The function of nonprofit organisations (NPOs) in managing healthcare and poverty relief and the role of accounting and reporting in their management control systems have many implications for accounting historians. The present research examines the relationship between NPOs and local governments in the management of public services, particularly during health emergencies. Specifically, this study examines the institutional cooperation between the Grand Duchy of Tuscany, the Misericordia of Florence and the Santa Maria Nuova Public Hospital during the cholera epidemic of 1855–1862. This research applies a conceptual framework based on Michel Foucault's concepts of ‘governmentality’, ‘nosopolitics’ and the ‘government of the poor’ and Mitchell Dean's ‘technologies of government’ to the study of archival primary sources. This research makes several contributions to the accounting history literature regarding the involvement of NPOs in healthcare, including an original analysis of the role of accounting and reporting in the ‘government of the sick’ from a nosopolitical perspective.