1891, Charles Hilton Fagge and Philip Henry Pye‐Smith, Text‐Book of the Principles and Practice of Medicine, J. & A. Churchill; third edition, Volume II, Mitral Incompetence, page #77:
There is dyspnœa and orthopnœa, though the latter is usually less severe than in aortic cases ; there is anæmia, but often modified by venous congestion of the lips, cheeks, chin, nose, and ears, and sometimes by an icteric tinge due to congestion of the liver.