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The Psychoanalytic Study of the Child
儿童的精神分析研究

(1950). Psychoanal. Study Child, (5):18-23
(1950). 精神分析学. 研究儿童, (5):18-23

Development of the Body Ego 11 11 ^(11){ }^{11}
身体自我发展 11 11 ^(11){ }^{11}

Willie Hoffer M.D. ( 1 ) ( 1 ) ^((1)){ }^{(1)}

In recent considerations on the genesis of mental structure Hartmann, Kris and Loewenstein (3) advocate a modification of Freud’s view on the origin of the ego as expounded by him in The Ego and the Id(1). They suggest with the support of impressive arguments that the ego should no longer be considered the result of differentiation from the id, but that both the ego and the id, should be conceived the result of differentiation from an undifferentiated state.
在最近关于心理结构起源的讨论中,哈特曼、克里斯和洛温斯坦(3)主张对弗洛伊德在《自我与本我》(1)中阐述的自我起源观点进行修改。他们以令人信服的论据支持,认为自我不再应被视为从本我中分化的结果,而是自我和本我都应被理解为从未分化状态中分化的结果。
Hartmann, Kris and Loewenstein explicitly “refrained from indicating at what point in early infancy the successive steps leading to structural differentiation take place,” but they state that the first and most fundamental step leading to it “concerns the ability of the infant to distinguish between the self and the world around him.” This agrees with Freud’s own thoughts on ego formation according to which “the ego is the part of the id which has been modified by the direct influence of the external world acting through the Pcpt-Cs” (PerceptualConsciousness).
哈特曼、克里斯和洛温斯坦明确“避免指出在早期婴儿期结构分化的连续步骤发生的具体时间”,但他们表示,导致这一点的第一步也是最基本的一步“涉及婴儿区分自我与周围世界的能力。”这与弗洛伊德关于自我形成的思想一致,根据他的观点,“自我是本我中受到外部世界通过感知意识直接影响而改变的部分。”
But there is, according to Freud, another differentiating agency which, instead of being tuned to stimulation from outside, responds to stimuli from within the organ system. Under certain conditions instinctual drives not only act on the bodily and mental apparatus but merely by operating within the organism cause changing states of tension or demands and relaxations which are registered within the body in respect to their intensity and perhaps the locality where they arise. I mean the very first sensations and the earliest processes of discharge following an excitation. Freud spoke of internal perceptions which, in contrast to external ones, are more fundamental and more elementary.
但根据弗洛伊德的说法,还有另一种区分机制,它不是调节外部刺激,而是对来自内部的刺激做出反应。在某些条件下,本能驱动不仅作用于身体和心理机制,而且仅通过在有机体内的运作,导致紧张状态或需求和放松的变化,这些变化在身体内以其强度和可能出现的部位被记录。我指的是最初的感觉和兴奋后最早的释放过程。弗洛伊德提到的内部感知与外部感知相比,更为根本和基本。

SELF, BODY AND OBJECT 自我、身体和物体

The visual, auditory and olfactory apparatus has a definite relation to our interest in the outer world which in the most primitive language is the “notself.” On it the environmentalists among us concentrate when
视觉、听觉和嗅觉器官与我们对外部世界的兴趣有着明确的关系,在最原始的语言中,这被称为“非自我”。在这方面,我们中的环境主义者集中注意力,当

1 1 ^(1){ }^{1} Contribution to the Panel on “Psychoanalysis and Developmental Psychology,” held at the Meeting of the American Psychoanalytic Association in Detroit on April 29, 1950.
在 1950 年 4 月 29 日于底特律举行的美国精神分析协会会议上,关于“精神分析与发展心理学”的小组贡献。

studying early ego functions. In contrast, inner perception seems according to Freud to be related at first to the pleasure-pain series. In other words: the experience of pleasure and of a self emerges in consequence of the relief of pain (relief of stimulation calling for restoration of the previous condition or of the relief of an increase of inner demands). This relief happens in two stages: 1) by an attempted relief due to an inner-psychical act, called “negative hallucination,” 2) by a physical act of discharge which in the first instance we can only interpret as the organism’s attempt to rid itself of a surplus stimulation (or inner demand).
研究早期自我功能。相反,内在感知似乎根据弗洛伊德的说法,最初与快乐-痛苦系列有关。换句话说:快乐的体验和自我的出现是由于痛苦的缓解(缓解刺激要求恢复先前状态或缓解内在需求增加)。这种缓解发生在两个阶段:1)通过一种内心心理行为的尝试性缓解,称为“负性幻觉”,2)通过一种身体释放的行为,在第一种情况下,我们只能将其解释为有机体试图摆脱多余刺激(或内在需求)。
Negative hallucination refers to the temporary abolition of a stimulus, inside or outside the body, not to the abolition of the mental representation of such stimuli like in repression. Negative hallucination is, therefore, in later life related to the pathological state of derealisation (Entfremdungsgefühl) and connotes one of the earliest and most primitive of mental processes.
负性幻觉是指对体内或体外刺激的暂时消失,而不是像压抑那样对这些刺激的心理表征的消失。因此,负性幻觉在后来的生活中与非现实感(Entfremdungsgefühl)的病理状态相关,并且暗示了最早和最原始的心理过程之一。
We feel on firm ground, however, as soon as we think of mental processes which characterize the spread of the feeling of self over the infant’s body, in which the self is housed. When the body is seen-after sight has been sufficiently developed-it is perceived like any other object reaching the infant’s mind, by the organ of vision. Quite different is the effect of the perceptual experience when the infant touches his body. Here two sensations simultaneously yield an experience, and this may arise very early in life, perhaps even in the intrauterine state. Our own experience when touching the body makes us think of one part of our body, the hand for instance actively approaching another part which passively experiences being touched. There seems no simple justification for assuming that the same happens in early infancy. Coming in touch with its own body elicits two sensations of the same quality and these lead to the distinction between the self and the not-self, between body and what subsequently becomes environment. In consequence this factor contributes to the processes of structural differentiation.
然而,当我们想到那些特征化自我感觉在婴儿身体上扩散的心理过程时,我们感到站在坚实的基础上。在视觉发展到足够的程度后,身体被看见时,就像任何其他物体一样,通过视觉器官进入婴儿的意识。当婴儿触摸自己的身体时,感知体验的效果则截然不同。在这里,两种感觉同时产生一种体验,这种体验可能在生命的早期阶段产生,甚至可能在子宫内状态下就已存在。我们在触摸身体时的体验使我们想到身体的一部分,例如手主动接触另一部分,而后者被动地体验被触摸。似乎没有简单的理由假设在早期婴儿期也会发生同样的事情。与自己身体的接触引发了两种相同质量的感觉,这些感觉导致了自我与非自我、身体与随后成为环境的事物之间的区别。因此,这一因素有助于结构分化的过程。

Delimitation between the self-body and the outer world, the world where the objects are found, is thus initiated.
自我身体与外部世界之间的划分由此开始,外部世界是物体存在的地方。

THE MOUTH-EGO 嘴-自我

In psychoanalysis we define the structural entity ego according to its function. In our clinical work they manifest themselves in highly organized and differentiated psychic activities. In childhood and especially in infancy they have a definite physical, bodily connotation.
在精神分析中,我们根据其功能定义结构实体自我。在我们的临床工作中,它们表现为高度组织和差异化的心理活动。在儿童时期,尤其是在婴儿期,它们具有明确的身体、肉体含义。
On another occasion (4) I have described the difference between a drive (instinct) gratification as such and one interfered with by a functioning
在另一个场合,我描述了驱动(本能)满足本身与被功能干扰之间的区别

ego. To summarize it once more: there is a striking difference between infants at the age of up to ten weeks as compared with those of twelve to sixteen weeks. An infant of four weeks when slightly hungry and waiting to be fed may display some oral activities, accompanied by movements of the head, arms and hands. The hands may still be kept in a position resembling the uterine position where the hands were nearest to the mouth (6), (2). While the hand is moving over the face the mouth may get hold of it and finger-sucking will ensue. Until a few weeks old it will not make much difference whether the whole hand or one or two fingers slip into the mouth, whether a bottle or a comforter has been offered to the baby. The behavior which it displays is (a) motor excitation, most probably due to hunger and influenced by former feeding experiences (searching for the breast) and (b) attempts to relieve the excitation by mouth activities which may lead to finger-sucking.
自我。再总结一次:十周以下的婴儿与十二到十六周的婴儿之间存在显著差异。四周大的婴儿在稍微饿的时候等待喂养,可能会表现出一些口腔活动,伴随着头部、手臂和手的运动。手可能仍然保持在类似于子宫的位置,手靠近嘴巴(6),(2)。当手在脸上移动时,嘴巴可能会抓住它,随后会出现吮指行为。在几周大的时候,无论是整个手还是一两个手指滑入嘴里,或者是给婴儿提供奶瓶或安抚物,都不会有太大区别。它表现出的行为是(a)运动兴奋,最可能是由于饥饿并受到以往喂养经验的影响(寻找乳房),以及(b)通过口腔活动尝试缓解兴奋,这可能导致吮指。
Quite different is the behavior observed in a sixteen-weeks-old infant. Little is left to chance gratification. During the state of expectancy before being fed or after a successful feed the infant may insist on a definite form of oral-sucking gratification and the activities leading to this gratification comply with almost all the criteria by which we assess ego functioning.
在一个十六周大的婴儿身上观察到的行为截然不同。几乎没有机会满足其需求。在喂食前的期待状态或成功喂食后的状态中,婴儿可能会坚持一种明确的口腔吸吮满足形式,而导致这种满足的活动几乎符合我们评估自我功能的所有标准。
There is: 有:
  1. Genuine Perceptual Activity. The infant of three months sees his hand, focuses on it, follows with his eyes its movements towards the mouth. If the infant’s eyes catch another visual stimulus, especially something moving, they may be distracted but will return to the hand which tends towards the mouth. In the setting described there is true perception.
    真实的感知活动。三个月大的婴儿看到自己的手,专注于它,眼睛跟随它向嘴巴移动的动作。如果婴儿的眼睛捕捉到另一个视觉刺激,尤其是移动的东西,他们可能会分心,但会回到向嘴巴移动的手上。在所描述的环境中,存在真正的感知。
  2. Motor Control. The movement of the hand towards the mouth may be achieved only with great difficulty; chance movements are either impossible or the infant counteracts them; it tries to aid the hand which has to be sucked.
    运动控制。手向嘴巴移动可能仅在极大困难下实现;偶然的动作要么不可能,要么婴儿会抵消它们;它试图帮助需要被吸吮的手。
When the eyes participate in the control of movement towards the mouth there seems to be a pleasant realization on the side of the space which is within reach of the arms and hands. The mouth-ego has widened to the space embraced by the arms.
当眼睛参与控制向嘴巴移动时,似乎在手臂和手能够触及的空间一侧有一种愉悦的意识。嘴巴自我已经扩展到手臂所包围的空间。

3. Functioning of Memory is suggested by the specific mode of gratification which is achieved by finger-sucking. Out of a vast free choice of possible positions of the hand and fingers, the infant develops and adheres to a number of sucking patterns, involving either his hand and fingers or his mouth or both.
3. 记忆的功能通过吮吸手指所获得的特定满足模式得以体现。在众多可能的手和手指的位置中,婴儿发展并坚持多种吮吸模式,这些模式涉及他的手和手指、嘴巴或两者。

4. Reality Testing can be traced by the infant’s meticulous choice of what he wishes to introduce into the mouth. When he wishes to use the fingers, he will reject the spoon or comforter or breast. Some infants display a minor feeding difficulty seldom mentioned by insisting on sucking
4. 现实测试可以通过婴儿对他希望放入口中的物品的细致选择来追踪。当他希望使用手指时,他会拒绝勺子、安抚奶嘴或乳房。一些婴儿表现出一种很少被提及的轻微喂养困难,坚决要求吮吸。

the fingers while being fed. This competition between feeding and fingersucking seems to be a further proof of the infant’s knowledge and understanding of mouth and hand in their relation to each other. No such specificity has generally been assumed for the infant’s relationship to the nursing mother, the breast or the bottle and no definite individual picture of an “object” seems yet to have been created in the child’s mind at that age. It should, however, be possible to put these problems to the test by experimentally investigating the infant’s reality testing with regard to objects which do not convey the feeling of self.
在喂食时的手指。这种喂食与吮指之间的竞争似乎进一步证明了婴儿对嘴和手之间关系的知识和理解。一般来说,婴儿与哺乳母亲、乳房或奶瓶的关系并没有被假定为如此具体,而且在这个年龄段,孩子的心中似乎还没有形成“物体”的明确个体形象。然而,通过实验性地研究婴儿对不传达自我感觉的物体的现实测试,这些问题应该是可以得到检验的。

5. Synthetic Function of the Ego. No definite suggestion about the operating of the synthetic function in early infancy characterizing what I called the “mouthego” can be put forward. But this may be merely due to lack of observational evidence or to the nursing mother’s activity who at this early stage may make this function unnecessary.
5. 自我合成功能。关于我所称的“口腔自我”在早期婴儿期合成功能的运作,没有明确的建议可以提出。但这可能仅仅是由于缺乏观察证据或是哺乳母亲的活动,在这个早期阶段可能使这一功能变得不必要。

MOUTH-EGO AND BODY-EGO 嘴-自我和身体-自我

With the help of the hand the oral-sucking drive undergoes a transformation from an instinctual demand to an ego-controlled activity. In the course of this process the hand, like the mouth, is perceived as part of the self and the differentiation between self and not-self is thus carried forward. All these processes have so far been confined to the oral phase of instinct and ego development. 2 2 ^(2){ }^{2}
在手的帮助下,口腔吸吮驱动从本能需求转变为自我控制的活动。在这个过程中,手像嘴一样被视为自我的一部分,因此自我与非自我之间的区分得以推进。到目前为止,所有这些过程都局限于本能和自我发展的口腔阶段。
With the emergence of a real mouth-ego the hand acquires the properties of a tool for the execution of needs serving the interests of the self. To give an example: a successful feed will in the first weeks of life be followed by sleep, almost immediately; when the mouth-ego is established satiation will be followed by two needs, sucking and sleep; thus the infant will actively introduce his fingers into the mouth, and will concentrate on this activity until it is achieved. Thus it serves the need for sleep as well. There is, we assume, no struggle between the two needs; the gratification of one leads to the gratification of the other. In this way the self has put itself in control of needs, a form of independence and an ability to channel instinctual drives according to earlier experiences.
随着真实口腔自我的出现,手获得了作为工具的特性,以满足自我利益的需求。举个例子:在生命的最初几周,成功的喂养几乎会立即伴随睡眠;当口腔自我建立后,满足感将伴随两种需求,吮吸和睡眠;因此,婴儿会主动将手指放入嘴中,并专注于这一活动,直到实现。因此,它也满足了睡眠的需求。我们假设,这两种需求之间没有斗争;一种需求的满足导致另一种需求的满足。通过这种方式,自我控制了需求,形成了一种独立性,并能够根据早期经验引导本能驱动。
In consequence, in the oral-sadistic phase aggressive impulses are already drawn away from the body and, I assume, directed into oral-biting activities which do not affect the self. In short, the self tries to protect itself against its own aggressive feelings-originating in instinctual demands-by directing them through the body organs towards the non-self, the outer world. This involves progressive libidinization of the body, and prepares the way for the integration of the subsequent instinctual stages
因此,在口腔-施虐阶段,攻击性冲动已经从身体中抽离出来,我假设,这些冲动被引导到口腔咬合活动中,而不影响自我。简而言之,自我试图通过将这些源于本能需求的攻击性情感引导通过身体器官指向非自我、外部世界来保护自己。这涉及到身体的逐步性欲化,并为后续本能阶段的整合铺平道路。

2 2 ^(2){ }^{2} The administration of the breast or bottle may stimulate formation of object relation at the expense of body-ego formation.
2 2 ^(2){ }^{2} 乳房或奶瓶的喂养可能会刺激物体关系的形成,而以身体自我形成为代价。

into the ego organization. I believe there is continuity of ego development and integrative endeavor at work, in parts very successful.
进入自我组织。我相信自我发展和整合努力在运作中是连续的,在某些方面非常成功。

FATE OF AGGRESSION DURING THE DEVELOPMENT OF THE BODY-EGO
身体自我发展中的攻击命运

Progressive libidinization of the infantile body and growth of the body-ego can only be assumed if self-destructive drives are either dealt with within the body or diverted elsewhere outside it. The fact that there is an increase of motor activity from the second half of the first year onwards supports the second alternative. It is primarily the pain barrier which protects the infant against his destructive instinct turning against his own self (5). In addition owing to the nursing activities but also to the mouth-hand relationship the process of libidinization of the body rises to the level of self-love. Increase of primary narcissism forms a second protective barrier. This occurs in the oral-sadistic stage characterized by the appearance of the teeth and heightened oral-
婴儿身体的逐步性欲化和身体自我的成长只能在自我毁灭的驱动力要么在身体内部处理,要么转移到身体外部的情况下假设。从第一年下半年的运动活动增加这一事实支持了第二种选择。主要是痛苦的屏障保护婴儿免受其破坏性本能对自身的反作用。此外,由于哺乳活动以及口手关系,身体的性欲化过程上升到自爱水平。原始自恋的增加形成了第二道保护屏障。这发生在口腔-施虐阶段,其特征是牙齿的出现和口腔需求的增强。

aggressive stimulation. The infant does not hurt himself because he likes himself so much. This statement does not contradict the concept of erotogenic masochism, but when speaking here of self-destructiveness this should be understood literally. When these steps towards deflection of selfdestructiveness fail, damage to oneself by biting, refusal of food and starvation open up the subject of the pathology of the body-ego.
攻击性刺激。婴儿不会伤害自己,因为他非常喜欢自己。这句话并不与性快感的自虐主义概念相矛盾,但在这里谈到自我毁灭时,这应该被字面理解。当这些转移自我毁灭的步骤失败时,通过咬自己、拒绝食物和饥饿造成的自我伤害揭示了身体自我病理学的话题。

CLINICAL IMPLICATIONS OF THE BODY-EGO
身体自我在临床中的意义

From what has been said of the path of early ego development it seems to me conceivable that, except for the experience of birth, the infant is equipped with the means of achieving equilibrium between his inner needs without necessarily heading towards traumatization. Still, infants may have to pass through and even succumb to most painful states of a traumatic character, in the sense that the quantity of excitation aroused is beyond the infant’s ability to master. Three possible sources of traumatization can be visualized:
从早期自我发展的路径所说的来看,除了出生的经历,婴儿似乎具备了在内心需求之间实现平衡的手段,而不必必然走向创伤化。然而,婴儿可能不得不经历甚至屈服于大多数痛苦的创伤状态,因为所引发的兴奋量超出了婴儿的掌控能力。可以想象三种可能的创伤来源:
  1. Increase of excitation (stimulation). As an example I mention the process of teething. This arouses inner-perceptual activities with which the self has to deal by means of (a) negative hallucination, which will be of short duration (withdrawal of cathexis from the sensation); (b) loss of oral sucking activity and of appetite, which corresponds to withdrawal of cathexis from the organ and its accustomed activity (extinction of oral-erotic desires); © turning inwards of oral aggression not utilized in the feeding process which is refused; (d) attempts at ego control of stimulation by biting the finger or hand with the gums, which are in
    兴奋(刺激)的增加。举个例子,我提到出牙的过程。这激发了内在的感知活动,自我必须通过以下方式处理:(a)负性幻觉,这将是短暂的(从感觉中撤回心理能量);(b)口腔吮吸活动和食欲的丧失,这对应于从器官及其习惯活动中撤回心理能量(口腔性欲的消退);(c)未在拒绝的喂养过程中利用的口腔攻击向内转化;(d)通过用牙龈咬手指或手来尝试对刺激的自我控制。

    fact attempts at integration of pain with the help of the hand; (e) failure of these attempts and cessation of self-control expressed in crying and convulsive activities.
    事实尝试通过手的帮助将疼痛整合;(e)这些尝试的失败和自我控制的停止表现为哭泣和抽搐活动。
The solutions found (a-e) may become paradigmatic for subsequent states of increased excitation (pathology of the body-ego).
所找到的解决方案(a-e)可能成为后续兴奋状态(身体自我病理)的范例。

2. Inadequacy of the self in dealing with excitation (stimulation). The self emerges as a function of the interaction between inner drive (stimulation) and the apparatus (bodily organs like the mouth) through which the drive acts.
2. 自我在处理兴奋(刺激)时的不足。自我是内在驱动(刺激)与通过其作用的器官(如口腔)之间互动的函数。

Sometimes this interaction seems inert, though there are ample signs of the presence of stimulation. the instinctual drive meets a body and a self which respond only slowly. This may mean mere delay of ego development which
有时这种互动似乎是无动于衷的,尽管有很多刺激存在的迹象。本能驱动遇到一个身体和一个自我,它们的反应却很缓慢。这可能意味着自我发展的单纯延迟。

need not be of any clinical significance, but it may also mean that ego development has been retarded to such a degree that it has fallen out of step with the instinctual development. Translated into the teething period it means that, while the teeth break through accompanied by a comparatively enormous increase of oral-sadistic stimulation, neither the stomach and intestinal apparatus nor the mouth, tongue and hand have sufficiently achieved the state of body-ego maturity which would be needed to master the quantity of oralsadistic excitation, in itself normal.
不一定具有任何临床意义,但这也可能意味着自我发展已经被延迟到一种程度,以至于它与本能发展脱节。翻译成出牙期,这意味着,虽然牙齿突破伴随着相对巨大的口腔施虐刺激,但胃肠系统以及口腔、舌头和手并没有充分达到掌握正常的口腔施虐兴奋所需的身体自我成熟状态。

3. Failure of the “Not-Self.” By this I mean the defect or excess displayed by the nursing mother, who is called upon to remove what interferes with the quiet growth of the self until it turns to the object as such. From the point of view of the infant’s inner economy this failure results either in an increase of excitation or in the self’s becoming inadequate for the dealing with normal excitation. Too little milk heightens the demand for abolishing hunger; enough food, enough intake, but inadequate administration does the same. In both conditions the infant will react as if only his inner excitation were raised. His capability of controlling excitation is low, but within its range the self makes use of the body and the apparatus as if it were acting thoughtfully and with foresight.
3. “非自我”的失败。我的意思是,哺乳母亲所表现出的缺陷或过度,她被要求去除那些妨碍自我安静成长的因素,直到它转向对象本身。从婴儿内在经济的角度来看,这种失败导致的结果要么是兴奋的增加,要么是自我在处理正常兴奋时变得不足。牛奶太少会加大对消除饥饿的需求;食物足够,摄入量足够,但管理不当也会产生同样的效果。在这两种情况下,婴儿的反应就像他的内在兴奋被提升了一样。他控制兴奋的能力较低,但在其范围内,自我利用身体和器官,仿佛是在深思熟虑和有远见地行动。

REFERENCES 参考文献

Freud, S.The Ego and the IdHogarth, London,1923
弗洛伊德,S. 自我与本我 霍加斯,伦敦,1923

Gesell, A. and Ilg, F. L. Feeding Behavior of Infants Lippincott, Philadelphia, 1937
Gesell, A. 和 Ilg, F. L. 婴儿的喂养行为 Lippincott, 费城, 1937
Hartmann, H., Kris,E. and Loewenstein, R. M. “Comments on the Formation of Psychic Structure,” Psychoanal. Study Child II 1946
Hartmann, H., Kris, E. 和 Loewenstein, R. M. “关于心理结构形成的评论,”心理分析儿童研究 II 1946
Hoffer, W. “Mouth, Hand and Ego Integration,” Psychoanal. Study Child III/IV 1949
霍弗,W. “口、手与自我整合,”心理分析。儿童研究 III/IV 1949
Hoffer, W. “Oral Aggressiveness and Ego Development,” Int. J. Psychoanal. XXXI 1950
霍弗,W. “口头攻击性与自我发展,”国际精神分析杂志 XXXI 1950
Preyer, W. Die Seele des Kindes Th. Grieben Verlag, Leipzig, 1895

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