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.