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Starting with DCMTK 3.6.2, the Nagle algorithm is not disabled by default since this does not seem to be appropriate (anymore) for most modern operating systems. In order to change this default, the environment variable TCP_NODELAY can be set to "1" (see envvars.txt for details). Alternatively, the macro DISABLE_NAGLE_ALGORITHM can be defined to change this setting at compilation time (see macros.txt for details).
Earlier versions of the DCMTK disabled the Nagle algorithm by default, and the macro DONT_DISABLE_NAGLE_ALGORITHM could be used to change this setting at compilation time.