Twisted sicker than mad cattle,

from Earl Sweatshirt – Earl Lyrics on Rap Genius

Meaning

Bovine spongiform encephalopathy (BSE) or mad cow disease, it is a fatal disease that can be transmitted to humans also. Cows infected can act ‘mad’ and therefore it’s called the mad cow disease

By “twisted” Earl means drunk and high at the same time(i.e. the following “six different liquors” line). The booze has him twisted sicker than mad cow disease, and that’s pretty sick.

Also, he refers to being “twisted” mentally (a sick mind)

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