It is a war that never ends. The COVID lockdown was just one of many fights against communicable diseases.

Over the years, one of the biggest has been the war against tuberculosis. Although it is not a major problem in first-world countries, there is now more TB in the world than ever, including strains that are highly resistant to antibiotics.

James E. Higgins describes how Pennsylvania fought the disease in his new book, “The War Against Tuberculosis: Samuel G. Dixon and the Rise of Modern Public Health in Pennsylvania” (191 pages; Pennsylvania State Community Press, 2025; hardcover, $104.95; paperback, $29.95; ebook, $23.99. The paperback is available at Lehigh Valley Heritage Museum.).

The book focuses on Samuel G. Dixon (1851-1918), Pennsylvania’s first head of the state’s Department of Health. There are many parallels between his times and ours, some that are hopeful and others that are disconcerting.

Higgins, executive director of Lehigh County Historical Society, says in an interview at Lehigh Valley Heritage Museum, 432 W. Walnut St., Allentown, “If you were transported back to Allentown in 1900, you would not be able to drink the water because of both the taste and the smell.”

Clean water and efficient sewage are mandatory today, but Dixon’s public health measures were often countered by the industrial polluters of the day and those who resented government regulations.

“It is a matter of technology meeting political will. It could be the will of the people or the politicians,” says Higgins. Just like today, many people resisted vaccination in Dixon’s time. “It is difficult arguing for vaccines because it is for something that never happens if they are effective, and people can get sick from the injection.”

One era of vaccination that was almost universally popular was that for polio in the 1950s.

“In 1955, many people remembered infectious diseases from the 1920s. Now we have three generations of people who have not grown up with them.” Skepticism about vaccination is an echo of Dixon’s era.

PBS’s “American Experience” states: “By the dawn of the 19th century, tuberculosis, or consumption, had killed one in seven of all people that had ever lived.”

Higgins says, “Tuberculosis comes from a simple small organism, not much different than the bacteria that decomposes the leaf litter in your backyard. It preys on run-down, hungry, stressed populations.”

Dixon’s public health measures, such as sanitation, ecological improvement and outreach to physicians, prevented many deaths throughout Pennsylvania.

Tubercular patients can live for months or years, so Dixon established three sanatoriums for patients in Pennsylvania, with an emphasis on breathing fresh air. Although isolation prevented further transmission, the sanatoriums ultimately failed to provide a cure.

Dixon, who was a lawyer, contributed to research on the tubercle bacillis. His work has been largely uncredited. He did rise, however, to become the president of the Academy of Natural Sciences of Philadelphia before he served as the head of state health for 12 years under four governors.

Dixon’s legacy is marred by his adaptation of the racial and cultural prejudices of his time.

“Modern thinking rejects reasoning that would have been thought proper at the time. 120 to 150 years ago, people thought of other races and ethnicities as subspecies. It was thought that the best should mate with the best. ‘We don’t want to dilute the gene pool.’

“The results were felt by the impoverished or the working poor. Wealth has a way of making itself its own best argument,” says Higgins.

Dixon was a chief advisor for a 1913 bill, the Eugenic Marriage Law, which prohibited marriage between people with intellectual disabilities, specified communicable diseases, and certain indigent people who could not guarantee their economic status.

Higgins says, “Dixon did more good that he did bad. We can’t expect a person to be all things to all people. Things change with the passage of time.”

Higgins says that the most important source for his research was the Historical Society of Philadelphia, where Dixon’s daughter donated all his papers. Although extensive, they revealed almost nothing about his personal life. There were no diaries, for example, and most of the photos were official-looking, staged portraits.

As director of Lehigh County Historical Society, Higgins is especially proud of its outreach to thousands of Lehigh Valley students, who visit their sites, including the Claussville One-Room Schoolhouse and the Troxell-Steckel Farm Museum. The Lehigh Valley Heritage Museum has exhibits and sponsors history-topic lectures.

Higgins has lived in the Lehigh Valley since he was 90 days old, growing up in South Whitehall Township. He graduated from Parkland High School in 1995 and received a PhD in History from Lehigh University.

“Literary Scene” is a column about authors, books and publishing. To request coverage, email: Paul Willistein, Focus editor, pwillistein@tnonline.com