Cholinergic neurons may influence the neural networks that subserve language. To learn if cholinergic drugs enhance the ability of anomic aphasic patients to name objects, we conducted studies of physostigmine and lecithin in three patients with anemia due to focal brain lesions. The first patient studied was amnestic and anomic, and presumed to be cholinergic-deficient due to a basal forebrain lesion. In open and blinded trials confrontation naming improved consistently with treatment but other cognitive measures did not. We subsequently tested two additional anomic patients with lesions outside the basal forebrain. We found improvement in confrontation naming but not other measures of cognition or mood during open-label physostigmine treatment. Physostigmine appears to improve naming in patients with anomia.