There are 4 classes of tantras, one of which is the Lower Tantras.

  1. We practice the Lower Tantras to clear a specific problem that obstructs us from practicing Higher Tantras.
  2. The Medicine Buddha practice belongs to the Lower Tantras and is very efficacious for medical and health problems.
  3. In the Medicine Buddha practice, it is twice as important to think of the Guru and Yidam as being one in nature.
  4. To remove our pain and suffering, we need the blessings of all the lineage lamas.

Therefore, if we think of the Guru and Yidam as one, and if we have faith and respect in the Guru, we effectively apply this to all the lineage lamas.


H.E. Tsem Tulku Rinpoche received the oral transmission for this practice from:

  • H.H. Pabongka Dorje Chang in 1987 (mantra only)
  • H.E. Kensur Rinpoche Jetsun Jampa Yeshe in 1992 (full initiation)
  • H.E. Denma Locho Rinpoche (full initiation)

Altar Set Up & Offerings

  1. Place a Medicine Buddha statue (or picture) on the altar.
  2. Set up 8 sets of sensory offerings in the following manner.
  3. Starting from the back of the altar and working forward, place a row of 8 argham, followed by a row of 8 padhyam, then 8 pushpe, and so on, rather than consecutive rows of all 8 offerings.
  4. Set up additional water offerings to make up a total of 108 offering bowls.
  5. Place a Medicine Buddha Sutra text, wrapped in five-coloured cloth, on the left.
  6. Place a copy of the Medicine Buddha mandala (small or large) in a gyapi, on the altar.
  7. Place the Guru’s picture in front of the Medicine Buddha statue.
  8. Prepare eight tormas (any size) made from the 3 whites and the 3 sweets (milk, butter, yoghurt, sugar, molasses and honey) in the shape of tear drops.


The full sadhana is as follows:

  1. Take Refuge
  2. 35 Confessional Buddhas
  3. 21x Migtsema (no need to do Guru Yoga)
  4. Medicine Buddha Sadhana
  5. Setrap Black Tea (if time allows)
  6. Completion dedication
  7. Yonten Shigyurma

This practice belongs to the Action Tantras. Because of this, it is best to abstain from black foods (meat, eggs, onions, garlic), intoxicants and sexual activity on the day of the puja (before and during the puja).

Ritual implements

One should have both dorje and bell, but no damaru or inner offering.

Please Note:
Throughout the text, small symbols of bells –@ or other instruments and handmudras appear in the margins to help the practitioner know when one should play these instruments or when to do certain mudras. It is hoped that these small indications will be helpful to those not yet familiar with these aspects of tantric practice. Other symbols and their meanings are:

\@/ Lotus mudra

_/\_ Prostration mudra

%-% Show the dorje

Medicine Buddha Practice

The Concise Essence Sutra Ritual of Bhagavan Medicine Buddha called “The Wish-Fulfilling Jewel”


The river of merely hearing your names
Makes even Avici’s hell-fires cool as a lotus pond.
Protectors in degenerate times, seven sugatas
And head of the Shakyas, to your feet I bow.

Distracted by activities of varying importance,
To benefit myself and those with faith in the life stories
Of these seven Buddhas for degenerate times,
I’ll condense the ambrosia sutra ritual to its molten essence.

Because of the infallibility of Arya Buddha’s proclamation that the power and blessings of the Medicine Buddhas are greater and swifter in degenerate times, we accept it. Having already made preparations as described in the sutra ritual, one who wishes to perform this quintessential ritual for invoking the heart commitment of the protectors during degenerate times, the seven sugatas, should recite as follows, fully infusing the mind with refuge and bodhicitta:

Refuge and Bodhicitta

Nature incorporating the entire body, speech, mind, qualities, and activity of all the tathagatas of the three times and ten directions, source of the 84 thousand collections of Dharmas, lord of all arya Sangha, I seek refuge in the kind and glorious holy root and lineage gurus.

I seek refuge in the completely enlightened lord Buddhas.
I seek refuge in the holy Dharma.
I seek refuge in the eight brothers gone to bliss, the lord Medicine Buddhas with their hosts of retinue deities.
I seek refuge in the glorious holy Protectors, Dharma Protector guardians endowed with the wisdom eye. (3x)

I go for refuge until I am enlightened
To the Buddha, the Dharma, and the Supreme Assembly.
By my merit from giving and other perfections
May I become a Buddha to benefit all sentient beings. (3x)

The Four Immeasurables

All sentient beings who, although self and all appearances are dharmadhatu by nature, have not realized it thus, I shall endow with happiness and the causes of happiness, I shall separate from suffering and the causes of suffering, I shall make inseparable from happiness without suffering, and I shall set in equanimity, the cause of well-being, free from attachment, aversion and partiality. (3x)

The Power of Truth

Through the power of the supreme truth of the Buddhas’ and Bodhisattvas’ blessings,
The might of the two collections, and the purity of the dharmadhatu,
May this realm’s beings and environment be enriched like Sukhavati
With all the desirable perfections of both samsara and nirvana.


Jeweled ground adorned with trees and with ponds
Whose bottoms are covered with gold, silver, and pearl dust;
Flowers strewn and sandalwood fragrance rising;
Human and divine enjoyments: Samantabhadra’s offerings everywhere.

There, in the centre of a charming jeweled palace
On lotuses and lion thrones, Buddhas and Bodhisattvas abide.
May [everywhere] be filled with oceans of clouds of offerings, which they enjoy,
Born through the force of mantra, samadhi, and aspiration.

Invocation (with burning incense)

Compassionate protectors in degenerate times, seven sugatas,
Buddha Shakyamuni, holy Dharma, bodhisattvas, and guardians,
Invited as the support and protector refuge to protect others and myself:
–@ May you come here, gather, and grant your blessings.

If one wishes, one can insert an extensive bath offering here.

The Seven-Limb Practice


%-% Root guru whose kindness is without equal,
–@ King of the Shakyas, Manjushri, Shantarakshita, and so on,
\@/ Holding in their hands this profound sutra:
_/\_ To the direct and lineage gurus, I prostrate.

%-% To the compassionate ones who liberate destitute beings –
–@ Seven sugatas, Buddha Shakyamuni, and holy Dharma,
\@/ Manjushri, Kyab Dröl, Vajrapani, Brahma and Ishvara,
_/\_ And the maharajas and yakshas – I prostrate.

–@ I make every collection of offerings, actually arranged and emanated
| Through the force of mantra, samadhi, and aspiration.
| I confess all downfalls and negativities,
| Rejoice in virtues, (Meditate strongly on rejoicing here.) request and beseech,
| And dedicate such virtues as these to the great enlightenment.