Hi,
After some experimentation, I figured out how to optimize the game for running on my 1920x1080 monitor, and I thought I'd share it with anyone else who might need help.

- In the IHNMAIMS game folder, open dosboxnomouth.config in Notepad.
Under [sdl]:
- Change "fulldouble=false" to "true".
- Change "fullresolution=original" to "1920x1080".
- Change "output=surface" to "opengl". (You might have to experiment with this, depending on your video card. From the notes in the file: "Possible values: surface, overlay, opengl, openglnb, ddraw.")
Under [render]
- Change "aspect=false" to "true"

The graphics are now much sharper while maintaining the original 4:3 aspect ratio.

I also was experiencing the audio stuttering problem, so while in the file, under [mixer], change "prebuffer=20" to "100". (This I learned from the thread below, so thanks to those guys, sorry, I forgot your handles!)

The game now runs perfectly for me. Hopefully this will help you, too.

Thanks so much for this! Really helps to get the game to be more easier on the eyes!

The GOG supplied graphics mode setup didn't work for me, so thanks for sharing this!

Thank you! I don't know why I didn't check that file because apparently GOG graphics mode was checked yet nothing happened. Good to know OpenGl seem to be working too, I usually have some trouble finding a decent render with dosbox.

Does anyone know how to get a more modern feel with the mouse? It feels sluggish but consistent so it's likely an option I need to change rather than find a glitch.

this really helped me, too.
i also changed "fullscreen=false" to "true" and now it runs perfect

thank you very much :-)

I nearly always use opengl (specifically openglnb because I hate the filter of default opengl) but there are points at which I Have No Mouth crashes on me in opengl mode (specifically I encountered this after solving the bathroom stall riddle). So even if it looks better, it's probably not the best choice for this particular game.