For centuries surgeons treated external injuries and diseases, while physicians diagnosed and treated internal diseases. When surgeons began undertaking abdominal operations early in the 19th century, they introduced modern surgery and challenged the dominant position of physicians within the medical hierarchy. Anaesthesia, used from 1847, made operations painless, but it was not safer until antisepsis, then asepsis, were enforced in hospitals in the 1880s and 1890s. Asepsis, however, meant that operating theatres, once open to the public, were closed to all but the participants.
Richard Thomas Tracy (1826-74), co-founder of the Lying-In Hospital (now the Royal Women's Hospital), established internal surgery in Australia by performing a series of successful abdominal operations in the 1860s. In the 1890s, when surgery was proposed as the best treatment for appendicitis, George Adlington Syme (1859-1929) of the (Royal) Melbourne Hospital emerged as leader in its diagnosis and treatment. When the Royal Australasian College of Surgeons was established in 1927 to regulate surgeons and surgery, George Syme was unanimously elected the first president of the college.
Leading surgeons such as Sir Thomas Naghten FitzGerald (1838-1908) taught at the Medical School established in 1862 at the University of Melbourne, while working as honoraries in public hospitals. Operations for paying patients were performed in private homes, but the introduction of costly surgical equipment and the development of specialised post-operative nursing meant minor and major operations were increasingly undertaken in private hospitals.
Melbourne's surgeons were male until 1890, when (Emma) Constance Stone (1856-1902) became the first woman registered as a medical practitioner in Australia. Together with fellow medical women, she opened the Queen Victoria Memorial Hospital in 1896 to provide general medical and surgical treatment for poor women. (Hannah Mary) Helen Sexton (1862-1950) was the first woman to undertake surgery at a major public hospital when she joined the staff of the (Royal) Women's Hospital in 1899.
Surgical specialisation, which began in the 1890s, expanded rapidly, especially after World War II, with operations developed to remove diseased organs as well as to repair or improve the body. Medical technology has extended the skills of surgeons beyond the use of scalpels to include the use of lasers and computers.