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Reviewed by:
  • A Life of Ernest Starling
  • Larry G. Rotert
John Henderson. A Life of Ernest Starling. Oxford, New York, Oxford University Press, 2005. 185 pp., illus. (No price given).

John Henderson's biography of Ernest Starling gives breadth and vitality to a subject that in the hands of a less gifted biographer could have been primarily an account of research projects and their data. A Life of Ernest [End Page 240] Starling presents an engaging narrative that has much to recommend it. Henderson, himself a physiologist, has a firm grasp of the clinical aspects necessary to render the details of Starling's work. Concurrently, he conveys a sense of genuine appreciation and admiration for his subject on a personal, humane level.

Henderson feels that Starling was never appropriately honored for his contributions to physiology and medical science. He also feels that previous biographies of this remarkable man failed to adequately integrate the clinical, personal, and political aspects of his life. These deficiencies are addressed in this diligently researched, skillfully organized, and refreshingly readable review of Starling's life. In addition, the appendices list Starling's voluminous output of publications in chronological order and provide an extensive annotated bibliography.

Starling's research contributions in gut motility, capillary osmotic, and hydrostatic forces ("Starling's Principle"); his discovery with William Bayliss of the hormone secretin; his study of the heart as a pump ("Starling's Law of the Heart"); and his less well known research regarding kidney functions are thoroughly reviewed. The findings are summarized in readily comprehended terminology, avoiding an excess of numbing detail. The research is interwoven with the personal and political threads of his life. This provides a more stimulating story than could have been achieved by addressing each of these areas as a separate subject within its own time frame.

Despite a lapse of several generations, it is noteworthy that so much of Starling's work remains relevant to the teaching and practice of medicine today. Henderson cites numerous examples to document these contributions. These include the areas of modern gastroenterology, cardiology, endocrinology, and nephrology.

Starling was, of course, primarily a research physiologist. He was also a physician, educator, politician, military officer, iconoclast, reformer, promoter of German educational and research models, mountaineer, husband, and father. Despite his many achievements, he was never awarded a Nobel Prize, knighthood, or other honors accorded to arguably less deserving contemporaries. These slights are a recurring theme throughout the book. Henderson's theories as to why this occurred create a disturbing undercurrent that dims the luster of Starling's clinical triumphs.

Perhaps the leading factor was Starling's lifelong tendency to speak his mind on strongly held views that collided with the views of establishment figures. In the process he bruised many large egos among academics, politicians, civilian and military bureaucrats, and influential "Harley Street physicians."

Early in his career, Starling himself may have had ambitions to join this elite group. Harley Street was home to the physicians who enjoyed the most prestigious and lucrative private practices of the time in London. [End Page 241] This exclusive group maintained a dominating influence over matters such as college curricula and faculty appointments. Fortunately, to the great benefit of physiology, medical science, and humanity, Starling chose another path. He later came to disparage the Harley Street physicians as contributing nothing to the advancement of medical education or to the science of medicine in general. The reforms Starling advocated to improve educational models represented a threat to their power and prestige, thereby earning him their lasting animosity.

These struggles provide a backdrop for fascinating glimpses of British general and medical education in the late nineteenth and early twentieth centuries. Although both the medical and the political establishments of his time resisted Starling's recommendations, the prescience of his views is validated by their later acceptance.

Details regarding aspects of Starling's personal and family life are more difficult to uncover. For these, Henderson relies on family letters and recollections of Starling's grandson (a retired surgeon). The information is limited but gives an intimate, human dimension to a life dominated by laboratory research. The story ends with the ironic circumstances of Starling's death, presumably of...

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