Registered with the Registrar of Newspapers for India under R.N.I 53640/91

Vol XXXI No. 19, January 16-31, 2022

Recalling a great orthopedic surgeon of Madras

by Dr. K. Sriram

Dr. Narasimha Iyer as he was referred to by most patients, was something of a legend in the medical circles of Madras in the first half of the last century.We requested his grandson and eminent orthopedic surgeon Dr. K. Sriram to write an article for us and reproduce the same here with thanks. The portrait of Dr. Narasimha Iyer that appears alongside is by Mrs. Kantimati Sriram.
– Editor

Dr. Narasimha Iyer

Narasinganellore Sankaranarayana Iyer Narasimha Iyer or Narasimha Iyer (N.S.N.), was the eldest of six children born to his parents. He was born on 20th April 1893 into an impoverished family. His schooling was in Pathamadai Ramaseshier High School where he completed F.A.

There was a provision for students to join medical college, provided they signed a bond to serve the defense forces for five years after completing their studies. NSN could not afford a medical university education and opted to join the L.M.P. course in the Prince of Wales Medical school at Thanjavur. The principal of the school Dr. Guruswami Mudaliar wrote a letter to one of his friends to provide food and accommodation for NSN during the course. He also helped him financially by asking him to assist him in some of his private cases. He obtained the license to practice medicine in 1913.

War broke out in 1914 and NSN joined the Naval Establishment in Bombay in the low position of a Hospital Assistant and served for five years. During spare time he took courses in Bombay Medical College and obtained his L.C.P.S. (Licentiate of the College of Physicians and Surgeons) He returned to the Madras Medical Service as Sub-Assistant Surgeon and was posted to work in several rural dispensaries. While on a routine inspection by the then Surgeon General, he was spotted for his talent and competence and transferred to the Royapuram Medical School as Assistant Lecturer in Surgery.

In 1927, NSN was given long leave to study in England. He passed the English Conjoint Diploma and studied in various surgical institutions. He was particularly impressed by the teaching of Orthopedics by Dr. Hey Groves at The Guys Hospital, London. This experience determined his career in Orthopedics. Before returning to India in 1929, he passed the final F.R.C.S.(Ireland) examination. He then started his uninterrupted career for 19 years in teaching at the Madras Medical College and working at The Govt General Hospital.

In 1931, he started the first Orthopedic department, though Orthopedics became a separate department only after the war ended. He was given the duties of organising the Orthopaedic department in addition to the duties of general surgeon. In 1936, during a short leave, he passed the final exam of F.R.C.S. (Eng).

During Second World War, Dr. NSN was working at full stretch. He was appointed Professor of Operative Surgery. In addition to supervision of two surgical units, he managed the expanding Orthopedic department. British soldiers who were admitted in the military wing of the hospital were cared for by him. He was reputed for his clinical wisdom, gentleness with patients, surgical skills, and excellent teaching abilities.

As a teacher, he showed a keen interest in guiding his students. To quote one instance, In October 1946, an advertisement appeared in The Hindu, wherein applications were called for specialty training in various medical subjects. One of his post graduate students, Dr B.Ramamurthi ­wanted to apply for thoracic surgery. Dr. NSN advised him to apply for Neurosurgery as it was unknown in India. Further, he said that a lot of seniors would apply for thoracic surgery, and he would not get selected. Dr B.Ramamurthi accepted the advice and subsequently became a neurosurgeon of International repute.

As a leading Orthopaedic surgeon in India, Prof N.S.N, used to treat V.I.Ps and celebrities. In November 1938, Sri Aurobindo accidentally fell in his room and sustained a fracture of his right thigh bone near the knee joint. Dr. Manilal from Baroda, who was visiting Sri Aurobindo for a Darshan gave him first aid and requested Prof. N.S.N. to attend on him in Pondicherry. Prof. N.S.N. left the city without the permission of the Govt to attend on him. Sri Aurobindo had after all sought political asylum in Pondicherry, which was French territory. The rules mandated that as a servant of the British Government in India, Dr N.S.N. had to seek official permission, a process he chose to bypass. He visited him on two occasions without the permission of the Govt. The Govt came to know of it and the Surgeon General sent for him. He informed Prof. N.S.N that the British Govt. was not against Sri Aurobindo, as he was supporting the war effort. An official order was then issued to Prof N.S.N. to attend on Sri Aurobindo at Pondicherry.

His services elicited unstinted encomiums of all and in recognition of the same, the British Govt. honored him with the titles of Rao Sahib and later Rao Bahadur. He retired from the Govt. service in 1948 after a strenuous career, but he would not relax in retirement. He continued to evince interest in professional matters. He was elected President of the Association of Surgeons of India in 1950. He donned the role of President of the Indian Orthopaedic Association in 1962 and 1963. To the end, he practiced as a consultant and regularly attended the clinical meetings in the Orthopaedic department of the Govt. General Hospital. He always strived to augment his learning.

He had a prolific output of publications to his credit. Autopsy studies and museum specimens were of special interest to him. (I.J.S. Vol 2 No7- March1940- Autopsy studies in Peptic ulcer patients). He was the first person to provide statistics on the incidence of Anterior Poliomyelitis in India. ( I.J.S. Vol. 1V No. 3 1942). He made a thorough study of Congenital deformities (M.M.J. Vol. XII No. 2) and stressed the view that acquired deformities are preventable. He recorded for the first time in India the following conditions (1) Fracture neck of femur in 9 children (2) Pancreatic Lithiasis (1934) (3) Bone and joint lesions in smallpox (1940) (4) Quadricepsplasty (1949). He authored the book Surgical Clinical Handbook (1925), intended for Indian students. He was Editor of the Orthopaedic section of the Indian Journal of Surgery from 1956-1962.

Dr. Narasimhan was keenly interested in post graduate education in Orthopaedics and was President of the Indian Medical Council Committee on post graduate education in Orthopaedics in 1967. He served as examiner for the M.S. degree in several universities.

Having led a full life, he left behind a rich legacy of doctors in his family. One of his daughters became a famous Obgyn. in Bombay and practised for 50 years. He inspired three generations of Orthopaedic surgeons, his nephew Prof. Balu Sankaran, New Delhi, Grandson Prof. Sriram, Chennai and great grandson Dr. Vijay Sriram. Two of his grandchildren are in other specialties.

Dr. Narasimhan was confined to bed for three months before he passed away on 8th November 1972. He would not have liked to stay in bed for a longer time. For all his achievements, he was unostentatious and free from pride. He was a gentleman to the core, unfailing in courtesy, kind and considerate to his patients.

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