In the Japanese language, shiatsu means "finger pressure". Shiatsu techniques include massages with fingers, thumbs, feet and palms; assisted stretching; and joint manipulation and mobilization. To examine a patient, a shiatsu practitioner uses palpation and, sometimes, pulse diagnosis. The Japanese Ministry of Health defines shiatsu as "a form of manipulation by thumbs, fingers and palms without the use of instruments, mechanical or otherwise, to apply pressure to the human skin to correct internal malfunctions, promote and maintain health, and treat specific diseases. The techniques used in shiatsu include stretching, holding, and most commonly, leaning body weight into various points along key channels.