Bhaishajyaguru

Bhaishajyaguru is the Medicine Buddha, one of the most widely venerated buddhas of East Asian and Tibetan Buddhism, whose colour is a deep lapis-lazuli blue and who is shown holding a bowl of medicine and, often, a stalk of the myrobalan plant, a fruit prized in Indian and Tibetan medicine. He presides over a pure land in the east, described as being made of radiant blue lapis. His importance rests on a set of vows recorded in the Sutra of the Medicine Buddha: as a bodhisattva, before his awakening, he made twelve great vows for the benefit of beings, which include curing the sick, healing the deformed and the disabled, feeding the hungry, clothing the naked, freeing the imprisoned, and bringing all who call on his name to health of body and mind and to the conditions for awakening. His worship is therefore deeply practical, addressed to suffering in its most concrete forms, illness, poverty, fear, as well as to the deeper sickness of the deluded mind.

In many parts of the Buddhist world his name and his mantra are recited for the recovery of the ill and the dying, and his image is set up in times of epidemic and hardship; in Tibetan medicine, which understands physical and spiritual healing as bound together, he holds a central place as the source of the medical teachings themselves. Bhaishajyaguru expresses the conviction, running through the Mahayana, that the compassion of the awakened extends to the body as well as the soul, and that the removal of ordinary suffering is itself part of the path.

Bhaisajyaguru is defined by a set of undertakings rather than by a biography. The sutra devoted to him has the Buddha describe an eastern buddha-field and the twelve great vows its buddha made while he was still a bodhisattva, and the vows are unusually concrete. He undertakes that his own body will blaze so that beings may see by it; that those with deformed or incomplete bodies will be made whole; that the sick who have no medicine, no doctor, no family and no means will be relieved on hearing his name; that the hungry will be fed before being given the teaching; and that those bound and punished unjustly will be freed. One vow, that women who wish it will not be born again as women, belongs plainly to the assumptions of its period, and later commentators handle it in a variety of ways.

The emphasis on hearing the name is what made the sutra practical. It supplied a devotion that could be performed by the sick and by those caring for them, with a text to recite, a name to repeat and a set of promises addressed to exactly the situation the reciter was in. That is why the sutra was translated into Chinese repeatedly from the fourth century onward, was copied in enormous numbers, and became one of the standard texts read at sickbeds and funerals across East Asia.

Bhaishajyaguru, known in Japan as Yakushi Nyorai, became one of the most heavily invoked Buddhist figures during one of the deadliest disease outbreaks recorded in early Japanese history, the Tenpyo epidemic of 735 to 737, believed by modern epidemiological historians to have been smallpox, which spread from Kyushu and is estimated in some scholarly reconstructions to have killed a substantial share of the entire Japanese population within a few years, including several of the powerful Fujiwara brothers who had dominated the imperial court. The court's documented religious response drew heavily on Buddhist ritual aimed at Yakushi as the Buddha of healing, including the construction and dedication of temples and images specifically to seek his intervention against the disease, part of a broader pattern in which Nara-period Japan responded to plague and disaster through large-scale state-sponsored Buddhist building and ritual projects rather than through medical intervention in any modern sense.

The Yakushiji temple in Nara, whose origins as an imperial vow-temple predate this specific epidemic but whose continued imperial patronage was shaped by the same recurring anxiety about plague and the court's health, remains one of the most historically significant Yakushi-dedicated temples in Japan today. This historical episode illustrates concretely what Bhaishajyaguru's twelve vows regarding illness and healing meant in practice for an early medieval society with no other effective response to a catastrophic epidemic: an entire imperial court turning, in a moment of demographic catastrophe, to the specific Buddha whose defining vows promised exactly the kind of bodily deliverance the era's actual medicine could not provide.

His pure land is Vaiduryanirbhasa, pure lapis lazuli, and he is shown blue for that reason, holding a bowl of medicine or nectar in the left hand and a sprig of myrobalan, a fruit central to Indian and Tibetan pharmacology, in the right. He is attended by Suryaprabha and Candraprabha, sunlight and moonlight, and by twelve yaksha generals who are matched in East Asian practice to the twelve animals and the twelve double hours.

In Japan he is Yakushi Nyorai and his cult is very old. Yakushi-ji at Nara was founded in fulfilment of a vow made for the recovery of an empress, and a large number of early images survive, so that the healing buddha is present in Japanese Buddhism from close to its beginning rather than as a later devotional addition.

In Tibet he is Sangye Menla, and his connection with medicine is institutional and not only devotional. The Gyushi, the Four Tantras that form the basis of Tibetan medical training, are framed as taught by the Medicine Buddha in the medicine city of Tanaduk, so that a physician's textbook opens as the discourse of a buddha and the study of pharmacology is placed inside the study of dharma. His mantra is among the most widely recited in the Tibetan world, and thangkas showing him at the centre of a group of eight medicine buddhas hang in medical colleges as readily as in temples.