Frederick Horace Smirk was born on 12 December 1902 in Accrington, Lancashire, England, the son of Thomas Smirk and his wife, Betsy Ann Cunliffe. He attended Haslingden School, where his father was assistant schoolmaster, before proceeding to Victoria University of Manchester. He graduated MB, ChB with first-class honours in 1925, and acquired an MD, with the gold medal of the British Medical Association, in 1927. He became an MRCP and published the first of 160 scientific papers in the same year.
After junior posts at the Manchester Royal Infirmary, he obtained the Medical Research Council’s Dickenson travelling scholarship, which took him to Vienna, and then a Beit memorial fellowship in 1930. That award gave a start, in difficult times, to many medical scientists of his generation; in his case it brought him to University College, London, and a post as research assistant in the departments of pharmacology and medicine. Here he worked under T. R. Elliott and was influenced by Sir Thomas Lewis. It also introduced him to Aileen Winifrede Bamforth, who was training to be a hospital social worker. They were married in Salford on 22 December 1931.
In 1935 Horace Smirk was appointed professor of pharmacology and physician to the postgraduate programme at the Egyptian University, Cairo. There he developed his interest in hypertension (high blood pressure). Meanwhile, at the University of Otago Medical School in Dunedin, New Zealand, D. W. Carmalt-Jones and F. W. Fitchett, the part-time professors of systematic and clinical medicine respectively, retired at the end of 1939. Funds were available for a full-time replacement and, in June 1940, Smirk was appointed to what now became the Mary Glendining chair in medicine.
He found a wartime lack of experienced physicians for teaching and clinical work, and of material resources, these lacks accentuated by an increase in the medical school annual intake. It was a challenge to his talents: he put together a research department from remnants of equipment and taught undergraduates himself. His long, lean figure, interrogative in posture, became a familiar sight throughout the hospital and medical school. He was blunt in manner but capable of guile.
His researches led him on a quest for a drug which could lower raised blood pressure. On a visit to London in 1949, as visiting professor at the Postgraduate Medical School of London at Hammersmith Hospital, he became interested in the potential of hexamethonium. Back in New Zealand in a series of ground-breaking papers, Smirk was able to show that hypertension could be successfully controlled. As his co-worker F. N. Fastier recalled: ‘From the patient’s standpoint, hexamethonium was a vile drug; but … it pointed the way to effective therapy’.
The department burgeoned, as did Smirk’s reputation. He was skilled at locating research funds: from the Medical Research Council of New Zealand; from life insurance organisations, who recognised the potential of his work; and from pharmaceutical companies. In 1958 he published a major monograph, High arterial pressure. By this stage he had become attracted to the idea of splitting the chair once again, this time into clinical and research elements, and his idea proved attractive to the dean, E. G. Sayers. They persuaded the Wellcome Trust to fund a research facility. The grant was announced during Sayers’s visit to London in 1960. The following year Smirk became research professor and director of the Wellcome Medical Research Institute. At his retirement in 1968 he was paid the unusual tribute of a commemorative issue of the New Zealand Medical Journal .
On his arrival in New Zealand in 1940 Smirk had been made a fellow of the Royal Australasian College of Physicians (then a vigorous two-year-old institution) and appointed to its board of censors. He held this position until he was elected its New Zealand vice president in 1958 for a two-year term, the same year he was knighted. He was on the World Health Organisation’s expert committee on hypertension. He received honorary doctorates of science in 1961 from Hahnemann Medical College in Philadelphia and in 1975, at the time of its centenary of medical classes, from the University of Otago. He had served on the Medical Research Council of New Zealand from 1944 to 1960, and in 1987 was awarded the council’s silver medal. By that time the inroads of Alzheimer’s disease had left him unable to travel to receive the award.
Horace Smirk died in Dunedin on 18 May 1991. His wife, Aileen, had died in 1988. There were three sons and a daughter of their marriage. In his obituary in the New Zealand Medical Journal he was described as having ‘an enquiring mind, an infinite capacity for work and a certain panache and style which always made him interesting’.