The term

The word “peritoneum” refers to the Greek “peritonaion” and means “to stretch”. Morticians in ancient Egypt were probably the first people to get a look at the peritoneum as they prepared the organs of influential Egyptians. The famous Greek physician Galen and other medical scholars of ancient Greece studied the open abdomens of injured gladiators. Early anatomists and surgeons described the size and features of the peritoneal membrane but failed to discover its detailed structure or function. These studies were followed by Friedrich Daniel von Recklinghausen in 1862, who gave the first scientific description of the peritoneum's cellular composition.



Removing water from the abdomen in the 17th century

The metabolic transport processes

In 1877, the German G. Wegner performed the first animal experiments to observe the metabolic transport processes occurring through the peritoneum. For example, he injected solutions of various contents and temperatures into rabbits and discovered that a concentrated sugar solution would lead to an increased amount of fluid in the abdominal cavity. This is how G. Wegner discovered the basis for using the peritoneum for fluid removal, or peritoneal ultrafiltration. In 1894, two Englishmen, Ernest Henry Starling and Alfred Herbert Tubby, discovered that fluid removal through the peritoneum was effected by blood vessels in the membrane.



Stephen Hales described an......................Georg Ganter was the first to
irrigation of the abdomen with....................use peritoneal dialysis to treat
red wine (1744).........................................a patient with kidney disease (1923)

First treatments of human beings

Stephen Hales and Christopher Warrick, an English surgeon, laid the cornerstone for peritoneal dialysis in humans in 1744: they attempted to treat a 50-year-old patient with ascites by first removing the excess abdominal fluid from the woman before using a leather tube to infuse a solution consisting of 50% water and 50% wine into her abdomen. However, the first peritoneal dialysis for uremic patients was performed quite some time later at the University of Würzburg by Georg Ganter. In 1923, after having experimented on animals, he infused one and a half liters of a physiological solution – one with the same salt concentration as the human blood’s – into the abdomen of a woman who suffered from a blocked ureter. Although the treatment alleviated the symptoms temporarily, the patient died a short time later.

Between 1924 and 1938, a number of medical teams in the U.S. and Germany performed the first regularly repeated – or intermittent – peritoneal dialysis treatments and proved that the procedure can be a short-term replacement for the kidneys’ natural function.

In the following years, the careful selection of materials such as porcelain, metal, latex and glass, which could be sterilized, made it possible to ensure reasonable hygienic conditions during peritoneal dialysis. Still, the procedure found only limited use, predominantly due to the lack of a safe method of accessing the patient’s abdomen.