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.
- Elements of human physiology.
London and Philadelphia, 1892; 7th edition, 1905.
- The influence of mechanical factors on lymph production.
Journal of Physiology, Cambridge, 1894, 16: 224-267.
- On the absorption of fluids from the connective tissue spaces.
Journal of Physiology, Cambridge, 1896, 19: 312-326.
- The Arris and Gale Lectures on Some Points in the Pathology of Heart Disease.
Lecture I. On the Compensatory Mechanisms of the Heart.
Lecture II. The Effects of Heart Failure on the Circulation.
Lecture III. On the causation of Dropsy in Heart Disease.
Lancet, 1897, 1: 569-572, 652-655, 723-726.
- The action of pituitary extracys of the kidney.
Written with Rudolf Magnus (1873-1927).
Journal of Physiology, Cambridge, 1901, 27: ix-x.
Magnus and Starlin reported that pituitary extracts caused expansion of the kidney and a marked and often prolonged diuresis. This was the first indication that the naurohypophysis plays a part in the regulation of urine secretion.
- The Mechanism of Pancreatic Secretion.
Journal of Physiology, Cambridge, September 1902, 28: 325-353.
Demonstrating the existence of secretin in the duodenal secretion.
Preliminary note in Lancet, 1902, 1: 813.
- The chemical regulation of the secretory process.
Written with William Maddock Bayliss. Proceedings of the Royal Society of London. Series A, 1904, 73: 310-322.
- The Croonian Lectures on the chemical correlation of the functions of the body.
Lancet, 1905, 2: 339-341, 423-425, 501-503, 578-583.
This is the first appearance of the word "hormone", which was suggested by William B. Hardy.
- An experimental enquiry into the factors which determine the growth and activity of the mmary glands.
Written with Janet Elizabeth Lane-Clayton (1877-1967).
Proceedings of the Royal Society of London. Series B, 1905-1906, 77: 505-522.
In their classic paper on the mammary gland, Janet-Clayton and Starling attributed its changes during pregnancy to the foetus.
- The Fluids of the Body. London, Constable, 1909.
Starling put forward the idea that renal excretion of salt (and water) was conditioned by the volume of body fluids, particularly the blood volume. He suggested that the sum total of body fluids was arranged so that the blood supply to the brain was maintained at a point just equal to its need.
- Principles of Human Physiology.
London, 1912; 5th edition, with Charles Arthur Lovatt Evans (1884-), 1930; 14th edition, 1968.
- On the Mechanical Factors Which Determine the Output of the Ventricles.
With S. W. Patterson. Journal of Physiology, Cambridge, September 8, 1914, 48: 357-379.
- The Regulation of the Heart Beat.
Written with S. W. Patterson and Hans Piper (1877-1915)
Journal of Physiology, Cambridge, October 23, 1914, pp 465-513.
- The Linacre Lecture on the Law of the Heart.
Delivered at St. John’s College, Cambridge, in 1915. London, Longmans, Green & Co., 1918.
Starling's law of the heart.
- Natural Sciences and Education: Notes of the Position of Natural Sciences in the Educational System of Great Britain.
Lancet, 1918, 2: 365-368.
- Science in Education. Science Progress, 1918-1919, 13: 466-465.
- The Oliver-Sharpey Lectures on the Feeding of the Nations.
London and New York, 1919.
- On the Circulatory Changes Associated with Exercise.
Journal of the Royal Army Medical Corps, 1920, 34: 258-272.
- The Action of Alcohol on Man. London, 1923.
- Das Herz-Lungenpräparat.
Handbuch der biologischen Arbeitsmethoden, part 5, T. 4, 1; Berlin and Vienna, 1923.
- The secretion of urine as studied on the isolated kidney.
Written with Ernest Basil Verney (1894-1967).
Proceedings of the Royal Society of London. Series B, 1924-1925, 97: 321-363.
Demonstration that the anti-diuretic action of vasopressin is exerted directly on the Kidney, and that tubules of the kidney reabsorb water.
- Die Correlation (Integration der Einzelfunktionen des Gesamtorganismus).
In: Handbuch der normalen und pathologischen Physiologie, volume 15, 1; Berlin, 1930.