Ernest Henry Starling
- Frank-Starling law of the heart
- Starling's equilibrium
- Starling's forces
- Starling's law of the capillaries
- Starling's law of the intestine
- Starling's mechanism
- Starling's sequence
Biography of Ernest Henry Starling
In circulatory physiology the Starling legacy is conceptually one of the most influential in the twentieth century. His contributions to a modern understanding of body functions, especially the “Starling sequence”, embracing both central circulatory function and fluid exchange at the capillary level was and remains the unifying theme of contemporary circulatory theory.
Besides "his" law of the heart, Starling discovered the functional significance of serum proteins. In 1902 along with Bayliss he demonstrated that secretin stimulates pancreatic secretion. He was the first to use the term hormone. In 1924 along with Ernest Basil Vernay (1894-1967) he demonstrated the reabsorption of water by the tubules of the kidney.
Ernest Henry Starling was born into a family of limited financial means and fundamentalist religious belief. His father, Matthew Henry Starling, was a barrister and served for many years as a clerk of the crown at Bombay, returning to England once every three years. Starling’s mother, the former Ellen Watkins, remained in Britain and had the responsibility of rearing their children, of whom Ernest was the eldest. He received his early education at Islington (1872-1879) and at King’s College School (1880-1882). In1882 he entered Guy’s Hospital Medical School, London, where he set a record for scholarship and received the qualifying degree (M.B., Lond.) in 1889.
One of the most influential periods in Starling’s formative years was the summer of 1885 spent in Willy Kühne’s (1837-1900) laboratory at Heidelberg. It probably marked the beginning of his strong rejection of empiricism as the basis for clinical practice, and it played a role in directing him toward physiology as a means of bringing basic science to the bedside. In 1889 he became demonstrator in physiology at Guy’s and in 1890 began part-time work in Sir Edward Albert Sharpey-Schäfer’s (1850-1935) laboratory at University College, where he began a lifelong association with William Maddock Bayliss (1860-1924). It was a highly productive and complementary union. Bayliss was the learned, methodical, and cautious partner; Starling was the aggressive, impatient, and sometimes incautious visionary. The first of their joint papers appeared in 1891.
In 1892 Starling again went abroad, this time to work with Rudolf Heidenhain (1834-1897) at Breslau, and and with Metchnikoff at the Institut Pasteur. On his return he attacked the problems of lymph production, capillary permeability, and the physiological effects of osmotic forces. On the basis of his findings, he began the synthesis of what came to be called the “Starling equilibrium,” referring to the balance between intravascular pressure and osmotic forces at the capillary level.
Formulating what is known as Starling's hypothesis (1896), he stated that, because the capillary wall may be considered a semipermeable membrane, allowing salt solutions to pass freely through it, the hydrostatic pressure forcing these solutions into tissues is balanced by the osmotic pressure--generated by colloidal (protein) solutions trapped in the capillary--forcing an absorption of fluid from the tissues.
With his acceptance in 1899 of the Jodrell professorship at University College, Starling finally joined Bayliss full time. Their collaboration immediately resulted in their demonstration (1899) of the nervous control of the peristaltic wave, the muscle action responsible for the movement of food through the intestine.
In January 1902 Starling and Bayliss presented a preliminary communication that opened the door to the vast field of hormonal function. Published in full in September 1902, the paper established the existence and role of secretin, a substance released into the blood from the epithelial cells of the duodenum (between the stomach and small intestine), which in turn stimulates secretion into the intestine of pancreatic digestive juice. In 1905 Starling coined the word “hormone” to designate the body’s “chemical messengers” produced by the endocrine glands.
Starling’s wartime service was turbulent, largely because of his outspoken impatience with the obtuseness, where scientific matters were concerned, of his military superiors. He was ultimately sent to Thessaloniki, Greece, with no specific assignment and little opportunity to apply his extraordinary talents in the service of his country. Paradoxically, the only recognition he ever received from his government was the comparatively minor Companion of the Order Of St. Michael and St. George, for his “services at Salonika.”
It was in 1915 Starling gave his famous Linacre Lecture on the Law of the Heart. Unfortunately, in his lecture he attempted rather uncritically to extend his findings on the isolated heart to the intact organism at rest and under stress. Within the next few years he recognised the inadequacy of his earlier concepts, and in 1919 he delivered what by many has been seen as the most significant lecture of his career, correcting some of his earlier oversimplified statements on circulatory control and anticipating many present-day workers. Unfortunately, the lecture received little attention at the time and was published in a journal of very limited circulation.
Starling's remaining years were vigorous but somewhat anticlimactic. In 1922 he accepted the Royal Society’s Foulerton research professorship. Studying kidney function, he found (1924) that water, chlorides, bicarbonates, and glucose, lost in the excretory filtrate, are reabsorbed at the lower end of the kidney tubules (glomeruli). Despite deteriorating health, he continued his research work with fellows and students from all over the world. He died aboard a ship, while on a Caribbean cruise, and was buried at Kingston, Jamaica.
Starling was elected fellow of the Royal Society in 1899 and was a prominent member of the Physiological Society. He was an honorary member of many foreign scientific organisations and bodies.
- “Science has only one language, quantity, and only one argument, the experiment"
"Only . . . by way of experiment, can we hope to attain to a comprehension of the “wisdom of the body and the understanding of the heart,” and thereby to the mastery of disease and pain, which will enable us to relieve the burden of mankind."
Lancet, 1923, 2: 865.
Starling on education:
[He called for] “. . . educational reform, or even revolution, for the maintenance of our place in the world.”
“. . . in matters of urgent necessity [such as education] it is unprofitable to count the cost.”
“The astounding and disastrous ignorance [of science] . . . displayed by members of the government in the early days of the war raised some doubts . . . as to the efficiency of the education imparted to . . . the upper classes.”
: “The great rally of the nation occurred in spite of an education which taught the ruling classes that their first duty was to their clan, their party, or their service . .”
Science and Education, page 474.