After much research here's what I came up with:
.bat file
SET FX_GLIDE_SWAPINTERVAL=0
SET FX_GLIDE_NO_SPLASH=1
SET SST_FASTMEM=1
SET SST_FASTPCIRD=1
SET SST_SWAP_EN_WAIT_ON_VSYNC=0
SET SST_SCREENREFRESH=60
SET SST_VIDEO_24BPP=1
SET SST_RGAMMA=1.80
SET SST_GGAMMA=1.80
SET SST_BGAMMA=1.80
SET SST_GRXCLK=59*
c:\quake2\quake2.exe -zone 512 +set gl_mode 3 -nocdaudio -nojoy +disconnect +toggleconsole +menu_multiplayer %1 %2 %3 %4 %5 %6 %7 %8 %9
*This has been overclocked. Lots of recommendations say don't raise it over 57, but I figure I have cooling so it'll be fine :)
.cfg file
//GL
set intensity "2.0"
set gl_shadows "0"
set gl_dynamic "1"
set gl_finish "0"
set gl_playermip "0"
set gl_picmip "0"
set gl_skymip "1"
set gl_polyblend "0"
set gl_ztrick "1"
set gl_cull "1"
set gl_round_down "1"
set gl_keeptjunctions "0"
set gl_ext_palettedtexture "1"
set gl_ext_swapinterval "1"
set gl_swapinterval "0"
set gl_ext_pointparameters "0"
set gl_flashblend "0"
set gl_modulate "2"
set gl_shadows "0"
set gl_texturemode "GL_LINEAR_MIPMAP_NEAREST"
With this config I can get about 33.4fps @ 640x480. with my p166 (o/c to 187) and 64meg running timedemo/demomap demo1.dm2.
Not too shabby I think and very playable.
Making a .bat file for Q2 was one thing that really helped.