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John M. Johnston, M.D.
JAMA. 1953;152(1):75. doi:10.1001/jama.1953.03690010081026.
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To the Editor:  —Phenylbutazone has recently been presented to the profession (J. A. M. A. 149:729 [June 21] 1952) and to the public (Time59:76 [June 16] 1952) as a non-narcotic analgesic substance more potent than the salicylates. Salt and water retention has been noted. My experience with this drug was gained from treating seven patients between Aug. 18, 1952, and Sept. 24, 1952. Each of the seven patients received the maximum recommended dose (200 mg. four times a day) of phenylbutazone for the number of days stated in the table. Each was instructed to restrict the amount of salt used in his food; the patients were not required to adhere to a "very low sodium" diet. I had known each patient for from 1 to 20 years. None of them had significant cardiovascular-renal limitations.Water retention, severe enough to be obvious to the patient himself, developed in


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