大般涅槃經義記 4.154

4.154

就初對中，前一復次舉小顯大，先喻、後合。喻中，「良醫」喻小乘經，「解八藥」者正是八術，八中有藥名解八藥，喻小乘中備合藥法。「滅一切病」喻能治惑，「唯除必死」彰其分齊，明不能治犯四禁等。合中，「契經諸定如是」合前良醫，「能治一切」合滅一切，「而不能」下合除必死。小乘力微不能廣治，故犯四禁、五無間等，望於小乘齊名必死，不同大乘唯說闡提為必死耳。

Regarding the first pair, the former "furthermore" adduces the small to reveal the great, first with a metaphor and then an application. In the metaphor, "skilled physician" illustrates the Hīnayāna scriptures; "understands the eight medicines" refers precisely to the eight arts, and having medicines among the eight is called understanding the eight medicines, illustrating that the Hīnayāna fully possesses the methods of compounding medicines. "Extinguishing all illnesses" illustrates the ability to cure delusions; "excepting only those destined to die" marks the demarcation, clarifying that it cannot treat those who transgress the four prohibitions and the like. In the application, "The sūtras and various concentrations are likewise" applies to the aforementioned skilled physician; "can treat all" applies to extinguishing all; "yet cannot..." downward applies to excepting those destined to die. Because the power of the Hīnayāna is slight, it cannot treat extensively; therefore, transgressing the four prohibitions, the five unpardonable offenses, and the like, are equally termed "destined to die" in view of the Hīnayāna, unlike the Mahāyāna, which speaks only of the icchantika as destined to die.