Richards and Cournand decided to use Forssmann's technique. In 1936, they began conducting research on dogs and chimpanzees and in 1941, they were able to introduce a catheter into a human right atrium. In the same year, they discovered that the catheter could remain in the right atrium for up to seven hours without any adverse effects on the patient. This allowed for the measurement of oxygen and carbon dioxide content, as well as cardiac output (the volume of blood ejected by each ventricle per unit time). Additionally, the researchers were able to measure blood pressure in the right atrium, right ventricle, pulmonary artery, and total blood volume. These measurements significantly contributed to the understanding of cardiovascular function. Cardiac catheterization and the associated measurements proved valuable in the diagnosis and treatment of cardiovascular and pulmonary diseases.
Contributions during World War II

During World War II, Richards served as the chairman of the Subcommittee on Shock Studies for the National Research Council's Committee on Medical Research. He and his colleagues were tasked by the government to study the cardiovascular system's activity during shock, evaluate the impact of bleeding and injury on the state of the circulatory organs, and test various treatment methods. Using cardiac catheterization, Richards and his colleagues made significant progress in studying the mechanisms of shock and determined that whole blood, rather than plasma, should be used for its treatment.
Later career and advocacy

In 1944, Richards became the Deputy Director of the Physiology Department at the Committee on Medical Research of the Office of Scientific Research and Development. He held this position until 1946. In 1945, he was also appointed as a resident physician at the Presbyterian Hospital and the Director of the Medical Division at Columbia University in Bellevue Hospital. He held this position until his retirement in 1961, when he was awarded the title of Honorary Professor. After the war and in the early 1950s, Richards continued clinical research in the Medical Division at Columbia University in Bellevue Hospital, studying the effects of digitalis drugs on heart contractility and the development of pulmonary insufficiency. Throughout these years, Richards continued to collaborate with Eleanor Baldwin, whose work formed the basis for the development of clinical methods for evaluating lung function. In 1948-1949, Richards, Cournand, and Baldwin proposed a classification of pulmonary insufficiency, demonstrating its progression from mild to severe stages.
In 1956, Richards, Cournand, and Forssmann were awarded the Nobel Prize in Physiology or Medicine "for their discoveries concerning heart catheterization and pathological changes in the circulatory system." In his Nobel lecture, Richards acknowledged the foundational work of Forssmann and other scientists, stating that their own discoveries often raised new questions rather than solving old ones. He emphasized that the true value of their work was the interest it generated and the subsequent research conducted in laboratories and clinics around the world. Richards frequently delivered public lectures on healthcare issues. In 1957, during a speech at the Joint Legislative Committee on Narcotics, he recommended the establishment of hospital clinics where officially prescribed narcotics would be provided to addicts with established dependence. He also criticized the New York administration for its inadequate attention to Bellevue Hospital's problems, receiving support from 450 interns and residents and five public committees. In 1962, he became the President of the Bellevue Improvement Association, initiating the reconstruction of the hospital. Additionally, he advocated for broad healthcare assistance for the elderly, while the American Medical Association held an opposing position at the time.
In 1931, Richards married Constance B. Riley, and they had four daughters. On February 23, Richards passed away at his home in Lakeville, Connecticut, from a heart attack. Throughout his career, Richards received numerous awards, including the John Phillips Memorial Award from the American College of Physicians (1960), the Trudeau Medal from the National Tuberculosis Association (1968), and the Kober Medal from the American Association of Physicians (1970). In 1963, he was made a Chevalier of the French Legion of Honor. He was a Corresponding Member of the American College of Physicians and a member of the American Medical Association, the American Association of Physicians, and the American Clinical and Climatological Association.