“Tic-Dolly-row” is an obscure colloquial reference to a disease known as trigeminal neuralgia, a neuropathic disorder characterized by sequences of extremely painful spasms or “ticks” in the facial muscles of the sufferer. The condition, also known as  tic douloureux (the phrase in French, which seems to be the one that Stubb has encountered, can be translate as “excruciating tick”), commonly afflicts individuals surpassing the age of fifty, but cases have been documented during infancy. The pain, which is the tell-tale symptom of trigeminal neuralgia, and which can occur randomly or from direct stimulus, has earned this condition the reputation of one of the more discomforting and disturbing afflictions of humankind. It is Ahab who is obscurely diagnosed with this affliction by his second-mate, Stubb, in Chapter 29 of Moby-Dick.

Muttering to himself as he descends the cabin-scuttle to his berth (after Ahab has taken none too kindly to his suggestions to wrap the peg-leg in a wad of tau to muffle the sound of his habitual pacing of the decks by night—“‘Down, dog, and kennel!’”), Stubb recalls a report he heard from the ship’s steward about the state of Ahab’s cabin and the old captain’s sleep habits (or lack thereof).

“He ain’t in his bed now, either, more than three hours of the twenty-four; and he doesn’t sleep then. Didn’t that Dough-Boy […] tell me that of a morning he always finds the old man’s hammock clothes all rumpled and tumbled, and the sheets down at the foot, and the coverlid almost tied into knots, and the pillow a sort of frightful hot, as though a baked brick had been on it? A hot old man! I guess he’s got what some folks ashore call a conscience; it’s a kind of Tic-Dolly-row they say—worse nor a toothache. Well, well; I don’t know what it is but keep me from catching it.”

In the midst of Stubb’s wild attempt to understand the “queer” behavior of his captain, an eerily apt diagnosis of Ahab’s malady emerges. Its various symptoms have been well noted by the crew. As Stubb has just braved informing Ahab, everyone sleeping below deck can hear that the old man isn’t often trying to sleep but rather restlessly pacing the quarter-deck. Dough Boy has told him that Ahab’s bedclothes are regularly found twisted into knots and his pillow “a sort of frightful hot.” So, Stubb reasons, when the old man is trying to sleep, he isn’t having much success. Of course, the pain associated with trigeminal neuralgia, indeed “worse nor a toothache,” would keep Ahab up at night; that condition might explain, too, the haunting, twisted aspect of Ahab’s face when he raged at Stubb’s suggestion to wad him (like a cannonball, Ahab says): “‘I was so taken aback with his brow, somehow. It flashed like a bleached bone.’” In Stubb’s estimation, Ahab’s sleeplessness is less cause than symptom of his malady. What he diagnoses the old man with is a “conscience,” which allows us (readers) to understand Ahab’s “Tic-Dolly-row” as Moby Dick himself. The captain’s pain is constant but not consistent; it can ascend slowly from the depths or arrive suddenly like a paralyzing electric shock.

Postscript—It is “queer’’ (isn’t it?), Stubb’s familiarity with this term. He is knowledgeable enough to use it in an abstract fashion yet unlearned enough to mispronounce it “Tic-Dolly-row.” Are we to imagine Stubb idly sitting against the mast, pipe in hand, flipping through an old medical textbook, studying obscure and rare medical conditions? Puffing monotonously, he would glance over this strange, foreign word and, whilst fascinated by the condition, manage to pronounce the word in a fashion phonetically accessible to him: “Tic-Dolly-row.” Perhaps he overheard the term in a bar or some other public place; he attributes the phrase to “folks ashore,” after all. Either way, it is a novel view of Ahab Stubb affords even as he affords us (readers) a novel view of himself. He gleaned a phrase, perhaps with the intention of one day dazzling a random conversational partner with his advanced knowledge of neurological disorder. And yet, here he is, just talking to himself.