Great time of year for a ‘scary spooky skeleton’ netsuke. The musical instrument is called a Wood Fish, which is used in Buddhist meditation. The ‘tok tok tok’ sound purifies the mind.

This was used in… fertility rituals

https://pamcollections.usc.edu/mwebcgi/mweb?request=record;id=11684;type=101

Good thing its a percussion instrument. I feel like they would’ve struggled with a flute.

That’s actually his penis and another little known fact this was the inspiration to the hit 80s song “Bang the drum all day” by Todd Rundgren.