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In Reply.—
Carter's letter presents an interesting observation. First, it should be noted that the report by Kertesz et al offers excellent background material for the study of aphasia. The particular question raised by Carter is pertinent and deserves attention.A number of possible explanations can be formulated in attempting to answer Carter's question. Whether any of these explanations is pertinent must, however, remain moot. For instance, it could be considered that the age difference between Broca's and Wernicke's aphasics could be based on the differences in pathologic conditions occurring with increasing age. In other words, the distribution of emboli, thrombosis, hemorrhage, or extracranial vascular disease may vary with the age of the patient. A second suggestion would be that cerebral blood flow changes with increasing age. A third possibility would take into account the additive effect of the aging brain; senility plus a cardiovascular accident (CVA) might produce a different clinical