Irving Sherwood Wright was the first doctor to use an anticoagulant to treat the blood clots that can cause heart attacks and strokes. Throughout a long career, he successfully combined clinical practice with research that contributed significantly to the management of peripheral vascular disease, myocardial infarction and cardiac arrhythmias. He also promoted the cause of clinical geriatrics and founded the Irving Sherwood Wright Center for Aging in New York.
Born in Manhattan, his father was an inventor who inspired his deep sense of curiosity and a love of books and history. He grew up in New Jersey and studied medicine at Cornell University and the Cornell University Medical College, which was the start of his long association with Cornell. Graduating in 1926, he moved to the New York Postgraduate Medical School at Columbia University for a residency in internal medicine. Three years later, he began a private practice to support his research, as was customary at the time, and commenced studying the peripheral circulation. A pioneer in this field, he published extensively on peripheral vascular disease, codifying disorders, extending diagnostic criteria and changing the prevailing view of the significance of this condition. He split his time between private practice and academic laboratory work for the next 40 years.
In 1931 he commenced clinical duties at the Cornell division of Bellevue Hospital and, seven years later, he became chairman of the department of medicine and professor of clinical medicine at the Cornell Postgraduate Medical School and Hospital. That same year, in 1938, he had an appendectomy and developed postoperative thrombophlebitis which was a disorder with a high level of mortality because the formation of blood clots could cause pulmonary embolisms. For several months he was seriously ill due to the lack of any effective treatment at the time. When he recovered he was presented with a patient suffering from the same disorder, Wright treated him experimentally with heparin. This was a natural anticoagulant, found in animal organs, that had been purified at the University of Toronto but never used on a patient. Within two weeks his patient showed a marked improvement and was still alive, remaining on anticoagulants, 56 years later when Wright presented him at a Grand Rounds as having been on anticoagulant therapy longer than anyone else in the world. He began to promote the use of anti-coagulants in myocardial infarction and, in 1940, tested a new oral anticoagulant, dicourmarol, which had been developed by others in the field.
During the Second World War, he was a colonel in the US Army and served as chief of the medical service at the Army and Navy General Hospital in Hot Springs, Arkansas from 1942 to 1943 and consultant in medicine for the 6th and then the 9th Service Command, from 1944 to 1946. Immediately after the war he was co-chairman of a special commission to aid in the rehabilitation of the German and Austrian medical schools and he continued as a civilian consultant in medicine to the Surgeon General until 1974.
During the war he had treated a number of patients successfully with dicoumarol but the results were not documented. In 1946 the American Heart Association (AHA) appointed him to chair a committee which conducted a trial using over 1000 patients. The trial, which was the largest clinical trial at that time, produced highly favourable results for anticoagulant therapy.
In 1948 he became professor of clinical medicine at Cornell. He organised the First International Congress on Thrombosis and Embolism in 1954. It was to be the first in a series of conferences on cerebral vascular disease, paying increasing attention to stroke and its management. It became apparent that the progress of research in this field was hampered by the chaotic nomenclature of the various blood clotting agents that were being identified in laboratories throughout the world. Wright chaired the ensuing International Committee on Blood Clotting Factors, later the Committee on Haemostasis and Thrombosis. The result was the adoption in 1960, of a Roman numeral system for the identification of basic factors which is now standard. He put forward the idea at a conference in Rome urging his fellow delegates to ‘do as the Romans do’. The same year he was awarded the AHA’s Albert Lasker Award for his study in the use of anticoagulants in 800 heart attack victims.
In 1969 he became national chairman of the Inter-Society Commission for Heart Disease Resources, which produced numerous reports and guidelines for cardiovascular care in the US. These were widely used in the planning of hospital, community and state health programmes.
Throughout his late 70s, he became concerned with the problems of aging and began to promote the discipline of clinical geriatrics. He worked to establish the Irving Sherwood Wright Center on Aging in New York, supported by the New York Hospital.
A prolific author, he published numerous important scientific papers and wrote You and your heart (New York, Random House, 1950), as well as contributing to 11 other books, mainly on circulatory problems.
During the 1950s he was president of the AHA and, at various times, of the American College of Physicians (who gave him the Alfred Stengel Award), American Geriatrics Society (with the Henderson Award), and, in 1980, the American Federation for Aging Research. Numerous other national and international societies made him a fellow or honorary member.
Outside medicine, he loved good food, travel and music. As one of the physicians at the Metropolitan Opera, he enjoyed what he called his ‘continuing education in operatic music’, only occasionally interrupted by the illness of the cast or audience.
His marriage to Grace née Demarest ended in divorce and he was married to Lois Elliman Wright for 40 years. Lois died in 1993, he was survived by the daughters of his first marriage, Barbara Wright Gatje and Alison Wright Cameron, five grandchildren and a great-grandson.
RCP editor
[New York Times www.nytimes.com/1997/12/21/nyregion/irving-s-wright-96-a-pioneer-in-treating-perilous-blood-clots.html - accessed 18 march 2015; Trans Am Clin and Climatol Assoc 1999 110 lvi-iii - www.ncbi.nlm.nih.gov/pmc/articles/PMC2194311 - accessed 18 March 2015; Clin Cardiol 1995 18 181-3]