In the central medallion, the lamb with seven horns and seven eyes takes the book with the seven seals from the Son of Man. "And when he had opened the book, the four living creatures, and the four-and-twenty elders fell down before the Lamb, having every one of them harps, and golden vessels full of aromatic spices, which are the prayers of saints. And they sang a new canticle." (Apocalypse 5:8-9)
The illuminator rendered this visionary imagery in a remarkably literal manner. The lamb stands on his hind legs to receive the book. To the left and right, the elders' instruments fall from their hands as they kneel.