The Koimesis, or "falling asleep in death," of the Virgin is first found in Byzantine art in the 900s. This image would become one of the most popular icons in the Middle and Late Byzantine world, often appearing over the doors of churches to be contemplated by the faithful as they left the service. In painted icons and in ivory ones like this example, the Virgin is shown lying on a bier, or pallet, for the dead. Christ stands behind her holding up her soul, as if it were a baby, offering it to attendant angels to take to heaven. The apostles stand witness, led by Saint Paul at her feet and Saint Peter behind her head. The holes on the ivory suggest that it may have been used as decoration on a book cover, probably in the Latin West, where Byzantine ivories were prized for such purposes.

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