Born in Manhattan in 1813 to Lavinia Smith, an enslaved woman, Smith described himself as the son of a self-emancipated mother. New York's gradual emancipation law made him legally free in 1827. He attended the African Free School, part of the city's vital but unequal landscape of Black education.
Glasgow connected him to university science and British abolitionism. Back in New York, however, professional organisations could still withhold recognition. The New York Academy of Medicine rejected his application in 1847 and granted him posthumous fellowship only in 2018.
Smith did not merely ask racist institutions to include an exceptional individual. He attacked colonisation schemes, defended Black intellectual life, and used supposedly neutral evidence to reveal structural injustice. His medicine and abolitionism were mutually reinforcing forms of public reasoning.