Julian Augustus Romaine Smith was one of the surgeons who, in the company of Thomas Dunhill, Hugh Devine, Douglas Shields and David Murray Morton, established Saint Vincent's Hospital, Melbourne, as arguably the premier surgical hospital in Victoria, if not Australia. Smith abandoned a most promising scientific career to study medicine, completing his medical course in Melbourne where he graduated top of his year in 1898/1899. He gained his MD in 1901 and set up practice in Morwell, a Victorian country town, where he initiated his surgical career. In 1905 Smith returned to Melbourne and worked as assistant to Mr F. D. Bird, a prominent surgeon. He travelled overseas in 1906, visiting leading medical centres in England where Almroth Wright's work on vaccination made a deep impression on him. On his return to Australia in 1908 he joined the surgical staff at Saint Vincent's Hospital as surgeon to outpatients, finally retiring as surgeon to inpatients in 1928. Smith was made a Foundation Fellow of the Australasian College of Surgeons in 1927. Smith was regarded by his peers as a brilliant innovative surgeon with a special interest in urology. He became an expert cystoscopist. After he retired, he continued his long-standing interest in portrait photography for which he was considered a master. During World War II he designed and built an elegant roller pump for use in direct blood transfusion. He died in 1947, survived by his wife, a daughter and three sons, one of whom became President of the Royal Australasian College of Surgeons.