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You can try the following, that helped me quite a bit with performance, and helps with other Unity Engine games too that do not have these settings applied:
Go to your Pathologic\Pathologic_Data folder, in there, there's a boot.config file.
Edit the following two lines in there:
One of these just has a blank space after the = by default, change that to 1, and one of these lines is missing entirely. Just add the missing one. This SHOULD give you a significant performance increase.
Its definitely not an ugly game, its really striking and beautiful. The characters are some of the most artistically done for a lot of games, and also have a ton of realism. Its an incredibly artistic game in its look and detail. Even just the brick working and architecture are amazingly well done. What is a bit backwards however for this game is just how stiff it feels. The physics feel like an old man who lost his limberness 2 decades ago. It just feels incredibly stiff, the physics feel extremely structured and predictable. This isn't really a terrible thing as the games physics aren't whats cool about pathologic 2. But the game does feel extremely awkward at times.