Ivy berries are somewhat poisonous to humans, but extracts from ivy leaves are part of current cough medicines. A 2020 evidence review found that H. helix preparations "may be a therapeutic option for treating early symptoms of respiratory tract infections", saying that "the best effectiveness for H. helix preparations has been proven for coughing, as an expectorant and to reduce the frequency and intensity of cough. Only weak evidence was found for all other researched symptoms." In the past, the leaves and berries were taken orally as an expectorant to treat cough and bronchitis. In 1597, the British herbalist John Gerard recommended water infused with ivy leaves as a wash for sore or watering eyes. The leaves can cause severe contact dermatitis in some people. People who have this allergy (strictly a type IV hypersensitivity) are also likely to react to carrots and other members of the Apiaceae as they contain the same allergen, falcarinol. Previous studies showed that the H. helix extract contains α-hederin and β-hederin, falcarinol, didehydrofalcarinol, rutin, caffeic acid, chlorogenic acid, emetine, nicotiflorin, hederasaponin B and hederacoside C. However, only three extracted components were detectable more than 1.5% in the Hedera helix leaves (hederacoside C 15.69%, chlorogenic acid 2.07%, and rutin 1.62%). Other components were detectable in very few amounts (< 1%) or not detectable in some studies. Owing to the large number of saponins in the leaves and fruits of H. helix, it is mildly poisonous to animals like rabbits and can lead to anemia. In a hunting session for resources, birds would restrict the number of ivy berries ingested because of the moderate toxicity.