Carl Siegmund Franz Cred introducer of the antiseptic eye prophylaxis with silver nitrate

Carl Siegmund Franz Credé (23.12.1819-14.03.1892) (Fig. 1) [8, 12-15] was born in Berlin where he went to school and studied medicine, with the exception of one semester at the university of Heidelberg (Germany). The principle of "nihil nocere" - an attempt to keep necessary treatment approaches as mild and gentle as possible - was his general philosophy in medicine. After several years of postgraduate study in Austria, France, Belgium and Italy, he returned to Berlin in 1847 and was appointed assistant in obstetrics at Berlin's clinic of obstetrics, where he remained until 1852. In 1850 he became a "Privatdozent" (university teacher) in obstetrics.

In 1852 he was appointed Director of the Berlin School of Midwives and Physician in Chief to the inpatient division of obstetrics and gynecology of the Berlin Royal Charité Hospital. In 1856 Credé was appointed Professor of Obstetrics and Director of the inpatient hospital in Leipzig, Germany where he retired in 1887 because of his poor health condition due to prostate cancer. Within the time in Leipzig he became "Nestor of German midwifery" [8].

During his time in Berlin he made a significant contribution to obstetrics by introducing a new and safer method for the delivery of the placenta ("Credé'scher Handgriff'ICredé's method) [16, 17]. Credé was a consistently modest person and did not claim priority for this method. This method is still used today in emergencies such as hemorrhage after delivery.

The affiliation with Leipzig gave him the chance of fully living his talents as a clinician, academic teacher and administrator, and his department became very prestigious. He personally focused on obstetrics being convinced that improvements in obstetrics are a key parameter to reducing the number of gynecological impairments. The famous obstetrician and gynecologist Gerhard Leopold was Credé's son-in-law [8].

Credé wrote several textbooks and original articles; he took over the editorship of gynecological journals of high reputation and was awarded the

Profilaxis Crede
Figure 1. Carl Siegmund Franz Crede (1819-1892)

"Senckenberg Preis/Senckenberg Award" due to his outstanding achievements in obstetrics and medicine [15]. Further, he received the prestigious post of a "Geheimer Medicinalrath/Aulic Counsellor".

After 1860, Crede began to work on optimizing warming devices for premature and feeble tiny children ("Erwärmungswanne") [18], which he established at his department thereafter - a significant contribution to obstetrics and a precursor of the incubators for newborns today.

Whereas the "Crede'scher Handgriff' and the "Erwärmungswanne" were mostly recognized by the public in the lifetime of Crede, he introduced an eye prophylaxis for ophthalmia neonatorum ("Crede'sche Prophylaxe"), which achieved highest recognition especially amongst physicians [15]. The prophylactic application of "Argentum nitricum/silver nitrate" 1:50 aqueous solution was introduced in all newborns from June 1st 1880 onwards in the Leipzig obstetrics department.

Crede wrote three consecutive publications with the same title on this topic "Die Verhütung der Augenentzündung der Neugeborenen" [19-21] (Prevention of inflammatory eye disease in the newborn) in the Journal "Archiv für Gynäkologie" between 1881 and 1883. The first [19, 22] focused on methodological aspects of the eye prophylaxis and will be the core issue of this chapter. His second publication presented more cases, and stressed the performance by midwives and by general practitioners. The third summarized his results and comprehensively addressed new aspects of etiology and practicable everyday prevention of ophthalmia neonatorum by his method. The second and third paper are discussed on the background of the "revolutionary" first one later in this chapter. In 1884, Crede summarized central aspects of his three publications in a booklet version in English [23].

An abbreviated English translation, translated by the WHO [22], of the first paper is given below. For systematic purposes, the original of the first paper of Crede in German language [19] is attached to this chapter as an "Addendum".

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