Dr. Gomes da Silva, the Principal Medical Officer of Macao, in recording the sanitary condition of the Chinese population, observed that they usually threw house refuse into the street, where it accumulated until such time as the torrential summer rains and the overflow of the Pearl River cleared it away.

A study by City University of Hong Kong also attributes the spread of plague to the hygiene and sanitary condition among local population at the time.

[14] 20th century Journalist[15] Trea Wiltshire, in her book "Old Hong Kong", believes the Hill District Reservation Ordinance was a law based on social segregation as its goal.

[5] The front seat of the tram was always reserved for the governor, who further accorded its desirable social status by building a summer retreat, the Mountain Lodge.

Such exemptions were invoked for such personalities as First Lady of the Republic of China Soong Mei-ling[8] and Eurasian millionaire Sir Robert Ho-Tung and his family who already had a retreat on the slopes of the Peak.