 Although some mental hospitals never used psychosurgery, or abandoned it after a brief trial, only a few voices were raised against it in the medical literature.Retired professor James MacDonald reminded psychiatrists at the Royal Medico-Psychological Association's March 1943 symposium on pre-frontal leucotomy that the frontal lobes represented the highest form of evolution, that there was no rational basis for leucotomy, and that the operation was of questionable legality.Donald Winnicott in a letter to The Lancet in the early days of leucotomy suggested that those who wanted to perform destructive operations should first establish that mental disorders were actually "brain-tissue diseases".