Henry of Lancaster's Livre de Seyntz Medicines is a vividly medicalized penitential narrative composed by a leading lay nobleman of fourteenth-century England. Grounded in the physiology of the medieval heart, Lancaster's understudied Livre demonstrates how medieval medical discourses could act as a vehicle for spiritual and psychophysiological change. Combining cognitive theories that view the heart as the tablet of memory with a physiology of the heart as a breathing organ that creates and circulates spirit, the Livre synthesizes medicine, natural philosophy, and theology into a program for the reform of memory, imagination, and will. As it articulates this process of reform through a series of meditative surgeries, the text adapts sophisticated Latinate clerical discourses for lay use and consciously uses physiological processes to make its program of spiritual self-reform available in physically and spiritually concrete ways to those who read or hear the text.

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