More than 800 of them have lost an arm, a leg, fingers or toes. More than 100 are blind. Dozens need tubes and machines to keep them alive. Hundreds are disfigured by burns, and thousands have brain injuries and mangled minds.

These are America's war wounded, a toll that has received less attention than the 3,500 troops killed in Iraq. Depending on how you count them, they number 35,000 to 53,000.

More of them are coming home with injuries of a scope and magnitude the government did not predict and is now struggling to treat.

Survival rates today are even higher than the record levels set early in the war, thanks to body armor and better care. For every American soldier or Marine killed in Iraq, 15 others have survived illness or injury there.

Unlike previous wars, few of them have been shot. The signature weapon of this war — the improvised explosive device, or IED — has left a signature wound: traumatic brain injury.

Soldiers hit in the head or knocked out by blasts — "getting your bell rung" is the military euphemism — sometimes have no visible wounds but a fog of war in their minds. They can be addled, irritable, depressed and unaware they are impaired.

Only an estimated 2,000 cases of brain injury have been treated, but doctors think many less-obvious cases have gone undetected. One small study found that more than half of one group of wounded troops arriving at Walter Reed Army Medical Center had brain injuries.

Around the nation, a new effort is under way to check every returning man and woman for this possibility.

Some of those on active duty may have subtle brain damage that was missed when they were treated for more visible wounds. Half of those wounded in action returned to duty within 72 hours — before some brain injuries may have been apparent. The military just adopted new procedures to spot these cases, too.

CARE STILL INADEQUATE

Back home, concerns grow about care. The Walter Reed hospital scandal and problems with some VA nursing homes have led Republicans and Democrats to call for better care for this new crop of veterans.

A lucky few get Cadillac care at one of the VA's four polytrauma centers, where the most complex wounds are treated with state-of-the-art techniques and whiz-bang devices like "power knee" or "smart ankle" prosthetics. Others battle bureaucracy to see doctors or get basic benefits in less-ideal settings.

Mental-health problems loom large. More than a third of troops received psychological counseling shortly after returning from Iraq, and a third of those were diagnosed with a problem, a recent Pentagon study found. The government plans to add 200 psychologists and social workers to help treat post-traumatic stress and other disorders.

No one knows what the ultimate cost will be. Harvard University economist Linda Bilmes estimates the lifelong healthcare tab for these troops will be $250 billion to $650 billion — a wide range, but a huge sum no matter how you slice it.

One of the wounded is Marine Cpl. Joshua Pitcher, 22, from upstate New York. He is a Purple Heart recipient who returned to Iraq after he was shot in 2005. Half of his skull was removed to allow his brain to swell as he now recovers from a brain injury and shrapnel wounds from a grenade blast in February.

"The mistake in Vietnam was, we hid the injured away from folks so they didn't get to tell their stories. Now it's important that we let them tell their stories to the public," said Dr. Steven Scott, director of the Polytrauma Rehabilitation Center at the Tampa VA Medical Center in Florida.

CHANGING THE COUNT

Counting the wounded can be contentious. Earlier this year, the Department of Defense changed how it tallies war-related injuries and illness, dropping those not needing to be flown to a military hospital from the total.

As of June 2, 25,830 troops had been wounded in action. Of these, 7,675 needed airlifts to military hospitals and the rest were treated and remained in Iraq.

There were another 27,103 nonbattle-related air transports. Of those, 7,188 had injuries. Most occurred from vehicle accidents, training or work-related accidents. Ten percent were sports injuries, said Dr. Michael Kilpatrick, who tracks this information for the Defense Department.

Nearly 20,000 of these "non-hostile" airlifts were for illnesses or medical issues: general symptoms like fever or pain needing tests or evaluation; back problems; psychological problems adjusting to being in a war zone; "affective psychoses" (not able to function or care for themselves); neuroses; respiratory or chest symptoms; depression; head and neck problems (including traumatic brain injury); epilepsy; infections; and muscle pulls and strains.

"I don't want to try to say these are not war-related. Being in the military is a very physically demanding job," Kilpatrick said.

For stress-related problems, the military tries "three hots and a cot" — warm meals and a chance to sleep. Most of the time it works, and troops return to their unit, Kilpatrick said.

Of the troops flown to the military hospital in Landstuhl, Germany, 20 percent return to Iraq and 80 percent go back to the United States for more care or disability discharge.

BRAIN INJURIES INCREASE

In earlier wars, one of every five to seven troops surviving a war-related wound had a traumatic brain injury, the military estimates. It's much higher in this war.

A pilot project at Walter Reed in 2003 to screen 155 patients returning from Iraq found that 62 percent had a brain injury.

"This is a very rapidly evolving area as a disease," with no screening test, agreed-upon set of symptoms for diagnosis, or even a billing code, said Kilpatrick, the military doctor.

Much needs to be learned about how to treat these injuries, he said, but he credited the military medical staff for having the chance.

"It's just amazing to me every day when I look at these numbers," he said. "The good news is that the majority of these people who become ill or injured ... are going to survive and are going to be able to return either to the military or to civilian life and be productive."