Můžete použít union all
pro zrušení pivotování datové sady a poté agregace:
select disease, count(*) total
from (
select disease from mytable
union all select additional_disease1 from mytable
union all select additional_disease2 from mytable
union all select additional_disease3 from mytable
union all select additional_disease4 from mytable
) t
group by disease
order by total desc, disease