Esther Hill Hawks and her husband Milton are in their way typical exemplars of what historian Allan Nevins termed the pulse of reform that beat so strongly in mid-19th-century America. Born in New Hampshire of solid New England stock, they were committed to a lifetime of causes, most notably the abolition of slavery. Milton was a doctor in practice in Manchester, N.H., when they married in 1854. They spent the first months of their marriage in Florida, where Esther taught at a school for black children -- risking imprisonment had complaint been made -- and read her husband's medical texts. In 1857, having completed the required 34 weeks of study, she graduated from the New England Female Medical College in Boston. A pioneer in the tiny cadre of women doctors, she opened a practice in Manchester while continuing to be, a friend recalled, "a pronounced anti-slavery agitator."

With the coming of the Civil War, Esther Hawks hurried to Washington to offer her services. Nursing was as close as she could come to utilizing her medical skills, but even in that she was disappointed. Dorothea L. Dix, superintendent of nurses, considered her too young (she was 28) and too attractive to be in such close proximity to soldiers, sick or wounded though they might be. Hawks contented herself with volunteer work as a hospital orderly, extending her services to the wretched camps where runaway slaves were put while the government tried to figure out what to do with this new kind of war contraband.

There was a similar situation in the Sea Islands, off the South Atlantic coast. In November 1861 the federal navy seized a base for its blockading squadron at Port Royal Sound, S.C., and immediately became host to thousands of abandoned and runaway blacks. Milton Hawks went to the Sea Islands in the spring of 1862 to minister to this population. Six months later he became an army surgeon in the 1st South Carolina, the first black regiment recruited from among slaves. Soon afterward Esther joined him. She came as a teacher employed by a private agency to bring education, one of her students wrote, to those previously denied "all larning and lost from all of the enjoyment of this life. . . ."

Esther Hawks kept a diary to the end of the war and well into Reconstruction, detailing her life, mostly as a teacher, in the Sea Islands, in Florida and finally in Charleston. Its fate was unknown until 1975, when it was discovered in an apartment undergoing renovation in Essex County, Mass., where she had spent the last years of her life. Gerald Schwartz, professor of history at Western Carolina University, has transcribed and annotated the diary, skillfully outlined the lives of Esther and Milton Hawks before and after the war and titled it "A Woman Doctor's Civil War: Esther Hill Hawks' Diary."

The title seems a promising one, but certain realities are soon apparent. Less than half the diary in fact deals with the Civil War, with the balance recording Esther Hawks' Reconstruction experiences to November 1866. The first 16 months of her wartime experience -- to February 1864 -- is described not in diary form but in a retrospective narrative that suggests she once intended publishing a memoir. This narrative lacks a diary's spontaneity and sometimes sags under its heavy Victorian prose. And Schwartz gives fair warning on the first page of his introduction: "The reader will detect that Dr. Esther Hawks at times devoted much space to personal trivia and comparatively little to details about her important medical and other achievements."

While much of this diary will appeal primarily to specialists, there are rewards for the persevering general reader. There are interesting descriptions of travel in wartime America and of Charleston in the first months of peace. Hawks is unsparing of the abuses of federal occupation troops and of the failings of Reconstruction policies. She writes candidly of the blind eye cast by even the best-intentioned whites toward slaves: "not looking at, or judging them as men and women -- capable of great improvement, but rather as a strange kind of anomaly neither brute or human . . ." She says disappointingly little about her role as a doctor, although she does note that for three weeks, in the absence of the regimental surgeons, she ran a hospital for black soldiers so well that headquarters never noticed the change. "I suppose I could not have done this . . . if the patients had been white men," she remarks. And Esther Hawks on the subject of equal pay for equal work, even among those devoted to the perfectability of mankind, has a decidedly modern ring.

She seldom speaks of what motivated her work. At one point, referring to her own childlessness, she wrote about how life is without "mother love -- dearer than all other!" and wonders "Why am I denied." Whether this explains her often expressed love for her students cannot be said, but what is beyond doubt is her total dedication. Schwartz quotes a letter sent to her by a black soldier she taught to read. She reminded him, the soldier wrote, "of the Saviour when he left high heaven and com down on earth to Save our lost and blind race . . ." If she did envision her charges as her children, they were grateful children.