Shiatsu is a form of Japanese bodywork based on the theoretical framework of traditional Chinese medicine. In the Japanese language, shiatsu means "finger pressure". Shiatsu techniques include massages with fingers, thumbs, and palms; assisted stretching; and joint manipulation and mobilization. To examine a patient, a shiatsu practitioner uses palpation and, sometimes, pulse diagnosis. Shiatsu derives from a Japanese massage modality called anma which was itself adapted from tui na. Tui na is a Chinese bodywork system that arrived in Japan by at least the Nara period (710–793 CE). Tokujiro Namikoshi (1905–2000) founded a shiatsu college in the 1940s, and is often credited with inventing modern shiatsu.