First things first, you need to get the video portion working. Since it's a VESA/SVGA-only game, you probably have a video compatibility issue. 

Presuming you have a full VDMSound install (the main program, "Update 1", and the GUI Launchpad), edit the SCREAM.BAT file that the installer places in the game directory. Erase all text in that file, then use the GUI version of VDMSound on it (right-click, "Run with VDMS" with little musical note). 

This will create a .VLP file for SCREAM.BAT. Whenever you want to tweak the VDMSound settings, this where you should do it, using the .VLP shortcut. 

Now edit SCREAM.BAT to contain this: 

S.EXE vesa 

Close and save. 

Does video work now. Hopefully so. If not You might have to use NOLFB or a similar tool (this depends on your video card). 

For audio, Choose "SoundBlaster 16" for sound effects, and either "General Midi" or "SoundBlaster Pro (Old)" for music. 

If you choose "General Midi", you should change the properties of your .VLP file. Click advanced, click on the MIDI tab, then change the MIDI output device from "MIDI Mapper" to "Microsoft GS Wavetable", then OK, OK. This gives you better MIDI.