The second appearance occurred at the beginning of the reign of the current Manu in the second Dwaapar Yug, about two billion years ago. Lord Vishnu foretold at the time of the churning that Dhanvantari would appear again in the human society and be offered sacrifices and worshipped by human beings. He would also teach them the science of Aayur Ved. Dhanvantari at that time was residing in the Heaven and Lord Indra seeing the misery of human beings afflicted by disease on earth, requested the Lord to teach Aayur Ved to the human race.

At the same time, the King Deerghtamaa of Kaashee was performing penance, desiring a son. The King desired to propitiate Lord Dhanvantari for the sake of a son. Thereupon, Dhanvantari appeared to him and urged the King to choose a boon as he was very pleased with he King. The King said, "O Lord, If you are pleased with me, be my son, bestower of my goal." The Lord replied, "So be it," and he vanished.

Lord Dhanvantari was then born in the royal household of Kaashee. He developed ascetic tendencies even as a young boy and performed severe austerities. Lord Brahmaa with great difficulty persuaded him to accept Lordship over the city of Kaashee and since then he became known as Kaashi-raaj. As a King he prepared the Sanhitaa on Aayur Ved in eight divisions for the benefit of humanity. Dhanvantari's teachings are recorded in the Agni Puraan 279-289 as well as through the teachings of his disciple Sushrut. The Bhaagavat Puraan states "smrta-matrarti-nasanah" One who remembers the name of Dhanvantari can be released from all disease.