Great question. This should answer (basically smaller movies used generic sheets, but big movies would have scores). In big theatres, there could be a small orchestra playing this score (organs included!); in smaller theaters just a single piano.
https://en.wikipedia.org/wiki/Silent_film#Live_music_and_sound
QUOTE:
Starting with the mostly original score composed by Joseph Carl Breil for D. W. Griffith's groundbreaking epic The Birth of a Nation (USA, 1915) it became relatively common for the biggest-budgeted films to arrive at the exhibiting theater with original, specially composed scores.[11] However, the first designated full blown scores were composed earlier, in 1908, by Camille Saint-Saƫns, for The Assassination of the Duke of Guise,[12] and by Mikhail Ippolitov-Ivanov, for Stenka Razin.
When organists or pianists used sheet music, they still might add improvisational flourishes to heighten the drama on screen. Even when special effects were not indicated in the score, if an organist was playing a theater organ capable of an unusual sound effect, such as a "galloping horses" effect, it would be used for dramatic horseback chases.
By the height of the silent era, movies were the single largest source of employment for instrumental musicians (at least in America). But the introduction of talkies, which happened simultaneously with the onset of the Great Depression, was devastating to many musicians.
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