304 LAWS OF MARYLAND. [CH. 336

First. That there was an accidental injury causing hernia,
arising out of and in the course of the employee's employ-
ment; or that the claimant sustained a hernia resulting from
a strain arising out of and in the course of his or her employ-
ment.

Second. That the hernia did not exist prior to the injury
or strain for which compensation is claimed; provided that
if as the result of an accidental injury, or as the result of a
strain, arising out of and in the course of the employee's em-
ployment a pre-existing hernia becomes so strangulated that an
immediate operation is necessary, the provision of this sub-
paragraph requiring proof that hernia did not exist prior to
the injury for which compensation is claimed shall not apply.
Third. That, anything in this Article respecting notice to
the contrary notwithstanding, such injury or strain was re-
ported to the employer within ten days next following its
occurrence.

All hernia, inguinal, femoral or otherwise, so proven to be
the result of such injury or strain, shall be treated in a sur-
gical manner by operation whenever practicable. If death
results from such operation, the death shall be considered as
a result of the injury, or strain, and compensation paid in
accordance with the provisions of this section. In non-fatal
cases, time loss only shall be compensated, provided, however,
that such compensation shall not be for a period of time
longer than eight (8) weeks, unless it is shown by special
examination that the injured employee has a permanent par-
tial or permanent total or temporary total disability resulting
from the operation. If so, compensation shall be paid in
accordance with the provisions of this Article, with reference
to permanent partial disability or permanent total or tempo-
rary total disability as the case may be.

In case the injured employee refuses to undergo an opera-
tion for the cure of the said hernia, he shall be allowed com-
pensation for a period of seven and one-half (7 1/2) weeks, and
if it be shown to the satisfaction of the Commission that be-
cause of age or previous physical condition, it is considered
unsafe for the employee to undergo such operation, such re-
fusal may be excused by the Commission, in which event the
employee shall be allowed compensation for the period of ac-
tual disability resulting from such hernia, not to exceed fifty-
two (52) weeks, and in either event such payments shall be
in lieu of all benefits for or on account of disability or death
resulting or alleged to have resulted from such injury.

SEC. 2. And be it -further enacted, That this Act shall take
effect June 1, 1945.

Approved March 24, 1945.