Ernest Henry Starling, His Predecessors, and the “Law of the Heart”

T he discovery that end-diastolic volume regulates the work of the heart is generally credited to Ernest Henry Starling, who described this relationship in a series of papers between 1912 and 1914 In these papers, Starling and his collaborators acknowledge that they were not the first to describe this relationship 6 ; they cite the work of Blix 7 and Evans and Hill 8 on the length-dependence of energy release by skeletal muscle, Frank's 1895 description of the influence of diastolic volume on the work of the frog ventricle, 9 and contemporary descriptions in canine 10 and feline hearts. The present article reviews evidence that what we now call "Starling's Law of the Heart" or "The Frank-Starling Relationship" was widely appreciated by late 19th century physiologists.