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SMITH, ALFRED CORBETT, physician, medical superintendent, and leprologist; b. 7 June 1841 in Bathurst, N.B., son of James Smith and Susanna M. Dunn; m. 2 May 1866 Helen Young, sister of Robert Young, and they had two daughters and one son; d. 12 March 1909 in Tracadie, N.B.

Little is known about Alfred Smith’s formative years. By 1858, however, he had fixed on a medical career and begun to study with Dr James Nicholson, the first resident physician at the leper hospital in Tracadie. In 1862 Smith entered Massachusetts Medical College (Harvard Medical School), where he received his degree on 9 March 1864.

In 1865 Smith succeeded Nicholson in Tracadie. Four years later, however, after the arrival at the lazaretto of a group of Religious Hospitallers of St Joseph [see Amanda Viger], he was dismissed, the casualty of a money-saving measure. By 1870 he had established a private practice in Bathurst, and later that decade he relocated in Newcastle, where he also served as coroner, justice of the peace, and health officer. From 1877 to 1878 he did postgraduate work at the University of the City of New York. He received an md in 1884 from Victoria University in Cobourg, Ont.

Smith had made no secret of his “long felt desire” to make leprosy “the special study” of his life. In fact, he amassed what he claimed to be the most complete library in Canada on the disease, and he corresponded with the leading dermatologists and leprologists of his time, including Dr Jonathan Hutchinson in England. Dr Joseph-Charles Taché* was one of the few Canadian physicians with whom he could share his enthusiasm for the study of leprosy. In 1880 Smith was appointed “Inspecting Physician” and “Medical Advisor” at the Tracadie lazaretto, but a more permanent position eluded him. He vigorously lobbied the federal government in 1889 to be given a “general superintendence” of leprosy in Canada and received a timely endorsement from the eminent physician Dr William Osler*. Urging the appointment of a full-time superintendent at Tracadie, Osler argued that there was “no one more suitable for the position” than Smith. In November 1889 Smith became “Inspector of Leprosy for the Dominion,” but the promotion was somewhat anticlimactic. His modest salary scarcely matched the grandeur of his title, and his private practice crumbled as clients were deterred by his chosen vocation. “I have never felt so poor,” he lamented in 1891. In 1899 he was placed on a firmer footing when the government resolved to administer the lazaretto more scientifically and elevated Smith to the rank of “Medical Superintendent.”

At the leper hospital Smith’s responsibilities were as varied as they were arduous. He visited the wards daily, drew up prescriptions, frequently performed surgical and dental procedures, and regularly engaged in laboratory research. He was entrusted with such matters as diet, hygiene, and discipline. To him fell the preparation of annual government reports, maintenance of registers of admissions, compilation of genealogical data on leper families, and fumigation of railway cars used to transport leprous persons.

Smith’s duties often took him outside the lazaretto on “tours of inspection.” Armed with a camera and notebook, he periodically crisscrossed Gloucester County, visiting households, lobster canneries, and fish-packing plants. On these trips he would engage in what he referred to facetiously as “leper hunting,” and would employ the requisite mixture of compassion and coercion to secure admission of “leper suspects” to the lazaretto. “When I declare an individual leprous,” he noted, “his nearest friends avoid him; he is refused employment, and he soon finds a resting place in the home provided for such unfortunates.” From the late 1880s Smith travelled farther afield – to Cape Breton, Victoria, and Winnipeg – to examine suspected cases of leprosy.

The widely read Smith had distinctive views about the aetiology and treatment of leprosy. Although he was convinced of its contagious character, his trademarks were diagnostic caution and therapeutic moderation. He experimented with the popular anti-leprotics of the day, such as ichthyol and chaulmoogra oil, only after studied consideration. Unlike some of his contemporaries, he was optimistic about a cure. He not only conceded the possibility of spontaneous recovery, but also upheld the efficacy of chaulmoogra oil in combination with a nutritious diet and sound hygiene. In sharp contrast, however, he regarded compulsory segregation as essential in the treatment and containment of the disease. He also sought more stringent legislation for the apprehension, detention, and medical supervision of leprous persons, an objective that was eventually realized in the federal Leprosy Act of 1906.

Under Smith’s superintendence the lazaretto at Tracadie was both modernized and humanized. He was unwavering in his vision that it should be more than a detention centre or a religious hospice. It should function both as a “hospital” and as a “home.” Its reputation at the turn of the century as a model institution was due in no small part to its caring and capable medical superintendent. For this reason alone, Smith deserves to be remembered more widely than he is.

It is more difficult to gauge the significance of Smith’s medical research. Unfortunately, he published nothing about his microscopic investigations, but his private papers mention the use of microphotography and detail complex staining procedures. The Canadian government offered him little incentive, however. As a result of its short-sighted stinginess Smith could not even attend the 1897 Leprosy Congress in Berlin as an invited delegate. It was not until 1901 that he received a fully equipped laboratory. By then glaucoma seriously interfered with his research.

Smith’s leisure time was filled with such purposeful Victorian hobbies as photography, taxidermy, natural history, and archaeology. He was a keen supporter of the Natural History Society of New Brunswick. In 1906 William Francis Ganong* observed that current knowledge of early Micmac camp and burial sites around Tracadie was attributable entirely to Smith, “who has studied them in the scholar’s spirit.”

All sources on Smith point to the fact that he was a singular personality, who deliberately courted eccentricity. He was reclusive in his habits, opinionated in his views, and macabre in his sense of humour. To the townspeople of Tracadie, the Presbyterian turned Unitarian who was always “reading and thinking” was an enigma. Undoubtedly Smith’s specialty, which was very much on the fringes of medical science, appealed to his solitary temperament. It also reinforced his reclusion, for his association with the lepers tainted him in the public mind and obliged him to share with them the burden of social exile.

In his later years Smith’s enthusiasm for his vocation was drained by an unsupportive government and the stubborn incurability of his patients. From 1907 ill health also took its toll. His death on 12 March 1909 was duly noted in the local newspapers and even merited an obituary in the New York Times. In his annual report that year Dr Frederick Montizambert*, director general of public health for Canada, registered the government’s loss of “a faithful and a zealous officer” and the lepers’ loss of “a kind and attentive friend.” No such acknowledgement was forthcoming from the Canada Lancet or the Canadian Practitioner and Medical Review. This omission was most telling, for during Smith’s era leprosy specialists more frequently captured media attention than professional recognition.

Laurie C. C. Stanley