Shiatsu (Kanji: 指圧 Hiragana: しあつ) is Japanese for "finger pressure"; it is a type of alternative medicine consisting of finger and palm pressure, stretches, and other massage techniques. There is no scientific evidence for any medical efficacy of shiatsu, but some shiatsu practitioners promote it as a way to help people relax and cope with issues such as stress, muscle pain, nausea, anxiety, and depression. Shiatsu was invented by Tokujiro Namikoshi who founded the first shiatsu college in 1940. There are two main Shiatsu schools: one incorporating elements of evidence-based anatomy and physiology, and the other based on Traditional Chinese Medicine (TCM). Shiatsu is usually performed on a futon mat, with clients fully clothed. It is also performed on horses.