I've always thought a problem with Nagel's algorithm is, that the socket API does not (really) have a function to flush the buffers and send everything out instantly, so you can use that after messages that require a timely answer.
For stuff where no answer is required, Nagel's algorithm works very well for me, but many TCP channels are mixed use these days. They send messages that expect a fast answer and other that are more asynchronous (from a users point of view, not a programmers).
Wouldn't it be nice if all operating systems, (home-)routers, firewalls and programming languages would have high quality implementations of something like SCTP...