Born on 28 February 1872 at Uduul, Jaffna, Ceylon, the second child and eldest son of William Thiliampalam Paul, a medical practitioner, and Ambrosia Ponamma, his wife. He was educated at the Central College, Jaffna, and at Wesley College, Colombo, before entering the medical school of Presidency College, Madras, where he was placed first in the first class at the MB BCh examination and was awarded the Johnstone medal. He then came to London and studied at King's College in the Strand and at King's College Hospital. He took the Conjoint qualification in 1900 and the Fellowship eighteen months later. Returning at once to Ceylon he was appointed lecturer in anatomy at the Ceylon Medical College on 6 February 1902. On 26 June 1905 he was appointed acting surgeon at the General Hospital, Colombo, was promoted surgeon on 16 August 1906 and senior surgeon on 16 August 1908, a post which he held till his retirement on 15 April 1931. In 1908 his diploma of Fellowship was partially destroyed by white ants while in the custody of the Council of the Ceylon Medical College, to whom it had been sent for registration, and a certificate of diploma was freely issued to him by the Council of the Royal College. Paul took a leading part in the professional, academic, and public life of Colombo. He served as president of the Ceylon branch of the British Medical Association, was commissioned a lieutenant-colonel in the Ceylon Medical Corps, was a member of council of the University College of Ceylon, a member of the Ceylon Banking Commission and of the Ceylon branch of the Royal Asiatic Society, and chairman of the Low Country Products Association of Ceylon. He practised at Rao Mahal, Ward Place, Colombo. Paul married on 15 April 1899 Dora Eleanor Aserappa, who survived him with six sons and three daughters. One of the sons, Milroy Paul, FRCS, followed his father and grandfather in the medical profession and was professor of surgery in the University of Ceylon at the time of S C Paul's death on 8 March 1942.