I alternate between using Dreamweaver MX 2004 and hand-coding. I primarily use Dreamweaver when I'm trying to do more complicated designs as I have trouble hand-coding really complex stuff.
When hand-coding, I use Optima Systems' PageSpinner 4.6 for Mac OS X. Very good and very simple WYSIWYG editor. Textedit works in a pinch, but syntax coloring is very useful
