The World Against Him (1916)

Cowboy Mark West lives on a ranch with his sister Mary, who suffers from a serious spinal disorder. Flighty East Coast socialite Violet Ridgeway flirts with Mark while vacationing at the ranch but returns to her fiancée, Dr. Welsh, when she leaves. Mark has been working hard to earn money for an operation Mary, which Doctor Welsh and Doctor Boyd agree to perform without telling him how dangerous it is. When Mary dies Mark receives a letter detailing the doctor’s risk-taking, filled with vengeance Mark kills Boyd, but Welsh flees to safety. Mark is imprisoned, but Violet convinces him to marry her, satisfying a stipulation in her late aunt's will. Mark escapes taking Welsh and Violet hostage. They are set upon by a villain and in the confrontation Welsh’s cowardly act shows Violet Mark’s true worth and the pair escapes to freedom across the Canadian border.