Lillias Horton Underwood

Life

She was born in 1851 in Albany, New York, the daughter of businessman James Mandeville Horton. She studied medicine at the Woman's Medical College of Chicago (now part of Northwestern University), receiving her degree in 1887, and trained at a hospital in Chicago. As a medical student, she reportedly hoped to serve as a medical missionary in India.

Sent by the Board of Foreign Missions of the Presbyterian Church in the U.S.A., she arrived in Seoul on March 27, 1888. She initially intended to remain unmarried and work as a medical missionary. Within six months of her arrival, however, she became engaged to Horace Underwood of the same mission, and they married in 1889. The couple combined their honeymoon with a missionary journey through the provinces of Hwanghae and Pyeongan, and they are regarded as the first foreign couple to undertake a missionary journey into the interior north of Seoul. Their only son, Horace Horton Underwood, was born in 1890. Her husband died in 1916, and she died in Seoul in 1921.

Ministry and Achievements

• Medical missions: She headed the women's department at Gwanghyewon (later renamed Jejungwon), the first Western-style hospital established by the Joseon government. When Annie Ellers, who had previously attended the queen, married, Underwood succeeded her as court physician to Empress Myeongseong. She continued to visit the royal household until the queen's assassination in the Eulmi Incident of 1895, and in her memoir she recorded sharing the gospel with the queen.
• Education and women's ministry: She taught English and arithmetic at the boys' orphanage founded by her husband. She also led a boys' Sunday school and women's Bible studies, and took part in itinerant evangelism in the countryside.
• Literature ministry and writing: In 1904 she published her memoir, Fifteen Years Among the Top-Knots, in the United States. The book records Joseon during a turbulent period that included the Sino-Japanese War, the Eulmi Incident, and the Eulsa Treaty, and it has been translated into Korean under titles such as Mrs. Underwood's Observations of Joseon. She also wrote a biography of her husband.
• Rights of married women missionaries: At the time, married women missionaries, unlike their single counterparts, were excluded from voting on mission matters such as finances. She challenged this practice and advocated for the rights of married women missionaries.
• Support for higher education: Together with her husband, she sought to establish an institution of higher education grounded in Christian principles (later Chosen Christian College) and worked to raise funds for it. When her husband's illness made it difficult for him to travel, she personally met with the Methodist leader John Franklin Goucher to seek his assistance.

Influence on the Korean Church

She worked at a time when religious freedom had not yet been granted. In that setting, she used medicine as a means of reaching women and children from various social classes. In a society where men and women could not freely interact, she opened a path, as a woman physician and missionary, for bringing the gospel to Korean women, and this laid a foundation for women's ministry in early Korean Protestant history. Her writings are read as sources that convey, from a missionary's perspective, the condition of Joseon society during the opening period (when Korea opened its doors to foreign nations) and the circumstances of the early church.

Assessment

For a long time she was remembered chiefly as "Underwood's wife," but recent scholarship has focused on her own work as a physician, educator, and author. A 2015 study published in a Korean studies journal categorized her ministry as medical missions, itinerant rural ministry, and literature ministry. It identified its distinguishing features as ministry by women for women, evangelism-centered mission, and an effort to become one with the local people (identification). On the centennial of her death in 2021, articles appeared reexamining her contributions to education and women's ministry. No notable criticism of her is widely known.