Verbal Paraphasia as a

COMPETENCE in arithmetic is so universal that evaluation of this ability has become a standard part of the mental status determination. Even though loss of calculating ability is readily demonstrable and frequently seen in the neurologic clinic, there are few detailed studies of calculation disorder in the literature. Most studies emphasize the intellectual manipulation necessary for calculation but fail to detail other disturbances which may cause calculating errors. We wish to report two patients demonstrating calculation disturbance caused by paraphasic substitution of one number for another. Paraphasia, the inappropriate substitution of a phoneme or word, is a well known aphasic symptom, but the relationship of calculation disturbance and paraphasia has not previously been reported. Report of Cases CASE1.—A 58-year-old retired army sergeant was admitted to the Boston Veterans Administration Hospital in September of 1964 following the acute onset of right-sided hemiparesis and aphasia. Despite past history of myocardial