This paper systematically explores the academic thought and characteristic formulas and medications of ancient physician ZOU Shu in Qing Dynasty for treating epilepsy. Integrating theories from the Huangdi Neijing and Shanghan Lun, Zou Shu innovatively proposed the "three reversals, three excesses and three escapes" pathogenesis model to elucidate the pathological mechanisms and dynamic evolution of mania, delirium and epilepsy. The "three reversals (Qi reversal, Jue reversal and Shen reversal)" represent the fundamental disease state, reflecting profound disturbances in Yin-Yang and Qi-blood. The "three excesses (Yang excess, fire excess and blood excess)" signify the intensified stage, characterized by hyperactive Yangqi and pathogenic fire. The "three scurries (wind scurry, phlegm scurry and fire scurry)" represent the manifest symptoms, reflecting the invasion of wind, phlegm and fire pathogens through the meridians and obstruction of the clear orifices. Based on this model, ZOU Shu distilled the core therapeutic principle of "regulating water and fire through earth, and guiding Yang back to Yin", emphasizing the fundamental importance of harmonizing Yin and Yang rather than merely suppressing spasms and convulsions. This paper provides an in-depth analysis of the properties, tastes and functions of medicinal herbs such as dragon bone, oyster shell, Stephania root and cicada slough, along with their corresponding relationships to the pathogenesis. Integrating modern pharmacological research, it reveals that these herbs exert antiepileptic effects through multiple pathways, including regulating calcium ion channels, inhibiting inflammatory responses, and preventing neuronal apoptosis. This paper highlights ZOU Shu's diagnostic philosophy, which prioritizes disease mechanism analysis and holistic regulation, providing classical foundations and clinical insights for modern traditional Chinese medicine treatment of epilepsy.