Ms. Pugh, now on a leave of absence owing to what she says are health concerns, has been the subject of investigative stories in the Baltimore Sun, whose enterprising reporters have uncovered one sleazy deal after another. The common denominator is that Ms. Pugh, a prominent Democratic state lawmaker before becoming Baltimore’s mayor, in 2016, managed to extract payments from institutions, businesses and, in one case, an individual businessman, most of whom depended on her position, power and influence to one degree or another.

The biggest chunk of the proceeds, $500,000, came from the University of Maryland Medical System, a sprawling health-care network whose 13 hospitals and 25,000 employees make it one of the largest private employers in the state. The payments began when Ms. Pugh was a state senator, sitting on a legislative committee overseeing the network, meaning she had a key role in its ongoing financial support from Annapolis. She also served on the UMMS board, even as she was selling her books — insipid tracts whose health education value was dubious, to put it mildly — to the network, where procurement officials seemed loath ever to question the arrangement.

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Ms. Pugh was later paid roughly $200,000 by Kaiser Permanente, which at the time was seeking a major contract to provide health benefits to Baltimore, and by a high-profile Baltimore foundation called Associated Black Charities, which funneled the funds from several organizations and firms seeking business arrangements with the city. In addition, a Maryland businessman, J.P. Grant, who has extensive business dealings in Baltimore, gave her $100,000. In return, he received one copy of a “Healthy Holly” book.

It is telling, as the Sun reported last week, that another public-health concern, Johns Hopkins Health System, said Ms. Pugh, at the time a state senator, had asked one of its senior employees to purchase “Healthy Holly” books on the system’s behalf. The employee refused — apparently one of the few instances in which a representative of a respected Maryland institution chose to do the right thing.

Gov. Larry Hogan (R) has called for a criminal investigation. The Maryland state prosecutor has initiated an inquiry, according to Ms. Pugh’s lawyer. The Baltimore City Ethics Board is also looking into the scandal, and the City Council has called for her resignation. That would seem the least she could do for Baltimore, having deepened the woes of a city that already was struggling with crime and dysfunction.