The audio is completely messed up as a result of this producing extreme aliasing and ringing artefacts that quickly spirals into full blown clipping distortion when enough sounds are played at once, Audacity revealed this to me:

I'm too stupid to understand C++ and low level code, and I don't know enough audio engineering ontop of this. Is there some math going completely wrong to produce this result? This issue is extremely awful and I'd like to get this fixed but it might end up being vKLp will have to roll back everything before the pull request restoring the original audio routines that were going through SDL_mixer.
I know I'm not crazy because I've had fond memories of playing Descent on a actual MS-DOS machine on an actual SB16, I've seen Twitch streamers with similar old hardware and the audio DOES NOT screw up this badly like it's doing here.