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He was educated at Stamford. Later he pursued his medical studies while teaching school in New York City and graduated from New York College of Physicians and Surgeons. Before joining the Mission Board, Dr. Smith practiced medicine for five years in New York City.
On April 18, 1842, he married Melicent Knapp at Greewich, Connecticut.
Dr. and Mrs. Smith were members of the Tenth Missionary Company, sailing from Boston on May 2, 1842 on the grigantine, "Sarah Abigail". They arrived in Honolulu on September 21, 1842, after a voyage of 142 days.
In November of the same year, Dr. Smith was stationed at Koloa, Kauai. This was to be the scene of his life's work. As the only physician on the island, his labors were arduous. Frequently, he was subject to sudden calls to Hanalei, 40 miles in one direction, and to Waimea, 12 miles in the other direction.
In November 1850 Dr. Smith requested release from the Mission to take effect January first. Four years later in July 1854 Dr. Smith was ordained to the ministry and became pastor of three native churches while continuing to serve as doctor. He served as pastor until 1860 when the American Board decided to place the churches in charge of native ministers and Dr. Smith resigned. However, he continued a member of the Evangelical Association of Kauai and co-operated and counseled with the native pastors.
Mrs. Smith established the Koloa Boarding School for Girls in 1862 and maintained it for ten years with the assistence of her sister, Miss Knapp, and the two older daughters, Emma and Charlotte.
In 1880 the doctor made his first and only trip back home, traveling the new "overland route" by Union Pacific Railway.
Dr. Smith died at Koloa on November 30, 1887, at the age of 77.
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