ABSTRACT
Public health pushed haltingly forward, but Smith was not part of the movement. He devoted his time to surgery, but also took a lead in New York City’s housing reform efforts, proposing some ideas that caught on and others that were not realized until the next century. The trustees of Baltimore’s Johns Hopkins Hospital requested his recommendations for the new facility but chose John Shaw Billings as their consultant in 1875. Smith was a surgical authority and William Welch, John Harvey Kellogg, and William Halsted, future leaders of American medicine, passed through Bellevue Hospital during his time there. Smith argued for germ prevention in public buildings and hospitals and brought Lister’s antiseptic techniques to Bellevue in 1875, where Halsted and a generation of young doctors picked them up. Smith advocated in 1878, decades before it happened, that operating rooms should be on the ground floor, disconnected from other rooms or buildings, that only the surgeon and assistants be in the room, and that the air and walls be thoroughly disinfected after each operation.
