How does the Cistern work?

[kastanok]

Huh... I just remembered, having played it twice, that the fleshy growths only appeared on my first play through. I imagine its appearance is linked to your play style in some way.

As for the voice, I get the impression it was someone still living in a torture chamber way below and every time I turned a switch, they got flooded with more water. Water cascading, pounding over their head and shoulders and rising up around him until, with the final valve released, it rose above is head... and he would cry no more.