From the perspective of relative truth, everything that we experience— including all the various kinds of happiness and well-being as well as all the various types of suffering—arises from causes and conditions.

If we experience happiness, good health, and spiritual growth, we do so because we have practiced virtue in the past.

If we experience sorrow and other forms of suffering, we do so because we have engaged in unvirtuous or negative activity in the past, in harmful and evil deeds of various sorts.

This principle of cause and effect explains the existence of illness and disease.

If we suffer illness or disease of any sort, it is not because of some sort of accidental physical cause unrelated to our own past negative actions of body, speech, and mind.

Rather, all diseases and illnesses, and all physical suffering arising out of disease and illness, arise as a result of negative karma—as a result of evil deeds of body, speech, and mind.

When these evil or unskillful deeds are minor, they will exhaust themselves naturally and one will get well whether or not one uses medicines. The duration of the illnesses arising out of such minor evil deeds will vary according to the frequency and period of time over which one committed such evil or unskillful deeds, as well as upon the factor of spiritual practice.

If these evil or unskillful deeds are serious, and yet we live in a time when, as a result of good causes arising out of virtuous actions we personally and collectively have performed in the past, there are effective medicines and medical procedures available which can cure us, and if we use them, we will recover from our illness or illnesses through the use of these medicines and procedures.

If the karmic causes of our illness or illnesses are extremely severe and we have not reached the eighth bhumi of bodhisattvic enlightenment—at which point we can transcend all physical illness if we so desire—then we will surely die of that illness.

But if the karmic causes of our illness or illnesses are so strong that medicines and medical procedures cannot cure us, but not so strong as to determine the certainty of imminent death based on that illness, and if we are willing to exert ourselves in the practice of dharma, then dharma practice can cure us. In such cases, the practice of the Medicine Buddha is invaluable.

When we speak of evil deeds or unskillful actions as being the causes of our illnesses, it is vitally important that we understand that these evil deeds are not simply the deeds of our body and speech, but also of our mind.

Of course, if we kill out of anger and aggression, these actions create strong negative karma that leave strong negative imprints in our mental continuum. If these negative imprints are not purified by spiritual practice, they will subsequently give rise to a variety of circumstances: to our being killed, to illness, to mental suffering—including increased anger and aggression and the continuing desire and irresistible urge to kill—and to being born in desolate environments in which there is lots of killing or even perpetual warfare.

All of this depends on and is conditioned by the frequency and the intensity of our killing and the intensity of the emotions motivating and driving our killing.

One should always remember, however, that these causes can be purified and that one can avoid such calamity through spiritual practice.

Short of physically engaging in killing, if out of anger and aggression we say such things as, “I hate you so much I am going to kill you,” or “I hate you so much, I could to kill you,” or “You are a despicable being and I hate you,” or simply “I hate you,” or “Your behavior is despicable and I am very angry with you,” then we are still creating verbal and mental karma which can become the basis of illness.

But even if we neither kill nor express angry and hateful sentiments, if we merely harbor in mind and ruminate on anger and hatred and resentment and bitterness towards others, and thereby reinforce these sentiments and cause them to grow stronger and increasingly intractable, these actions of our minds will still give rise to illness.

There is no medicine that will cure this type of illness completely, because its causes are not physical. Its causes are mental and emotional, and unless these causes exhaust themselves naturally, the only way that this type of illness can truly be cured is by purifying the mental and emotional causes that give rise to it.

This is one of the reasons why the practice of forgiveness is so important. Forgiveness in this sense does not mean that out of my exalted or greater goodness and/or superior wisdom, I magnanimously forgive the person whom I imagine to be responsible for my anger, hatred and/or resentment.

It means rather that I recognize that regardless of what another may do to me, my anger or hatred—and the harm that it can do to me physically, emotionally, and mentally—is my own.

It comes from nowhere else but my own mind, the character of which has been formed by my own actions, both negative and positive.

Recognizing this truth and making the appropriate mental adjustments is the basis of reviving mental, emotional, and physical health, which in turn becomes the basis of true reconciliation with others.

Since the practice of the Medicine Buddha derives its effect from the powerful and rapid purification of mental and emotional negativity and of the karmic causes that give rise to such negativity, the Medicine Buddha is a particularly powerful spiritual technique for accomplishing such forgiveness, revivification, and reconciliation.

The practice of the Medicine Buddha is also invaluable in counteracting any sort of illness arising out of excessive desire, including addiction or addictive behavior: relationship addiction, drug addiction, alcohol addiction, over-eating addiction, addiction to using harsh words, etc.

When the Buddha first taught about the origin of suffering, the Second Noble Truth, he taught that it was tanha (Pali), which has been translated as “thirsting” or “craving.”

In modern day parlance, tanha might also be translated as “addiction.”

The idea of tanha or addiction is that one’s thirsting or craving after something is so strong that one finds it extremely difficult, if not nearly impossible, to resist grasping after the object of one’s desire.

The practice of the Medicine Buddha, if engaged in with effort and concentration and with the primary intention of reversing or purifying one’s addiction, quite naturally increases the “No!” in one’s system, and enables one with increasingly less struggle to let go of and finally give up one’s addictive behavior.

Therefore, the practice of the Medicine Buddha is invaluable. Most of the time, of course, we have no idea why we are ill. This comes about as a consequence of our present inability to recognize many of the various negative emotions that we suppress in our minds and to “see,” with the eye of wisdom, the karmic deeds, usually committed in previous lives, which are responsible for such emotions and for our illnesses.

These recognitions are the prerequisite for “seeing” directly the relationship between negative mental/emotional states, evil deeds, and illnesses. The practice of the Medicine Buddha will also eventually remove the obscurations of mind that block such recognitions.

In the meantime, if we understand the general principle of karmic cause and effect and have confidence in the possibility of spiritual purification, we can practice the Medicine Buddha and attain results long before the dawning of such spiritual insight.

All of these benefits come about because the basis of all illness is evil deeds and the emotional defilements that give rise to them. The practice of the Medicine Buddha is one of the most profound ways of purifying such deeds and defilements and the karmic imprints that they leave in the psychosomatic system in the form of illness and compulsive behavior.

In this way, the Medicine Buddha removes the causes of our illnesses and the illnesses themselves.

Source: Based on Khenchen Thrangu Rinpoche. Medicine Buddha Teachings. Oral translation by Lama Yeshe Gyamtso. Introduced, edited, and annotated by Lama Tashi Namgyal. Ithaca, New York: Snow Lion Publications, 2004.

Reflection:

According to the teachings of the Buddha Shakyamuni, recorded in the Sutra on Entering the Womb, there are four classes of illness.

The first includes illnesses which are relatively inconsequential, and from these illnesses one will recover whether or not one takes medicines.

The second class of illness includes more serious, even dangerous, illnesses, but if one takes the appropriate medicines, one will recover from these as well. A modern update of this category would surely include many effective modern medical procedures, such as acupuncture, surgery, radiation therapy, chemotherapy, etc.

The third class of illness includes those for which medicines are of no use, illnesses from which one cannot recover simply through the use of medicines or other medical procedures. These illnesses, however, can be cured, and one can thereby recover one’s health, through the practice of appropriate spiritual techniques taught in the buddhadharma.

The fourth class of illness includes those which have a karmicly determined irreversibly terminal nature. When one’s body manifests such an illness, death is inevitable and no amount of medicine or medical procedure can prevent it. In fact, the use of medicines in such cases—with the exception of narcotics for pain—only serves to increase one’s suffering.

(Khenchen Thrangu Rinpoche. Medicine Buddha Teachings.)