A Life of Ernest Starling (People and Ideas Series)


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Bulletin of the History of Medicine

A Life of Ernest Starling (People and Ideas Series)

Ernest Starling became a medical student at Guy's Hospital , London, in when he was He had a brilliant career there and set his sights on becoming a Harley Street physician. At that time such a job description did not exist in Britain. Guy's had no physiological laboratories, but Starling's enthusiasm changed all this, and he published nine papers on lymph and capillary function between and He showed that there are opposing forces across the capillary wall — an outward movement of water due to hydrostatic pressure derived from the heart's contraction and an inward movement, secondary to the osmotic pressure of the plasma proteins within the capillary.

The inward and outward forces are often referred to as "Starling forces". They established him as a serious contributor. He was elected a Fellow of the Royal Society in Starling enjoyed collaborating with William Bayliss — , who was on the staff of University College London UCL , and together they published on the electrical activity of the heart and on peristalsis.

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In , when he was 25, Starling married Florence Amelia Wooldridge, the widow of Leonard Charles Wooldridge, who had been his physiology teacher at Guy's and died at the age of She was a great support to Starling as a sounding board, secretary, and manager of his affairs as well as mother of their four children. In Bayliss married Gertrude, Starling's beautiful sister, so the two were brothers-in-law. When Starling was appointed professor at UCL in , the scientific family was even closer.

Bayliss and Starling were in the newspaper's headlines when involved in the Brown Dog affair , a controversy relating to vivisection. Bayliss and Starling investigated pancreatic secretion , which at that time was believed to be entirely under nervous control. They called this substance secretin and Starling proposed that the body produces many secretin-like molecules, and in proposed that these substances should be called hormones. By doing this, he began a whole new biological subject, which became known as endocrinology.

Starling felt passionately about many subjects, one of which was medical education. He found the lack of science behind medical practice intolerable, and when in a Royal Commission The Haldane Commission was set up to improve medical education, Starling was an enthusiastic contributor.

One of the consequences of the Commission was the establishment of medical units in London teaching hospitals: clinical practice supported by laboratory research is now taken for granted in every large institution. The physiological discovery most often associated with Starling is the Law of the Heart. Occupying two years of his life — his investigations examined how the heart increased its output in response to more blood entering the organ, which increases the size of the chambers during filling. For this work he made use of the anesthetized dog, in an experimental arrangement known as the heart-lung preparation.

Starling was unaware of previous work by a German physiologist, Otto Frank , using the isolated frog heart. Frank showed that the longer the heart-muscle fibers were stretched the stronger the contraction. He did this with no interest in the circulation as a whole, so his finding have to be taken in parallel with Starling's, so it became the Frank-Starling law. During the — war , Starling first was involved in research into poison gases. This did his prospects no good at all. Many of his distinguished contemporaries received knighthoods.

Starling was awarded a CMG. He resigned from the army in June and finally was able to undertake war work that utilized his abilities. As chairman of the Royal Society Food War Committee he was instrumental in setting up rationing that provided needed calories and also the nutritional supplements then known. Rationing actually improved nutrition in wartime Britain.


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Germany had a similar food shortage during the war, but coped with it disastrously. Starling returned to UCL at the end of the war. His wartime experiences had left him with a scathing vision on how the country was run, and in particular the educational system.

He was especially outspoken on public the British designation for private school education. And particularly the teaching of classics themes: "After nine years, nine-tenths of the boys can read neither Latin nor Greek. They may have acquired a few catchwords or allusions to classical mythology, but they can give no account of the manner in which the Greeks lived, or the part played by Greek philosophy in the evolution of modern ideas, or in the way in which western government has been founded on Roman inventions. During the s he was very busy doing experiments and his reputation attracted distinguished collaborators.

Many of these involved the heart-lung preparation. It was used to investigate the control of blood pressure with G. Anrep , the activity of insulin with F. Knowlton [11] , and renal function with E. In —24 the American embryologist, George Washington Corner worked with Starling in his laboratory. This became the first programme of pre-clinical training in Britain. Appointed assistant surgeon at St Thomas's Hospital in , Cheselden was made a principal surgeon within a year, enabling him to develop his own operative techniques, especially for bladder stone extraction.

His new, faster procedure reduced operative mortality to less than 10 per cent. His first major work, The Anatomy of the Human Body , was published in and was to become a standard anatomical text for more than a hundred years. Its popularity was partly due to the fact that it was written in English rather than Latin.

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The bones were shown life size and illustrated by Cheselden himself. Astley Paston Cooper was both an accomplished surgeon and an original anatomist and teacher. Initially articled to his uncle William Cooper, senior surgeon at Guy's Hospital, he was later apprenticed to Henry Cline, surgeon at St Thomas's Hospital and became a teacher there. In his uncle resigned as surgeon to Guy's Hospital and Cooper was elected to the post.

Cooper stressed practical demonstrations over didacticism and gained the respect and admiration of his students, who included the poet John Keats [link]. Cooper helped Guy's to establish its anatomical and surgical museum the Gordon Museum with specimens from his own dissections. He would typically dissect for two or three hours before breakfast and once dissected an elephant in the front garden of his house, throwing a carpet over the railings to conceal it from public view.

He remained there for more than a decade, assembling a team of talented young scientists, extending his earlier work on the cell membrane, and becoming involved in the development of anti-cancer drugs. With Hugh Davson, he investigated the mechanisms that made the membranes of red blood cells selectively permeable.

The model the two researchers first proposed in is the basis for modern understanding of how drugs enter cells — and thus for much later physiological and pharmacological research.

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During the war, he was involved in research on the problems of wound healing and on the search for an antidote to the chemical warfare poison Lewisite. Later in life, he studied environmental health issues such as waste-water treatment and water pollution and campaigned for the preservation of the DNA of endangered species. Harold Ellis has taught Anatomy at Guy's Hospital since — an inspirational teacher now in his nineth decade who has introduced generations of medical students to anatomy and surgery.

He is the author of 25 books, including the student textbook Clinical Anatomy, now in its twelfth edition. Professor John Ernsting was a senior British military commander and renowned aerospace physiology and medicine researcher and teacher. His research and development of breathing systems enabled test pilots and aircrew to conduct trials of prototype military and civilian aircraft over four decades.

The counter-measures he devised to the stresses encountered at high altitude and supersonic speeds won him international acclaim. It continues to attract physicians from around the world. He was famous for the speed at which he worked — a great advantage in the days before anaesthetics. It was said that if you blinked during one of his lithotomies, you would miss it entirely.

Table of contents

In , Fergusson was appointed surgeon-in-ordinary to Prince Albert, and in surgeon-extraordinary; in he became sergeant-surgeon to Queen Victoria. Fergusson was known to be ambitious and something of a dandy. Rosalind Franklin came to King's in early and that summer she took the famous 'Photo 51' and made important studies of the DNA molecule. When Francis Crick and James Watson of Cambridge University obtained this photo, together with some of Franklin's data in the report of an MRC visit to King's, they were able to use this with their own deductions to build the first correct model of the DNA molecule.

This was the beginning of a further seven years of work for Maurice Wilkins and his colleagues to check and verify Crick and Watson's hypothetical model.

It was for this, as well as his original X-ray diffraction studies, that Wilkins was awarded the Nobel Prize for Physiology or Medicine with Crick and Watson in Rosalind Franklin died of cancer at the age of 37 in Grant and his colleague Basil Reeve recognised that haemorrhage was a major factor in wound shock and suggested that patients with massive injuries and continuing haemorrhage could be kept alive by transfusions. The philosopher Ludwig Wittgenstein was a laboratory assistant to the team from to Personal grants from the Medical Research Council and the Wellcome Trust allowed him to continue working at the bench up to the age of Jean Hanson was one of the most influential researchers to have worked at King's in modern times.

Hanson discovered the overlapping arrays of actin and myosin filaments which slide past each other during contraction. She demonstrated the existence of the double sliding filament mechanism in a wide variety of muscle types, including smooth muscles from invertebrates. Her work led to an understanding of how athletes can run faster and develop greater stamina by providing an insight into the molecular secrets of locomotion.

Ernest Starling

Recovery from injury and disease became speedier and more complete with increased knowledge of the operation of muscles, including those of the heart. Frederick Gowland Hopkins entered Guy's Hospital as a medical student at the mature age of 28 and was immediately given the William Gull Studentship. He then taught physiology and toxicology at Guy's Hospital for four years.

A Life of Ernest Starling (People and Ideas Series) A Life of Ernest Starling (People and Ideas Series)
A Life of Ernest Starling (People and Ideas Series) A Life of Ernest Starling (People and Ideas Series)
A Life of Ernest Starling (People and Ideas Series) A Life of Ernest Starling (People and Ideas Series)
A Life of Ernest Starling (People and Ideas Series) A Life of Ernest Starling (People and Ideas Series)
A Life of Ernest Starling (People and Ideas Series) A Life of Ernest Starling (People and Ideas Series)
A Life of Ernest Starling (People and Ideas Series) A Life of Ernest Starling (People and Ideas Series)
A Life of Ernest Starling (People and Ideas Series) A Life of Ernest Starling (People and Ideas Series)

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