Following the overthrow of the Hawaiian Kingdom, the stricter government enforced the 1865 "Act to Prevent the Spread of Leprosy" carried out by Attorney General and President of the Board of Health William Owen Smith.

A revolt broke out in Kauaʻi, against the forced relocation of all infected by the disease to the Kalaupapa Leprosy Colony of Kalawao on the island of Molokai.

The Leper War started when Louis H. Stoltz, a deputy sheriff, attempted to force an isolated leprosy colony in Kalalau Valley, Kauaʻi to be deported.

[1] On June 24, 1893, Deputy Sheriff Louis H. Stolz, along with two other policemen by the names of Penikila and Peter Noland, sailed to Kalalau to enforce the quarantine law to relocate lepers to Kalaupapa.

Shortly after they established themselves a band of lepers led by Koʻolau seized the camp and chased the lawmen back to the coast.

Following the killing, Marshal Edward G. Hitchcock dispatched the Kalalau expedition commanded by Captain William Larsen comprising a 35-man platoon from the National Guard of Hawaii, a howitzer, and representative of the Board of Health, Executive Officer Charles B. Reynolds.

At this point, they were informed of the proclaimed martial law that all lepers were to be imprisoned within 24 hours, and after this time is up, they were to be taken dead or alive if they had not yet complied.

Finding the shore safe the rest of the expedition was delivered and set up camp a mile inland.

Larsen fired five round from the howitzer against the eastern ridge of the valley with the intention of intimidating the lepers with the cannon's reports.

At noon, Wahinealoha returned with the message that a group of lepers were willing to surrender if Luther Wilcox were to meet with them.

Koʻolau was with his wife Piilani and son Kaleimanu in caves in the slope of one of the western ridge of the valley.

Koʻolau shot the point man Private John Anderson, a Norwegian, from the well-camouflaged ledge of the cave entrance as the team neared.

He would die of his wound; the other two guardsmen survived their fall but Private Johnson was badly injured and the group withdrew back to Camp Dole.

This time the point man was a combat veteran of the American Civil War, Private John McCabe who served in the Union Army.

[5] Once again the group retreated, but during the withdrawal, Private John Herschberg snagged his rifle on foliage and the gun went off killing him.

On July 7, Reynolds with six soldiers collected ten lepers at Hanalei that had been caught outside Kalalau aboard the Iwalani and sent them to Honolulu.